非语言声音在多模态隐喻构建中的机制分析——以Greenpeace公益广告Breathe为例

以Greenpeace的环保公益广告Breathe为语料,探讨非语言声音如何通过转喻激活始源域,冲破语言和文字的阻碍,与由影像转喻激活的目标域通过隐喻映射相互作用,整合概念,构建以转喻为基础的多模态隐喻语篇,有效传递广告信息。

Early Birds Breathed Easy

When thinking of paleontology and the study of fossilized remains,we typically envision a white,petrified skeleton lying in some desert badland,exposed by wind and rain.However,recent discoveries have put an ever-increasing focus on the preservation of non-skeletal fossil remains–that is to say,the preservation of soft tissues that have remarkably survived the test of time,sometimes hundreds of millions of years.

Breathe Easy

AIR quality is a long-standing problem in China due to excessive coal burning and traffic as the population increases. Many cities including Beijing routinely face hazardous air pollution levels. Chinese technology firms such as Lenovo and smartphone maker Xiaomi have come out with smart air purifiers in a bid to expand in the connected devices market. The sales of air purifiers reached 3.5 billion yuan （S458 million）in 2013. according to market research carried out by Daxue Consulting, which has offices in Shanghai and Beijing.

Modern approaches for detection of volatile organic compounds in metabolic studies focusing on pathogenic bacteria:Current state of the art

Pathogenic microorganisms produce numerous metabolites,including volatile organic compounds(VOCs).Monitoring these metabolites in biological matrices(e.g.,urine,blood,or breath)can reveal the presence of specific microorganisms,enabling the early diagnosis of infections and the timely implementation of tar-geted therapy.However,complex matrices only contain trace levels of VOCs,and their constituent com-ponents can hinder determination of these compounds.Therefore,modern analytical techniques enabling the non-invasive identification and precise quantification of microbial VOCs are needed.In this paper,we discuss bacterial VOC analysis under in vitro conditions,in animal models and disease diagnosis in humans,including techniques for offline and online analysis in clinical settings.We also consider the advantages and limitations of novel microextraction techniques used to prepare biological samples for VOC analysis,in addition to reviewing current clinical studies on bacterial volatilomes that address inter-species in-teractions,the kinetics of VOC metabolism,and species-and drug-resistance specificity.

Evaluation of urea breath test as a diagnostic tool for Helicobacter pylori infection in adult dyspeptic patients

In this editorial,we discuss the article in the World Journal of Gastroenterology.The article conducts a meta-analysis of the diagnostic accuracy of the urea breath test(UBT),a non-invasive method for detecting Helicobacter pylori(H.pylori)infection in humans.It is based on radionuclide-labeled urea.Various methods,both invasive and non-invasive,are available for diagnosing H.pylori infection,inclu-ding endoscopy with biopsy,serology for immunoglobulin titers,stool antigen analysis,and UBT.Several guidelines recommend UBTs as the primary choice for diagnosing H.pylori infection and for reexamining after eradication therapy.It is used to be the first choice non-invasive test due to their high accuracy,specificity,rapid results,and simplicity.Moreover,its performance remains unaffected by the distribution of H.pylori in the stomach,allowing a high flow of patients to be tested.Despite its widespread use,the performance characteristics of UBT have been inconsistently described and remain incompletely defined.There are two UBTs available with Food and Drug Administration approval:The 13C and 14C tests.Both tests are affordable and can provide real-time results.Physicians may prefer the 13C test because it is non-radioactive,compared to 14C which uses a radioactive isotope,especially in young children and pregnant women.Although there was heterogeneity among the studies regarding the diagnostic accuracy of both UBTs,13C-UBT consistently outperforms the 14C-UBT.This makes the 13C-UBT the preferred diagnostic approach.Furthermore,the provided findings of the meta-analysis emphasize the significance of precise considerations when choosing urea dosage,assessment timing,and measurement techniques for both the 13C-UBT and 14C-UBT,to enhance diagnostic precision.

Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy

BACKGROUND Helicobacter pylori(H.pylori)infection has been well-established as a significant risk factor for several gastrointestinal disorders.The urea breath test(UBT)has emerged as a leading non-invasive method for detecting H.pylori.Despite numerous studies confirming its substantial accuracy,the reliability of UBT results is often compromised by inherent limitations.These findings underscore the need for a rigorous statistical synthesis to clarify and reconcile the diagnostic accuracy of the UBT for the diagnosis of H.pylori infection.AIM To determine and compare the diagnostic accuracy of 13C-UBT and 14C-UBT for H.pylori infection in adult patients with dyspepsia.METHODS We conducted an independent search of the PubMed/MEDLINE,EMBASE,and Cochrane Central databases until April 2022.Our search included diagnostic accuracy studies that evaluated at least one of the index tests(^(13)C-UBT or ^(14)C-UBT)against a reference standard.We used the QUADAS-2 tool to assess the methodo-logical quality of the studies.We utilized the bivariate random-effects model to calculate sensitivity,specificity,positive and negative test likelihood ratios(LR+and LR-),as well as the diagnostic odds ratio(DOR),and their 95%confidence intervals.We conducted subgroup analyses based on urea dosing,time after urea administration,and assessment technique.To investigate a possible threshold effect,we conducted Spearman correlation analysis,and we generated summary receiver operating characteristic(SROC)curves to assess heterogeneity.Finally,we visually inspected a funnel plot and used Egger’s test to evaluate publication bias.endorsing both as reliable diagnostic tools in clinical practice.CONCLUSION In summary,our study has demonstrated that ^(13)C-UBT has been found to outperform the ^(14)C-UBT,making it the preferred diagnostic approach.Additionally,our results emphasize the significance of carefully considering urea dosage,assessment timing,and measurement techniques for both tests to enhance diagnostic precision.Nevertheless,it is crucial for researchers and clinicians to evaluate the strengths and limitations of our findings before implementing them in practice.

Advancements in breath-based diagnostics for pancreatic cancer:Current insights and future perspectives

Recent decades have seen a concerning surge in carcinogenic diseases,with cancer cases and deaths on the rise globally.Conventional diagnostic methods are often invasive and time-consuming,highlighting the need for fast,accurate,and painless alternatives.Non-invasive exhaled breath analysis emerges as a promising solution,with over 200 volatile organic compounds(VOCs)detected in exhaled air,showing potential as biomarkers for various diseases,including cancer.Despite the lack of standardized methodologies,advancements in analytical instruments have expanded detection capabilities,reaching 3500 VOCs.Studies have identified specific VOC patterns associated with different cancers,offering hope for non-invasive diagnosis.Techniques such as gas chromatography-mass spectrometry and electronic noses show promise in distinguishing between healthy individuals and cancer patients.However,further research and standardization are needed to realize the full clinical potential of breath-based diagnostics,particularly in the early detection of challenging cancers like pancreatic cancer.

Identification of breath volatile organic compounds to distinguish pancreatic adenocarcinoma,pancreatic cystic neoplasm,and patients without pancreatic lesions

BACKGROUND Volatile organic compounds(VOCs)are a promising potential biomarker that may be able to identify the presence of cancers.AIM To identify exhaled breath VOCs that distinguish pancreatic ductal adenocar-cinoma(PDAC)from intraductal papillary mucinous neoplasm(IPMN)and healthy volunteers.METHODS We collected exhaled breath from histologically proven PDAC patients,radiological diagnosis IPMN,and healthy volunteers using the ReCIVA®device between 10/2021-11/2022.VOCs were identified by thermal desorption-gas chromatography/field-asymmetric ion mobility spectrometry and compared between groups.RESULTS A total of 156 participants(44%male,mean age 62.6±10.6)were enrolled(54 PDAC,42 IPMN,and 60 controls).Among the nine VOCs identified,two VOCs that showed differences between groups were dimethyl sulfide[0.73 vs 0.74 vs 0.94 arbitrary units(AU),respectively;P=0.008]and acetone dimers(3.95 vs 4.49 vs 5.19 AU,respectively;P<0.001).After adjusting for the imbalance parameters,PDAC showed higher dimethyl sulfide levels than the control and IPMN groups,with adjusted odds ratio(aOR)of 6.98(95%CI:1.15-42.17)and 4.56(1.03-20.20),respectively(P<0.05 both).Acetone dimer levels were also higher in PDAC compared to controls and IPMN(aOR:5.12(1.80-14.57)and aOR:3.35(1.47-7.63),respectively(P<0.05 both).Acetone dimer,but not dimethyl sulfide,performed better than CA19-9 in PDAC diagnosis(AUROC 0.910 vs 0.796).The AUROC of acetone dimer increased to 0.936 when combined with CA19-9,which was better than CA19-9 alone(P<0.05).CONCLUSION Dimethyl sulfide and acetone dimer are VOCs that potentially distinguish PDAC from IPMN and healthy participants.Additional prospective studies are required to validate these findings.

Helicobacter pylori infection may result in poor gastric cleanliness in magnetically controlled capsule gastroscopy examination: A singlecenter retrospective study

Objective:Magnetically controlled capsule gastroscopy(MCCG)is an effective method for screening gastric diseases;however,its performance may be affected by gastric cleanliness.We aimed to explore the correlation between Helicobacter pylori infection and the degree of gastric cleanliness in the MCCG.Methods:This retrospective study enrolled 297 participants from October 2020 to April 2024 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Participant characteristics,MCCG examination results,and(13)C-urea breath test(C13-UBT)results were collected.The gastric cleanliness in MCCG examinations was assessed using a gastric cleanliness score.Binary logistic regression was used to analyze the relationships among participant characteristics,H.pylori infection,and gastric cleanliness.Chi-square tests and Fisher's exact tests were used to analyze the relationships among gastric lesions,H.pylori infection,and gastric cleanliness.Results:Among the participants,24.2%had H.pylori infection,and 17.5%had poor gastric cleanliness.Hypertension(odds ratio[OR]:2.63;95%confidence interval[CI]:1.36e5.09;p?0.004)was associated with a greater likelihood of H.pylori infection.H.pylori infection(OR:3.76;95%CI:1.99e7.09;p<0.001)was an independent risk factor for poor gastric cleanliness in the MCCG.A significant disparity was noted in the prevalence of focal erosions(p<0.001),gastric ulcers(p?0.001),and positive gastric lesions(p?0.027)between the 2 groups with and without H.pylori infection.The proportion of positive gastric lesions was not significantly different between the good gastric cleanliness group and the poor gastric cleanliness group(25.7%vs.21.2%;p?0.490).Conclusion:The findings of this study revealed that H.pylori infection was associated with hypertension.H.pylori infection may lead to poor gastric cleanliness.Institutions are advised to perform C13-UBT before MCCG,and participants should be informed of the risk of poor gastric cleanliness if the results are positive.The decision to perform H.pylori eradication before MCCG should take into account patient willingness and the benefit-to-risk ratio.

Static Stretching Combined with Conscious Slower Breathing May Increase Parasympathetic Activity and Reduce Stress in Adult Women

Background: Women are thought to be more susceptible to stress than men in a stressful society, and reducing stress is crucial for women to maintain their health. Static stretching (SST) is applied in various fields to not only increase muscle flexibility but also reduce stress. Additionally, conscious slower breathing (CSB) predominates parasympathetic activity, causing a relaxing effect. These results indicate that combining SST and CSB may be more useful in reducing stress. However, to the best of our knowledge, the effect of this combination remains unclear. Objective: This study aimed to elucidate the effects of the combination of SST and CSB on autonomic activity and stress in adult women. Methods: Eleven healthy Japanese adult female participants performed SST with nonconscious natural breathing for 20 min. The same participants performed SST in combination with CSB (2 s inspiratory and 4 s expiratory) for 20 min on another day. Salivary cortisol and chromogranin A levels were measured before and after stretching as stress markers of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. The coefficient of variation of the R-R interval (CVR-R) and high-frequency component (HF), which reflect parasympathetic nerve activity, and heart rate and low-frequency component (LF)/HF ratio, which reflect sympathetic nerve activity, were measured before, during, and after stretching. Results: SST decreased cortisol levels but with no significant changes in chromogranin A, heart rate, CVR-R, HF, or LF/HF ratio. The combination of SST and CSB increased CVR-R and HF levels in addition to decreasing cortisol levels but with no significant changes in chromogranin A, heart rate, or LF/HF levels. Conclusion: These results indicate that the combination of SST and CSB may increase parasympathetic activity and reduce stress. However, future randomized controlled trials with larger sample sizes should support this conclusion.

Inter-Fraction Analysis of One Week Hypo-Fractionation of Deep Inspiration Breath Hold (DIBH) Technique for Left Sided Breast Cancer Radiation Treatment

The aim of this study was to investigate the inter-fraction variations, patient comfort and knowledge at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). The differences in set-up that occurred between treatment sessions for the left sided breast patients were observed and recorded. Measurements of routine set-up variation for 24 patients were performed by matching the cone beam computed tomography (CBCT) and the planning computed tomography (CT). Scans of all five fractions per patient were used to quantify the setup variations with standard deviation (SD) in all the three directions (anterior posterior, left right, and superior inferior). The patients DIBH comfort and knowledge was also evaluated. The average translational errors for the anterior posterior (AP, z), left-right (LR, x), and Superior-inferior (SI, y) directions were 0.40 cm, 0.40 cm, and 0.40 cm, respectively. The translation variation of the three directions showed statistical significance (P < 0.05). On comfort and knowledge investigation, among all participants, 80% moderately agreed that the therapist’s instructions for operating the deep inspiration breath hold (DIBH) technique were easy to understand, and 63.33% indicated that their comfort with the DIBH technique was neutral or average. The inter-fraction variations in patients with left-sided breast cancer were qualitatively analyzed. Significant shifts between CBCT and planning CT images were observed. The daily treatment verification could assist accurate dose delivery.

Application Effect of External Diaphragm Pacemaker Combined with Active Respiratory Circulation Technology in Pulmonary Rehabilitation of Perioperative Lung Cancer Patients

Aim: To explore the application effect of external diaphragm pacemaker combined with active respiratory circulation technology in pulmonary rehabilitation of perioperative lung cancer patients. Methods: A total of 98 lung cancer patients admitted to our hospital from April 2020 to November 2021 were selected as the observation objects, and then divided into a control group and an observation group using the random number table method, with 49 cases in each group. The control group received routine admission guidance and active respiratory circulation training, while the observation group was supplemented with external diaphragm pacemaker on the basis of the control group. The intervention effect was evaluated by blood gas indicators, pulmonary function indicators, diaphragm function indicators, sputum comfort degree, and activity tolerance indicators before and after intervention. Results: Before intervention, there were no significant differences in blood gas analysis indicators, pulmonary function indicators, diaphragm function indicators, sputum comfort degree, and activity tolerance indicators between the two groups (P > 0.05). After intervention, the improvement degree of the above indicators in the observation group was higher than that in the control group (P < 0.05). Conclusions: The application of external diaphragm pacemaker combined with active respiratory circulation technology in pulmonary rehabilitation of perioperative lung cancer patients is significant, which can effectively improve the pulmonary function, blood gas function, and diaphragm function of lung cancer patients after surgery, and improve the activities of daily living and quality of life of patients.

Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy:a pilot study

Objective:This study aimed to determine the effect of the relaxation breathing exercise(RBE)on fatigue and cortisol levels among Indonesian women with gynecological cancer undergoing chemotherapy.Methods:This pilot study consecutively recruited 44 gynecological cancer patients to receive RBE(22)or usual care(22).Cortisol level was measured before and after completion of the intervention(day 8).Fatigue was measured using the Piper Fatigue Scale(PFS).Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale(HADS)at the baseline days of the study for days 1,4,and 8.The obtained data were analyzed using Fisher’s exact test,the independent t-test,and the Mann-Whitney U test.Results:There were significant increases in cortisol levels within the groups,either the intervention or control groups,respectively(P-value=0.0003 and 0.001).Despite there being no statistical significance between the intervention and control groups,there were noticeable differences in the cortisol levels,indicating the extreme increase in cortisol levels in the control group(Median[IQR1-IQR3]:2.30[0.99-9.09];Min-Max:0.43-23.38)compared with the intervention group(Median[IQR1-IQR3]=2.97[1.26-5.18];Min-Max=0.39-6.91).Conclusions:RBE helps prevent a significant increase in cortisol levels that can alleviate fatigue for women with gynecological cancer.Further research was recommended to compare several intervention modalities for fatigue and cancer-related symptom management based on cortisol level changes.

Analysis of the Effect of Psychological Nursing Combined with Breathing Exercises in Improving Lung Function in Patients with Pneumoconiosis

Objective: To analyze the effect of psychological nursing combined with breathing exercises on lung function of patients with pneumoconiosis, and to analyze the methods. A total of 64 cases of pneumoconiosis admitted from January 2020 to December 2022 were divided into the reference group and the experimental group by random numerical table. On the basis of symptomatic treatment, the control group was combined with conventional nursing measures and breathing exercises, while the experimental group was treated with psychological nursing on the basis of the control group, and the pulmonary function indexes and adverse mood of the two groups before and after nursing were compared. Results: There was no difference in SAS score, SDS score and pulmonary function indexes between the two groups before intervention (P > 0.05), and the SAS score in the experimental group was the SDS score was lower than that of the control group, and FEV1, FEV1% and FEV1/FVC were higher than those of the control group, and the P < 0.05 was lower.

The Importance of Breathing Training in Folk Dance Teaching

The importance of breathing training in dance teaching is reflected in the two aspects of enhancing the quality of dance movements and sublimating the connotation of dance movements.For example,high-quality breathing can help performers complete the dance movements and improve the coordination of the movements;at the same time,the unique body rhythm formed by breathing can strengthen the visual effect of the performance and convey its spirit and soul to the audience.This requires folk dance teachers to carry out relevant training and teaching activities based on the categories and skills of dance breathing,such as changing students’ideological cognition,developing periodic breathing training courses,providing personalized guidance to students,and allowing students to adjust their learning and practice methods in the evaluation.

Infant’s Sigh Breathing Matters—The Role of the Hering-Breuer Deflation Reflex in Bronchial Decongestion

Background: The prolonged slow expiratory (PSE) technique can induce sigh breaths related to the Hering-Breuer reflex in children.PSE is a specific chest physiotherapy technique often used in children to help with the clearance of secretions, reduce pulmonary obstruction and decrease ventilatory effort. Purpose: The main objective of this review was to synthesize and clarify the existing knowledge of the physiological mechanism behind the Hering-Breuer reflex and its utility in the PSE technique. The secondary objective was to provide an overview of PSE which is probably the main mechanical feature for mucus clearance in infants and to identify gaps and any further research required. Method: A comprehensive literature search was performed using PubMed/MEDLINE and Ovid EMBASE, from 1968 to January 2024, using search terms relating to “Interaction of Hering-Breuer reflex and chest physiotherapy therapy, sigh breath in infants and prolonged slow expiration technique” to create an overview of the advances and gaps in current knowledge of PSE. Result: The data obtained following treatment with PSE maneuvers in infants with histories of recurrent wheezing shows that the presence of sighs could be the main active principle of treatment. Conclusion: Changes in volume induced by PSE technique and, effects from crying may stimulate the Hering-Breuer deflation reflex and sighs in turn improving alveolar ventilation as well as lung volume in infants.

Epidemiology of small intestinal bacterial overgrowth

Small intestinal bacterial overgrowth(SIBO)is defined as an increase in the bacterial content of the small intestine above normal values.The presence of SIBO is detected in 33.8%of patients with gastroenterological complaints who underwent a breath test,and is significantly associated with smoking,bloating,abdominal pain,and anemia.Proton pump inhibitor therapy is a significant risk factor for SIBO.The risk of SIBO increases with age and does not depend on gender or race.SIBO complicates the course of a number of diseases and may be of pathogenetic significance in the development of their symptoms.SIBO is significantly associated with functional dyspepsia,irritable bowel syndrome,functional abdominal bloating,functional constipation,functional diarrhea,short bowel syndrome,chronic intestinal pseudo-obstruction,lactase deficiency,diverticular and celiac diseases,ulcerative colitis,Crohn’s disease,cirrhosis,metabolic-associated fatty liver disease(MAFLD),primary biliary cholangitis,gastroparesis,pancreatitis,cystic fibrosis,gallstone disease,diabetes,hypothyroidism,hyperlipidemia,acromegaly,multiple sclerosis,autism,Parkinson’s disease,systemic sclerosis,spondylarthropathy,fibromyalgia,asthma,heart failure,and other diseases.The development of SIBO is often associated with a slowdown in orocecal transit time that decreases the normal clearance of bacteria from the small intestine.The slowdown of this transit may be due to motor dysfunction of the intestine in diseases of the gut,autonomic diabetic polyneuropathy,and portal hypertension,or a decrease in the motor-stimulating influence of thyroid hormones.In a number of diseases,including cirrhosis,MAFLD,diabetes,and pancreatitis,an association was found between disease severity and the presence of SIBO.Further work on the effect of SIBO eradication on the condition and prognosis of patients with various diseases is required.

Crack Fault Diagnosis and Location Method for a Dual-Disk Hollow Shaft Rotor System Based on the Radial Basis Function Network and Pattern Recognition Neural Network

The crack fault is one of the most common faults in the rotor system,and researchers have paid close attention to its fault diagnosis.However,most studies focus on discussing the dynamic response characteristics caused by the crack rather than estimating the crack depth and position based on the obtained vibration signals.In this paper,a novel crack fault diagnosis and location method for a dual-disk hollow shaft rotor system based on the Radial basis function(RBF)network and Pattern recognition neural network(PRNN)is presented.Firstly,a rotor system model with a breathing crack suitable for a short-thick hollow shaft rotor is established based on the finite element method,where the crack's periodic opening and closing pattern and different degrees of crack depth are considered.Then,the dynamic response is obtained by the harmonic balance method.By adjusting the crack parameters,the dynamic characteristics related to the crack depth and position are analyzed through the amplitude-frequency responses and waterfall plots.The analysis results show that the first critical speed,first subcritical speed,first critical speed amplitude,and super-harmonic resonance peak at the first subcritical speed can be utilized for the crack fault diagnosis.Based on this,the RBF network and PRNN are adopted to determine the depth and approximate location of the crack respectively by taking the above dynamic characteristics as input.Test results show that the proposed method has high fault diagnosis accuracy.This research proposes a crack detection method adequate for the hollow shaft rotor system,where the crack depth and position are both unknown.

Helicobacter pylori infection in Xinjiang Uyghur Autonomous Region:Prevalence and analysis of related factors

BACKGROUND^(14)C urea breath test(^(14)C UBT)and immunohistochemical staining(IHC)are widely used for detection Helicobacter pylori(H.pylori)infection with different sensitivity,and there is a difference in H.pylori infection rate in Uyghur and Han ethnic groups.Both need large cohort studies to evaluate the differences more accurately.AIM To analyze the difference between^(14)C UBT and IHC for H.pylori detection in Xinjiang Uyghur Autonomous Region and the difference between Uyghur and Han populations.METHODS There were 3944 cases of H.pylori infection detected by both IHC and^(14)C UBT at the same time(interval<1 wk,with sampling site including gastric antrum,selected from 5747 patients).We compared the sensitivity of^(14)C UBT and IHC.We also compared 555 pairs of Han/Uyghur cases(completely matched for gender and age)for their H.pylori infection rates.The overall H.pylori infection rate of all 5747 cases and the correlation with other clinicopathological data were also further analyzed.SPSS V23.0 software was used for statistical analysis.RESULTS The sensitivity was 94.9%for^(14)C UBT and 65.1%for IHC,which was a significant difference(n=3944,P<0.001).However,among those cases negative for H.pylori by^(14)C UBT(detection value≤100),4.8%were positive by IHC.Combining both methods,the overall H.pylori infection rate was 48.6%(n=5747),and differences in gender,age group,ethnicity and region of residence significantly affected the H.pylori positive rates.According to age group(Han/Uyghur),the positive rates were≤30 years(62.2%/100.0%),31-40 years(45.2%/85.7%),41-50 years(47.2%/79.2%),51-60 years(44.6%/76.1%),61-70 years(40.9%/68.2%),71-80 years(41.7%/54.1%)and≥81 years(42.9%/NA).The H.pylori infection rates of Han/Uyghur paired cases were 41.4%and 73.3%,which was a significant difference(P<0.001)(555 pairs).H.pylori positivity was significantly related to moderate-severe grade 2-3 chronic/active gastritis and intestinal metaplasia(all P<0.05).CONCLUSION The sensitivity of^(14)C UBT was significantly higher,but combined application can still increase the accuracy.The prevention H.pylori should be emphasized for Uygur and young people.

Ability of lactulose breath test results to accurately identify colorectal polyps through the measurement of small intestine bacterial overgrowth

BACKGROUND While colorectal polyps are not cancerous,some types of polyps,known as adenomas,can develop into colorectal cancer over time.Polyps can often be found and removed by colonoscopy;however,this is an invasive and expensive test.Thus,there is a need for new methods of screening patients at high risk of developing polyps.AIM To identify a potential association between colorectal polyps and small intestine bacteria overgrowth(SIBO)or other relevant factors in a patient cohort with lactulose breath test(LBT)results.METHODS A total of 382 patients who had received an LBT were classified into polyp and non-polyp groups that were confirmed by colonoscopy and pathology.SIBO was diagnosed by measuring LBTderived hydrogen(H)and methane(M)levels according to 2017 North American Consensus recommendations.Logistic regression was used to assess the ability of LBT to predict colorectal polyps.Intestinal barrier function damage(IBFD)was determined by blood assays.RESULTS H and M levels revealed that the prevalence of SIBO was significantly higher in the polyp group than in the non-polyp group(41%vs 23%,P<0.01;71%vs 59%,P<0.05,respectively).Within 90 min of lactulose ingestion,the peak H values in the adenomatous and inflammatory/hyperplastic polyp patients were significantly higher than those in the non-polyp group(P<0.01,and P=0.03,respectively).In 227 patients with SIBO defined by combining H and M values,the rate of IBFD determined by blood lipopolysaccharide levels was significantly higher among patients with polyps than those without(15%vs 5%,P<0.05).In regression analysis with age and gender adjustment,colorectal polyps were most accurately predicted with models using M peak values or combined H and M values limited by North American Consensus recommendations for SIBO.These models had a sensitivity of≥0.67,a specificity of≥0.64,and an accuracy of≥0.66.CONCLUSION The current study made key associations among colorectal polyps,SIBO,and IBFD and demonstrated that LBT has moderate potential as an alternative noninvasive screening tool for colorectal polyps.