船身式水上飞机中高速静水滑行阻力估算

根据水上飞机起飞滑行阶段特殊的多介质环境,参考滑行艇水面滑行阶段的阻力特性分析方法,提出一种考虑气动布局影响的估算船身式水上飞机中高速静水滑行阻力的半理论半经验公式;用此公式计算得到某船身式水上飞机中高速滑行阶段的水动阻力及俯仰角随体积弗劳德数变化曲线,并分析水动阻力及俯仰角变化的原因;根据得到的水动阻力及俯仰角,计算某船身式水上飞机起飞滑跑距离,计算结果与试验结果一致,间接验证了所提出阻力计算公式的有效性,同时也为计算船身式水上飞机起飞滑跑距离提供一种思路.

Detection of Serum Aberrant CDKN2/P16 DNA in Colorectal Cancer

Objective： To search for a biomarker for colorectal cancer. Methods： The MSP, SSCP and deletion tests with serum have been taken simultaneously in 100 cases of colorectal cancer and 2 groups of controls, as well as the specimens of 26 cancer tissues and 22 paracancerous tissues and 29 cases of benign disease tissues for a contrast. Results： The aberrant methylation rate of P16 in the serum was 69.00%, deletion rate 4.00% and suspicious point mutation rate 15.00% in colorectal cancer patients. The data of cancer tissues were the same as those of the serum, but in paracancerous tissue those were significantly lower. In 10 cases, sequencing analysis revealed that there were 3 cases of missense, one case of frameshift and one case of nonsense. Among them, four cases had P16 protein deletion. As a tumor marker, the sensitivity of combined use of three methods was 88.00%, specificity 96.87% and accuracy 90.15%. The combined use of MSP and SSCP could obtain the same results. Conclusion： The content of DNA in serum is minimal, but it reflects the tumor burden of patients. The 10^-3 fragments of DNA could be detected in the serum by MSP. It can be used in the clinical diagnosis or popular investigation, and long-term postoperative follow-up.

Three-dimensional interpretation of sparse survey line MT data: Synthetic examples

Currently, most of MT （magnetotelluric） data are still collected on sparse survey lines and interpreted using 2D inversion methods because of the field work cost, the work area environment, and so on. However, there are some 2D interpretation limitations of the MT data from 3D geoelectrical structures which always leads to wrong geological interpretations. In this paper, we used the 3D inversion method to interpret the MT sparse lines data. In model testing, the sparse lines data are the MT full information data generated from a test model and processed using the 3D conjugate gradients inversion code. The inversion results show that this inversion method is reasonable and effective. Meanwhile, we prove that for inversion results with different element parameters, the results by joint inversion of both the impedance tensor data and the tipper data are more accurate and closer to the test model.

Endoscopic ultrasound:It’s accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

AIM:To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. METHODS:Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran’s Q test based upon inverse variance weights. RESULTS:Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI:82.9-86.4) to 88.0% (95% CI:85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI:83.2-85.9) to 96.4% (95% CI:95.3-97.4). The P forchi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION:EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy.

Frequently overlooked and rarely listened to: Music therapy in gastrointestinal endoscopic procedures

To elucidate the role of music therapy in gastrointestinal endoscopic procedures following the conflicting outcomes reported in two recent studies. The findings of our recent meta-analysis that examined this matter were discussed in the context of later studies. Our meta-analysis illustrated the beneficial effects of music therapy on patient anxiety levels when used as a single measure of relaxation and analgesia. Beneficial effects were also shown on analgesia and sedation requirements and procedure duration times when used as an adjunct to pharmacotherapy. These findings are in agreement with those of both studies excluded from analysis and those that followed it. Music therapy is an effective tool for stress relief and analgesia in patients undergoing gastrointestinal endoscopic procedures.

Endoscopy is of low yield in the identification of gastrointestinal neoplasia in patients with dermatomyositis: A cross-sectional study

To determine the prevalence of gastrointestinal neoplasia among dermatomyositis patients who underwent an esophagogastroduodenoscopy and/or colonoscopy. METHODSA cross-sectional study examining the results of upper endoscopy and colonoscopy in adults with dermatomyositis at an urban, university hospital over a ten year period was performed. Chart review was performed to confirm the diagnosis of dermatomyositis. Findings on endoscopy were collected and statistical analyses stratified by age and presence of symptoms were performed. RESULTSAmong 373 adult patients identified through a code based search strategy, only 163 patients had dermatomyositis confirmed by chart review. Of the 47 patients who underwent upper endoscopy, two cases of Barrett’s esophagus without dysplasia were identified and there were no cases of malignancy. Of the 67 patients who underwent colonoscopy, no cases of malignancy were identified and an adenoma was identified in 15% of cases. No significant differences were identified in the yield of endoscopy when stratified by age or presence of symptoms. CONCLUSIONThe yield of endoscopy is low in patients with dermatomyositis and is likely similar to the general population; we identified no cases of malignancy. A code based search strategy is inaccurate for the diagnosis of dermatomyositis, calling into question the results of prior population-based studies. Larger studies with rigorously validated search strategies are necessary to understand the risk of gastrointestinal malignancy in patients with dermatomyositis.

Management of patients with stercoral perforation of the sigmoid colon:Report of five cases

To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann＇s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

Colorectal cancer screening

Colorectal cancer is a major public health burden worldwide. There is clear-cut evidence that screening will reduce colorectal cancer mortality and the only contentious issue is which screening tool to use. Most evidence points towards screening with fecal occult blood testing. The immunochemical fecal occult blood tests have a higher sensitivity than the guaiac-based tests. Zn addition, their automation and haemoglobin quantification allows a threshold for colonoscopy to be selected that can be accommodated within individual health care systems.

Identification of serum proteins discriminating colorectal cancer patients and healthy controls using surface-enhanced laser desorption ionisation-time of flight mass spectrometry

AIM： To detect the new serum biomarkers for colorectal cancer （CRC） by serum protein profiling with surfaceenhanced laser desorption ionisation - time of flight mass spectrometry （SELDI-TOF MS）. METHODS： Two independent serum sample sets were analysed separately with the ProteinChip technology （set A： 40 CRC ＋ 49 healthy controls; set B： 37 CRC ＋ 31 healthy controls）, using chips with a weak cation exchange moiety and buffer pH 5. Discriminative power of differentially expressed proteins was assessed with a classification tree algorithm. Sensitivities and specificities of the generated classification trees were obtained by blindly applying data from set A to the generated trees from set B and vice versa. CRC serum protein profiles were also compared with those from breast, ovarian, prostate, and non-small cell lung cancer. RESULTS： Mass-to-charge ratios （m/z） 3.1×10^3, 3.3× 10^3, 4.5×10^3, 6.6×10^3 and 28×10^3 were used as classitiers in the best-performing classification trees. Tree sensitivities and specificities were between 65% and 90%.Host of these discriminative m/z values were also different in the other tumour types investigated. M/z 3.3× 10^3, main classifier in most trees, was a doubly charged form of the 6.6× 10^3-Da protein. The latter was identified as apolipoprotein C-I. M/z 3.1×10^3 was identified as an N-terminal fragment of albumin, and m/z 28× 10^3 as apolipoprotein A-I. CONCLUSION： SELDI-TOF MS followed by classification tree pattern analysis is a suitable technique for finding new serum markers for CRC. Biomarkers can be identified and reproducibly detected in independent sample sets with high sensitivities and specificities. Although not specific for CRC, these biomarkers have a potential role in disease and treatment monitoring.

Incidence of gallstone disease in Italy:Results from a multicenter,population-based Italian study (the MICOL project)

AIM:To evaluate gallstone incidence and risk factors in a large population-based study. METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study. RESULTS: Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identifi ed as risk factors in men while, in females, the only risk factors were increasing age and a high BMI.Increasing age and pain in the right hypocondrium in men and increasing age in females were identifi ed as predictors of gallstones. Pain in the epigastrium/ right hypocondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain. CONCLUSION:Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypocondrium and/or epigastrium is confi rmed as the only symptom related to gallstones.

Two cameras detect more lesions in the small-bowel than one

AIM:To explore the feasibility of dual camera capsule (DCC)small-bowel(SB)imaging and to examine if two cameras complement each other to detect more SB lesions.METHODS:Forty-one eligible,consecutive patients underwent DCC SB imaging.Two experienced investigators examined the videos and compared the total number of detected lesions to the number of lesions detected by each camera separately.Examination tolerability was assessed using a questionnaire.RESULTS:One patient was excluded.DCC cameras detected 68 positive findings(POS)in 20(50%)cases.Fifty of them were detected by the"yellow"camera,48 by the"green"and 28 by both cameras;44%(n=22)of the"yellow"camera’s POS were not detected by the"green"camera and 42%(n=20)of the"green" camera’s POS were not detected by the"yellow"camera.In two cases,only one camera detected significant findings.All participants had 216 findings of unknown significance(FUS).The"yellow","green"and both cameras detected 171,161,and 116 FUS,respectively;32%(n=55)of the"yellow"camera’s FUS were not detected by the"green"camera and 28%(n=45)of the"green"camera’s FUS were not detected by the "yellow"camera.There were no complications related to the examination,and 97.6%of the patients would repeat the examination,if necessary.CONCLUSION:DCC SB examination is feasible and well tolerated.The two cameras complement each other to detect more SB lesions.

Barium meal follow through with pneumocolon:Screening test for chronic bowel pain

AIM： To study the sensitivity, specificity and cost effectiveness of barium meal follow through with pneumocolon （BMFTP） used as a screening modality for patients with chronic abdominal pain of luminal origin in developing countries. METHODS： Fifty patients attending the Gastroenterology Unit, SMS Hospital, whose clinical evaluation revealed chronic abdominal pain of bowel origin were included in the study. After routine testing, BMFT, BMFTP, contrast enhanced computed tomography （CECT） of the abdomen, barium enema and colonoscopy were performed. The sensitivity, specificity and cost effectiveness of these imaging modalities in the detection of small and/or large bowel lesions were compared. RESULTS： Out of fifty patients, structural pathology was found in ten. Nine out of these ten patients had small bowel involvement while seven had colonic involvement alone or in combination with small bowel involvement. The sensitivity of BMFTP was 100% compared to 88.89% with BMFT when detecting small bowel involvement （BMFTP detected one additional patient with ileocecal involvement）. The sensitivity and specificity of BMFTP for the detection of colonic pathology were 85.71% and 95.35% （41/43）, respectively. Screening a patient with chronic abdominal pain （bowel origin） using a combination of BMFT and barium enema cost significantly more than BMFTP while their sensitivity was almost comparable. CONCLUSION： BMFTP should be included in the investigative workup of patients with chronic abdominal pain of luminal origin, where either multiple sites （small and large intestine） of involvement are suspected or the site is unclear on clinical grounds. BMFTP is an economical, quick and comfortable procedure which obviates the need for colonoscopy in the majority of patients.

Laparoscopic hemicolectomy in a patient with situs inversustotalis

As among persons with normal anatomy, occasional patients with situs inversus develop malignant tumors. Recently, several laparoscopic operations have been reported in patients with situs inversus. We describe laparoscopic hemicolectomy with radical lymphadenectomy in such a patient. Careful consideration of the mirror-image anatomy permitted safe operation using techniques not otherwise differing from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus is feasible and safe.

Effect of music on procedure time and sedation during colonoscopy:A meta-analysis

AIM:To integrate results from different studies in examining the effectiveness of music in reducing the procedure time and the amount of sedation used during colonoscopic procedure. METHODS: An electronic search in various databases was performed to identify related articles. Study quality was evaluated by the Jadad’s scale. The random effect model was used to pool the effect from individual trials and the Cohen Q-statistic was used to determine heterogeneity. Egger’s regression was used to detect publication bias. RESULTS: Eight studies with 722 subjects were included in this meta-analysis. The combined mean difference for the time taken for the colonoscopy procedure between the music and control groups was -2.84 with 95% CI (-5.61 to -0.08), implying a short time for the music group. The combined mean difference for the use of sedation was -0.46 with 95%CI (-0.91 to -0.01), showing a significant reduction in the use of sedation in the music group. Heterogeneity was observed in both analyses but no publication bias was detected. CONCLUSION: Listening to music is effective in reducing procedure time and amount of sedation during colonoscopy and should be promoted.

Effect of music on patients undergoing outpatient colonoscopy

AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. METHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. RESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

Dissection of No.13 lymph node in radical gastrectomy for gastric carcinoma

AIM: To evaluate the feasibility and safety of No. 13 lymphadenectomy in radical gastrectomy for gastric carcinoma. METHODS: Medical records of the patients undergone No. 13 lymph node dissection during D2 gastrectomy for gastric carcinoma, were reviewed from March 2003 to May 2007. RESULTS: One hundred and fifty-eight patients underwent No. 13 lymph node dissection for D2 gastric carcinoma, of them, 4 (2.53%) were found to have metastasis in No. 13 lymph node. Metastasis to No. 12 lymph node was detected in 6 patients and 4 of them had positive No. 13 lymph node. The operative morbidity except for wound infection was 15.19% (24/158), and hospital death rate was 1.27% (2/158). No obstructive jaundice caused by No. 13 lymph node metastasis after No. 13 lymph node dissection in radical gastrectomy for gastric carcinoma was detected during the follow-up study to end of January 2007. CONCLUSION: Dissection of No. 13 lymph node in D2 gastrectomy for gastric carcinoma is safe with a low morbidity and mortality rate. Further study is needed to explore its long-term effect.

Objective assessment of the antispasmodic effect of Shakuyaku-kanzo-to (TJ-68),a Chinese herbal medicine,on the colonic wall by direct spraying during colonoscopy

AIM： To objectively evaluate the effect of TJ-68 on colonic spasms during colonoscopy. METHODS： One hundred and one patients subjected to screening colonoscopy were randomly assigned to two groups： T1-68 in 51 subjects and saline as the control in 50. The endoscope was inserted into the sigmoid colon, then a spastic region was identified and the tip of the colonoscope was positioned at a distance of about 10 mm from the spastic region. The endoscopic view was recorded before and after direct spraying of the TJ-68 solution or warm saline. The intraluminal area of the spastic region was serially measured using a computer image analyzer and expressed as pixel counts. The area under the curve （AUC） was calculated from the pixel curve. Statistical significance was assessed by Wilcoxon＇s test and Mann-Whitney U test. RESULTS： The mean AUC of the spastic region before and after TJ-68 spraying was 29 128 and 121 943 pixels, respectively, while with saline, it was 31 635 pixels and 48 617 pixels, respectively. Thus, the AUC significantly increased after TL-68 spraying compared with the spraying of saline （P〈0.001）. CONCLUSION： Direct spraying of TJ-68 on the colonic mucosa suppressed colonic spasm and it may be useful during colonoscopy when anticholinergic agents are contraindicated.

Colonoscopy and the role of music therapy: How to go about an ideal protocol?

We read with great interest the two articles in the December 2006 issue of your esteemed journal on the utility of music therapy in the performance of colonoscopy. The role of non-pharmacological or cognitive behavioral interventions in improving performance of GI Endoscopic procedures is actively undergoing research world over.

Colon capsule endoscopy

Wireless capsule endoscopy has become the first imaging tool for small bowel examination. Recently, new capsule endoscopy applications have been developed, such as esophageal capsule endoscopy and colon capsule endoscopy. Clinical trials results have shown that colon capsule endoscopy is feasible, accurate and safe in patients suffering from colonic diseases. It could be a good alternative in patients refusing conventional colonoscopy or when it is contraindicated. Upcoming studies are needed to demonstrate its utility for colon cancer screening and other indications such us ulcerative colitis. Comparative studies including both conventional and virtual colonoscopy are also required.

INTER-OBSERVER VARIATIONS OF DIGITAL RADIOGRAPH PULMONARY NODULE MARKING BY USING COMPUTER TOOLKIT

Objective To assess inter-observer variations of pulmonary nodule marking in routine clinical chest digital radiograph (DR) softcopy reading by using a lung nodule computer toolkit.Methods A total of 601 chest posterior-anterior DR images were randomly selected from routine outpatient screening in Peking Union Medical College Hospital. Two chest radiologists with experience more than ten years were first asked to read the images and mark all suspicious nodules independently by using computer toolkit IQQA-Chest, and to indicate the likelihood for each nodule detected. They were also asked to draw the boundary of the identified nodule manually on an enlarged region of interest, which was instantly analyzed by IQQA-Chest. Two sets of diagnostic reports, including the marked nodules, likelihood, manually drawn boundaries, quantitative measurements, and radiologists’ names, were automatically generated and stored by the computer system. One week later, the two radiologists read the same images together by using the same computer toolkit without referring to their previous reading results. Marking procedure was the same except that consensus was reached for each suspicious region. Statistical analysis tools provided in the IQQA-Chest were used to compare all the three sets of reading results.Results In the independent readings, Reader 1 detected 409 nodules with a mean diameter of 12.4 mm in 241 patients, and Reader 2 detected 401 nodules with a mean diameter of 12.6 mm in 253 patients. In the consensus reading, a total of 352 nodules with a mean diameter of 12.4 mm were detected in 220 patients. Totally, 42.3% of Reader 1’s and 45.1% of Reader 2’s marks were confirmed by the consensus reading. About 40% of each reader’s marks agreed with the other. There were only 130 (14.4%) out of the total 904 unique nodules were confirmed by both readers and the consensus reading. Moreover, 5.6% (51/904) of the marked regions were rated identical likelihood in all three readings. Statistical analysis showed significant differences between Readers 1 and 2, and between consensus and Reader 2 in determining the likelihood of the marks (P<0.01), but not between consensus and Reader 1. No significant difference in terms of size was observed in nodule segmentation between either two of the three readings. Conclusion Large variations in nodule marking and nodule-likelihood determination but not in nodule size were observed between experts as well as between single-person reading and consensus reading.