目的探讨萎缩及肠化分期与胃癌发生风险的相关性并优化活检策略。方法回顾性收集自2020年11月至2022年10月在山东省立医院接受内镜检查并进行五点活检的患者资料。比较胃癌与非胃癌患者基线资料、不同部位萎缩及肠化情况,通过logistic...目的探讨萎缩及肠化分期与胃癌发生风险的相关性并优化活检策略。方法回顾性收集自2020年11月至2022年10月在山东省立医院接受内镜检查并进行五点活检的患者资料。比较胃癌与非胃癌患者基线资料、不同部位萎缩及肠化情况,通过logistic回归分析可操作的与胃癌风险联系的胃炎评估(operative link for gastritis assessment,OLGA)和可操作的与胃癌风险联系的肠化生评估(operative link for gastric intestinal metaplasia assessment,OLGIM)分期系统与胃癌的相关性。计算Kendall tau相关系数比较不同活检方案(两点、三点及四点)与标准五点活检进行OLGA和OLGIM分期的一致性。进一步绘制受试者工作特征曲线比较不同活检方案对OLGA和OLGIMⅢ~Ⅳ期的诊断效能。结果共122例患者纳入数据分析,年龄(61.0±10.0)岁。多因素logistic回归分析显示OLGA分期与胃癌发生无关(P=0.788),OLGIMⅢ~Ⅳ期与胃癌发生相关(P=0.006,OR=3.39,95%CI:1.41~8.17)。萎缩、肠化在胃窦小弯[56.6%(69/122)和66.4%(81/122)]和胃角[57.4%(70/122)和52.5%(64/122)]的发生率较高,程度也较重,在胃体大弯发生率[2.5%(3/122)和5.7%(7/122)]较低,程度也较轻。四点和三点活检与标准五点活检进行OLGA及OLGIM分期时一致性较高,其中包括胃窦小弯、胃体小弯及胃角的三点活检一致性相当高,相关系数分别为0.969和0.987。结论OLGIMⅢ~Ⅳ期增加胃癌发生的风险。建议同时对胃窦小弯、胃体小弯及胃角三点活检,以筛查和监测萎缩或肠化。展开更多
Upper gastrointestinal haemorrhage (UGIH) remains a common medical emergency worldwide. It is increasingly recognised that early risk assessment is an important part of management, which helps direct appropriate patie...Upper gastrointestinal haemorrhage (UGIH) remains a common medical emergency worldwide. It is increasingly recognised that early risk assessment is an important part of management, which helps direct appropriate patient care and the timing of endoscopy. Several risk scores have been developed, most of which include endoscopic findings, although a minority do not. These scores were developed to identify various end-points including mortality, rebleeding or clinical intervention in the form of transfusion, endoscopic therapy or surgery. Recent studies have reported accurate identification of a very low risk group on presentation, using scores which require simple clinical or laboratory parameters only. This group may not require admission, but could be managed with early out-patient endoscopy. This article aims to describe the existing pre- and post-endoscopy risk scores for UGIH and assess the published data comparing them in the prediction of outcome. Recent data assessing their use in clinical practice, in particular the early identification of low-risk patients, are also discussed.展开更多
Mutual funds are usually classified on the basis of their objectives. If the activities of mutual funds are consistent with their stated objectives, investors may look at the latter as signals of their risks and incom...Mutual funds are usually classified on the basis of their objectives. If the activities of mutual funds are consistent with their stated objectives, investors may look at the latter as signals of their risks and incomes. This work analyzes mutual fund objective classification in China by statistical methods of distance analysis and discriminant analysis; and examines whether the stated investment objectives of mutual funds adequately represent their attributes to investors. That is, if mutual funds adhere to their stated objectives, attributes must be heterogeneous between investment objective groups and homogeneous within them. Our conclusion is to some degree, the group of optimized exponential funds is heterogeneous to other groups. As a whole, there exist no significant differences between different objective groups; and 50% of mutual funds are not consistent with their objective groups.展开更多
OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis （LNM） in undifferentiated EGC （early gastric cancer）, as well as identify the appropriate medical management. METHODS From...OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis （LNM） in undifferentiated EGC （early gastric cancer）, as well as identify the appropriate medical management. METHODS From January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone gastrectomy with regional lymphadenectomy. We used univariate and multivariate associated with lymph node entiated EGC. analyses to determine the features metastasis in patients with undiffer- RESULTS Signet ring cell carcinoma （SRC） was more common in patients with undifferentiated EGC than other undifferentiated carcinoma （UDC）. SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion, lymphovascular invasion, and histological type. CONCLUSION Complete endoscopic resection is suitable for SRC- type intramucosal EGC, which is less than 2 cm in diameter without lymphovascular invasion in the postoperative histological examination.展开更多
文摘目的探讨萎缩及肠化分期与胃癌发生风险的相关性并优化活检策略。方法回顾性收集自2020年11月至2022年10月在山东省立医院接受内镜检查并进行五点活检的患者资料。比较胃癌与非胃癌患者基线资料、不同部位萎缩及肠化情况,通过logistic回归分析可操作的与胃癌风险联系的胃炎评估(operative link for gastritis assessment,OLGA)和可操作的与胃癌风险联系的肠化生评估(operative link for gastric intestinal metaplasia assessment,OLGIM)分期系统与胃癌的相关性。计算Kendall tau相关系数比较不同活检方案(两点、三点及四点)与标准五点活检进行OLGA和OLGIM分期的一致性。进一步绘制受试者工作特征曲线比较不同活检方案对OLGA和OLGIMⅢ~Ⅳ期的诊断效能。结果共122例患者纳入数据分析,年龄(61.0±10.0)岁。多因素logistic回归分析显示OLGA分期与胃癌发生无关(P=0.788),OLGIMⅢ~Ⅳ期与胃癌发生相关(P=0.006,OR=3.39,95%CI:1.41~8.17)。萎缩、肠化在胃窦小弯[56.6%(69/122)和66.4%(81/122)]和胃角[57.4%(70/122)和52.5%(64/122)]的发生率较高,程度也较重,在胃体大弯发生率[2.5%(3/122)和5.7%(7/122)]较低,程度也较轻。四点和三点活检与标准五点活检进行OLGA及OLGIM分期时一致性较高,其中包括胃窦小弯、胃体小弯及胃角的三点活检一致性相当高,相关系数分别为0.969和0.987。结论OLGIMⅢ~Ⅳ期增加胃癌发生的风险。建议同时对胃窦小弯、胃体小弯及胃角三点活检,以筛查和监测萎缩或肠化。
文摘Upper gastrointestinal haemorrhage (UGIH) remains a common medical emergency worldwide. It is increasingly recognised that early risk assessment is an important part of management, which helps direct appropriate patient care and the timing of endoscopy. Several risk scores have been developed, most of which include endoscopic findings, although a minority do not. These scores were developed to identify various end-points including mortality, rebleeding or clinical intervention in the form of transfusion, endoscopic therapy or surgery. Recent studies have reported accurate identification of a very low risk group on presentation, using scores which require simple clinical or laboratory parameters only. This group may not require admission, but could be managed with early out-patient endoscopy. This article aims to describe the existing pre- and post-endoscopy risk scores for UGIH and assess the published data comparing them in the prediction of outcome. Recent data assessing their use in clinical practice, in particular the early identification of low-risk patients, are also discussed.
文摘Mutual funds are usually classified on the basis of their objectives. If the activities of mutual funds are consistent with their stated objectives, investors may look at the latter as signals of their risks and incomes. This work analyzes mutual fund objective classification in China by statistical methods of distance analysis and discriminant analysis; and examines whether the stated investment objectives of mutual funds adequately represent their attributes to investors. That is, if mutual funds adhere to their stated objectives, attributes must be heterogeneous between investment objective groups and homogeneous within them. Our conclusion is to some degree, the group of optimized exponential funds is heterogeneous to other groups. As a whole, there exist no significant differences between different objective groups; and 50% of mutual funds are not consistent with their objective groups.
文摘OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis （LNM） in undifferentiated EGC （early gastric cancer）, as well as identify the appropriate medical management. METHODS From January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone gastrectomy with regional lymphadenectomy. We used univariate and multivariate associated with lymph node entiated EGC. analyses to determine the features metastasis in patients with undiffer- RESULTS Signet ring cell carcinoma （SRC） was more common in patients with undifferentiated EGC than other undifferentiated carcinoma （UDC）. SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion, lymphovascular invasion, and histological type. CONCLUSION Complete endoscopic resection is suitable for SRC- type intramucosal EGC, which is less than 2 cm in diameter without lymphovascular invasion in the postoperative histological examination.
