Influence of BPPV and Meniere's Disease on Cognitive Abilities: A Questionnaire-Based Study

The vestibular system connects the inner ear to the midbrain and subcortical structures and can affect cognition. Patients with vertigo often experience cognitive symptoms such as attention deficits, memory problems, and spatial perception difficulties. This study aimed to explore the cognitive impairments associated with Benign paroxysmal positional vertigo(BPPV) and Meniere's Disease(MD). A non-experimental group comparison design was used with 107 participants divided into three groups: Group I(clinically normal), Group II(BPPV), and Group III(MD). Participants completed a questionnaire with 10 cognition-related questions, and their responses were scored. The data were found to be non-normally distributed. The analysis revealed a significant difference in scores between Group I and both Group II and Group III. Chi-square tests showed that the responses to cognition-related questions varied among the groups, with Group II exhibiting more cognitive problems. Associated conditions like hypertension, diabetes, and hearing loss did not significantly influence the responses within each group. This study suggests a significant relationship between cognitive problems and patients with BPPV and MD. However, there was no association found between the cognitive problems experienced in BPPV and MD patients. These findings align with previous research indicating that vestibular disorders can lead to deficits in spatial memory, attention, and other cognitive functions. By understanding the link between cognition and vestibular disorders, we can improve diagnosis and rehabilitation services to enhance the quality of life for these patients.

Saccades of video head impulse test in Meniere's disease and Vestibular Migraine: What can we learn from?

Background:Saccades are often observed on video head impulse tests(vHIT)in patients with Meniere's Disease(MD)and Vestibular Migraine(VM).However,their saccadic features are not fully described.Objective:This study aims to identify the saccades characteristics of MD and VM.Methods:75 VM patients and 103 definite unilateral MD patients were enrolled in this study.First raw saccades were exported and analyzed.The VM patients were divided into left and right based on their ears,while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.Results:The MD patients have more saccades on the affected side(85%vs.69%),and saccade velocity is more consistent than the contralateral side(shown by the coefficient of variation).The saccades occurrence rates on both sides are similar in VM(77%vs.76%),as are other saccadic parameters.The MD patients have more significant inter-aural differences than the VM patients,manifested in higher velocity(p-value 0.000),earlier arriving(p-value 0.010),and more time-domain gathered(p-value 0.003)on the affected side.Conclusions:Bilateral saccades are commonly observed in MD and VM.In contrast to MD,saccades on VM are subtle,scattered,and late-arrived.Furthermore,the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.

The role of cochlear implantation in alleviating Tumarkin drop attacks of Meniere's disease;a case report

Ménière’s disease(MD)patients may suffer episodes of sudden falls,named Tu markin drop attacks(DAs).This fall occurs abruptly and without warning or loss of consciousness.DAs usually aggravate the clinical picture of MD and are challenging to manage.The present report describes a case treated by cochlear implantation(CI)due to concomitant deafness and offers some clinical considerations for this condition.A male patient aged 48 years with a 10-year history of definite bilateral MD had profound SNHL on the right and severe SNHL on the left side.He suffered from intermittent attacks of vertigo,ear fullness,and tinnitus and,in the last year,had developed DAs and experienced 14 episodes in the previous six months.The preoperative category of acoustic performance was 3.The Dizziness Handicap Inventory(DHI)questionnaire showed a total score of 46,which indicated a moderate degree of disability.A CI was planned for the right side.The patient did not report any further DAs episode for two years since then.The postoperative category of acoustic performance became 11,and the postoperative DHI questionnaire showed a decrease in the total score(from 46 to 19),which indicated a mild disability.Unilateral CI effectively alleviated the DAs associated with bilateral MD.Our report proposes a new modality for managing vertiginous symptoms in cases of MD with hearing loss without the need for more aggressive surgical interventions with the need for clinical trials to confirm our results.

A study of efficacy of Nigella sativa in treatment of Meniere's disease: A randomized, placebo controlled clinical trial

Purpose:Meniere's disease(MD),first introduced by Prosper Meniere,is characterized mainly by vertigo,tinnitus,aural fullness and sensorineural hearing loss.Though the exact pathophysiology of MD is unknown,immunologic and inflammatory interactions are possible underlying mechanisms involved in MD.This study is aimed to investigate the immunomodulatory and anti-inflammatory effect of Nigella sativa on MD as a therapeutic agent.Methods:We divided 40 patients with definite MD into two groups of 20 cases.The study group received 1 g of Nigella sativa oil daily for three months and the control group received a placebo.Changes in hearing,tinnitus and vertigo were estimated by pure tone audiometry,tinnitus handicap inventory questionnaire and dizziness handicap inventory questionnaire,respectively.Results:At the end of the study we did not observe any significant improvement in study's group hearing threshold,tinnitus and vertigo compared to the control group.Conclusions:In this study,statistical analysis showed that Nigella sativa failed to improve signs and symptoms of MD.However,further investigations with a larger study population are needed to ascertain the current conclusion.

Dexamethasone does not affect endolymphatic hydrops(EH)in patients with Meniere's disease within 24 h,and intratympanic administration of gadolinium plus dexamethasone simplifies high-quality imaging of EH using a novel protocol of 7 min

Background:Intratympanic administration of gadolinium chelate allows for a better visualization of endolymphatic hydrops(EH)using MRI than intravenous injection and was recently further improved to facilitate high-quality imaging of EH in 7 min.The aim of the present study was to simplify the intratympanic administration protocol by mixing gadolinium chelate with therapeutic dexamethasone and to evaluate the effects of this mixture on the visualization of EH in MRI.Materials and methods:In an in vitro study,the potential impact of gadolinium-diethylenetriamine pentaacetic acid(Gd-DTPA)on the stability of dexamethasone was evaluated by analyzing dynamic changes in dexamethasone with high-performance liquid chromatography(HPLC)after mixing with GdDTPA.Ten patients with definite Meniere's disease(MD)were recruited to study the potential interference of dexamethasone on MRI visualization of EH,and 49 patients with MD were recruited to evaluate the effect of intratympanic injection of Gd-DTPA mixed with dexamethasone on MRI of EH using a 3T MR machine and a novel heavily T2-weighted 3-dimensional fluid-attenuated inversion recovery reconstructed using a magnitude plus zero-filled interpolation(hT2FLAIR-MZFI)sequence.Results:The retention times and peak area of dexamethasone in HPLC were not modified by the addition of Gd-DTPA.EH grading in the cochlea and vestibule was not influenced in any ear by intratympanic injection of dexamethasone.Excellent inner ear images were obtained from all patients,and EHs with various grades were displayed.There were significant correlations between diagnosis and cochlear EH(p<0.01,Spearman's Rho),between diagnosis and vestibular EH(p<0.01,Spearman's Rho),and between cochlear and vestibular EH(p<0.01,Spearman's Rho).The distribution of Gd-DTPA plus dexamethasone negatively correlated with the grade of vestibular EH.Injury of the endolymph-perilymph barrier was detected in one cochlea and three vestibules of 59 inner ears with MD.Conclusions:Intratympanic administration of Gd-DTPA plus dexamethasone yielded high-quality MRI images of EH in patients with MD using a novel 7-min protocol and simplified the clinical application.Intratympanic administration of Gd-DTPA plus dexamethasone might be used to test its therapeutic effect in future work.

ELECTROACUPUNCTURE TREATMENT OF MENIERE'S DISEASE

Objective: To observe the effect of electroacupuncture (EA) on Meniere's disease. Methods: A total of 114 cases (38 males and 76 females) of Meniere's disease were treated with EA of Ermen(耳门 TE 21), Tinggong (听宫 SI 19), Tinghui (听会 GB 2), Yifeng (医风 TE 17), Fengchi (风池 GB 20) and Baihui (百会 GV 20). The treatment was given 3 times a week,9 times altogether. Follow-up was made at the end of the 3rd, 6th and 12th months after treatment. Results; Follow-up in 114 patients showed that after EA treatment, 63 cases (55.26%) were cured, 30 (26.31%) had remarkable improvement in their symptoms, 10 (8. 77%) responded with improvement and 11 (9.65%) failed in the treatment, with a total effective rate of 90.35%. Conclusion: EA treatment was effective in controlling Meniere's disease patients' symptoms and reducing attack.

Highly sensitive troponin I assay in the diagnosis of coronary artery disease in patients with suspected stable angina

BACKGROUND Evaluation of suspected stable angina patients with probable coronary artery disease(CAD)in the community is challenging.In the United Kingdom,patients with suspected stable angina are referred by community physicians to be assessed by specialists within the hospital system in rapid access chest pain clinics(RACPC).The role of a highly sensitive troponin I(uscTnI)assay in the diagnosis of suspected CAD in a RACPC in a“real-life”setting in a non-academic hospital has not been explored.AIM To examine the diagnostic value of uscTnI(detection limit 0.12 ng/L,upper reference range 8.15 ng/L,and detected uscTnI in 96.8%of the reference population),in the evaluation of stable CAD in a non-selected patient group,with several co-morbidities,who presented to the RACPC.METHODS One hundred and seventy two RACPC patients were assigned to either functional or anatomical testing according to the hospital protocol.RESULTS The investigations offered to patients were exercise tolerance test 7.6%,24 h ECG 1.2%,Echocardiogram 14.5%,stress echocardiogram 8.1%,coronary computed tomography angiography(CCTA)12.8%,coronary angiogram 13.4%,17.4%were diagnosed with non-cardiac chest pain,3.5%treated as stable angina,8.2%reviewed by cardiologists,electronic medical records were not available in 10.4%.Receiver operating characteristic curves for CAD used uscTnI values measured in patients who underwent functional testing,angiogram or CCTA.Values>0.52 ng/L showed 100%sensitivity and at>11.6 ng/L showed 100%specificity.In the range>0.52-11.6 ng/L,uscTnI may not have the same diagnostic potential.In patients assigned to coronary angiogram higher concentrations of uscTnI was associated with severe CAD.Low levels of uscTnI and low pre-test probability of CAD(QRISK3)may decrease patient numbers assigned to CCTA.CONCLUSION The uscTnI diagnostic cut-off values in a RACPC will depend on patient population and their presenting co-morbidity.In the presence of clinical comorbidities and previous CAD the uscTnI needs to be used in conjunction with clinical assessment.

MEFV,IRF8,ADA,PEPD,and NBAS gene variants and elevated serum cytokines in a patient with unilateral sporadic Meniere's disease and vascular congestion over the endolymphatic sac

The etiology and underlying mechanism of Meniere's disease(MD)development are still unknown,although inflammation and autoimmunity have been implicated as underlying mechanisms.The human endolymphatic sac(ES)has been reported to have innate and adaptive immune capacity in local immune reactions.In vivo demonstration of inflammation of the ES in patients with MD is missing in the literature.We report the case of a 47-year-old female patient diagnosed with unilateral MD with genetic variants and cytokine markers indicating inflammation and vascular congestion of the ES.Endolymphatic hydrops in the right cochlea(grade 2)and vestibulum(grade 3)were detected using MRI.She carried heterozygous variants in MEFV(c.442G>C),IRF8(c.1157G>T),ADA(c.445C>T),PEPD(c.151G>A),NBAS(c.4049T>C),CSF2RB(c.2222C>T),HPS6(c.277G>T),IL2RB(c.1109C>T),IL12RB1(c.1384G>T),IL17RC(c.260_271del GCAAGAGC TGGG),LIG1(c.746G>A),RAG1(c.650C>A),and SLX4(c.1258G>C,c.5072A>G).In the serum,the levels of granulocyte colony-stimulating factor(G-CSF),macrophage inflammatory protein 1a,and IL7 were significantly elevated,and the level of IL2Ra was reduced.Intratympanic administration of dexamethasone temporarily alleviated her hearing loss.Her vertigo was significantly relieved but remained slight after ES administration of corticosteroids.

Study on medication rules of traditional Chinese medicine for Meniere's disease based on data analysis

Objective:Study on medication rules of traditional Chinese medicine in treating Meniere's disease based on data mining technology.Methods:Computer retrieval with since establishment of the“CNKI”,“WF”,“VIP”,there have been literatures on the treatment of Meniere syndrome with Traditional Chinses medicine.Memory preprocessing in accordance with inclusion criteria.Then,EXCLE 2010,SPSS Statistics(ver.25)and SPSS Modeler(ver.18.0)were adopted respectively for frequency analysis,cluster analysis and association rules analysis.Result:A total of 133 references were included in this study,146 prescriptions,192 kinds of drugs,and the total frequency of drugs was 1702.The high frequency Meniere syndrome types were spleen deficiency and phlegm dampness syndrome,wind phlegm syndrome,gallbladder depression and phlegm disturbance syndrome,hyperactivity of liver yang syndrome,phlegm and blood stasis syndrome.The efficacy of drug frequency≥25 were summarized as follows,antiasthmatic drugs for relieving phlegm and relieving cough,diuresis-removing dampness,Tonic drugs,etc.High frequency meridian of drugs are:lung,liver,spleen,etc.High frequency drug properties are:temperature,cold,flat etc.High frequency drug taste:bitter,sweet,pungent,etc.Core drugs:Pinellia,Atractylodes,Poria,Gastrodia,etc.The main prescriptions werealisma soup,Banxia Baizhu Tianma Decoction,Zhengan Xifeng Decoction and Xiaochaihu Decoction.Conclusion:In this study,data mining was used to sort out the treatment of Meniere's disease by traditional Chinese medicine.It was found that the treatment of Meniere's disease was mainly to calm the liver and strengthen the spleen,supplemented by regulating qi and activating blood,clearing heat and opening orifices,tonifying deficiency and tranquilizing mind.

基于“人机料法环测”管理模式的疑似白喉在医疗机构中的防控策略

白喉是由白喉棒状杆菌引起的死亡率高的急性呼吸道传染病,是我国《传染病防治法》规定的乙类传染病。感染者咽喉部可出现白色伪膜,同时出现发热、声音嘶哑、犬吠样咳嗽、呼吸困难等症状,严重感染患者可能会产生全身性中毒症状,甚至诱发周围神经麻痹和心肌炎,曾严重危害人民健康。虽然现阶段白喉在我国属于罕见传染病,但国内仍有散发病例出现,与此同时,非产毒菌分离率呈上升趋势。本研究通过对西安市某三甲医院检出的疑似白喉患者的防控策略进行梳理,旨在有力、有序推进医疗机构内发现疑似白喉等罕见传染病的防控策略,为医疗卫生行业疑似白喉的医院感染防控提供先进成熟经验。

2015-2023年黔东南州疑似职业病流行病学特征及诊断情况分析

目的了解黔东南州2015-2023年疑似职业病的流行病学特征及后续诊断情况,为疑似职业病监管提供数据依据。方法收集黔东南州2015-2023年报告的疑似职业病和职业病病例,分析疑似职业病的分布和诊断情况,并电话追踪未进行诊断的疑似职业病患者。结果2015-2023年黔东南州共报告疑似职业病3大类10种共424例,主要为尘肺病和职业性耳鼻喉口腔疾病,尘肺病以矽肺为主,职业性耳鼻喉口腔疾病为噪声聋。报告重点地区为天柱县、凯里市和镇远县;报告重点行业为采矿业和制造业,采矿业主要以其他采矿业、其他未列明非金属矿采选和粘土及其他土砂石开采为主,制造业主要以采矿、冶金、建筑专用设备制造和水泥制造为主;重点报告经济类型为私有经济;重点报告企业规模为小型和微型企业;报告的疑似职业病诊断率为7.31%,确诊率为67.74%,不同报告机构类别、不同接害类别、不同报告年份、不同企业规模疑似职业病的诊断率均有统计学差异(P<0.05)。未进入诊断程序的主要原因为岗前体检发现未被录用、尚在职业病诊断流程中、到其他职业体检机构进行复查、本人不愿意申请职业病诊断和未被告知自己是疑似职业病。结论矽肺和职业性噪声聋是黔东南州疑似职业病主要病种,疑似职业病的诊断率较低,应加强疑似职业病重点病种、重点地区和重点行业的监督管理工作,同时加强疑似病例报告和管理,提高疑似职业病的诊断率。

Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.

The role of selective serotonin reuptake inhibitors and tricyclic antidepressants in addressing reduction of Meniere's disease burden:A scoping review

Objective:To assess the effect of selective serotonin reuptake inhibitors(SSRIs)and tricyclic antidepressants(TCAs)in reducing vertigo,tinnitus,and hearing loss among patients with Meniere's disease(MD).Data Sources:The following databases were utilized in this scoping review:Ovid Medline,PubMed-NCBI,CINAHL,Cochrane Library,Web of Science,and Clinicaltrials.gov.Method:Studies were identified through the following search phrases:"serotonin specific reuptake inhibitors"OR"tricyclic antidepressants"AND"Meniere's disease."References from included manuscripts were examined for possible inclusion of additional studies.Results:The literature search yielded 23 results,which were screened by three independent reviewers.Seventeen studies and three duplicates were excluded.An examination of references from the included studies yielded two additional publications.A total of four published studies assessing SSRIs and TCAs among 147 patients with MD were ultimately included.Four studies described significant reductions in vertigo attack frequency among patients treated with either SSRIs or TCAs compared to their pretreatment baseline.Three studies assessed the drugs'effects on hearing,of which none found a significant difference among patients treated with SSRIs or TCAs.One study found a significant decrease in patient-reported tinnitus following treatment with TCAs or SSRIs compared to their pretreatment baseline.Conclusions:Data exploring SSRIs and TCAs among patients with MD suggests that these medications may reduce the frequency of tinnitus and vertigo,although there was significant heterogeneity in outcome reporting.There remains a need for larger-scale prospective studies that emphasize objective data to evaluate their effective-ness in reducing common MD symptoms.

内耳1.5T MRI钆造影对可疑梅尼埃病的诊断价值

目的1.5T MRI条件下经咽鼓管给药行内耳3D-FLAIR序列MRI扫描,探讨其对可疑梅尼埃病的诊断价值。方法选取2019年3月-2023年10月在我院就诊的可疑梅尼埃病患者38例做为研究对象,经咽鼓管注射钆双胺24小时后进行内耳MRI检查,分析前庭及耳蜗膜迷路积水情况。结果38例可疑梅尼埃患者中临床确诊梅尼埃病31例,伴发眩晕的突聋4例,前庭性偏头痛2例,良性阵发性位置性眩晕1例。31例确诊梅尼埃患者中内淋巴积水27例,无积水4例,其中27例内淋巴积水患者中合计有32耳积水,其中双耳积水5例,单耳积水22例,32耳积水中轻度积水12耳,重度积水20耳。非梅尼埃患者中内淋巴积水1例、为轻度积水,无积水6例。内耳1.5T MRI钆造影对梅尼埃病诊断的灵敏度为87.1%、特异度85.7%,ROC曲线下面积为0.864,对于临床诊断价值较高。结论经咽鼓管给药内耳1.5T MRI钆造影可清晰显示内耳膜迷路积水情况,对梅尼埃病的诊断是可行的。

基于异常行为分析的疑似病猪实时监测系统设计

鉴于人工观察猪异常行为识别疑似病猪的方法存在不足,设计了一种基于行为分析的实时监测系统,用于发现疑似病猪。通过部署在猪舍饮食间的长焦镜头和顶部的广角摄像头及从属传感器,对生猪的饮食行为进行24 h监控;通过改进运动目标检测算法和图像识别技术,实现对行为异常的病猪及疑似病猪进行非接触监测,并生成日志和记录数据;预警模块会将图像信息通过网络服务器传送至监控中心,这样可以有效发现猪的异常行为,从而更早地干预和治疗病猪。经过训练模型识别,共发现疑似病猪50只,经过检验,实际患病猪为49只,该系统检测精确度为99%,基本达到了预期的设计目标。

2022年栖霞市手足口病疫苗接种率和疑似预防接种异常反应监测分析

目的调查2022年栖霞市手足口病疫苗接种率,监测疑似预防接种异常反应发生情况。方法采用整群随机抽样法,选择2022年1月—2022年12月在栖霞市居住的1090例学龄前儿童及其家长作为研究对象,调查与监测手足口病疫苗接种情况与疑似预防接种异常反应发生情况,调查儿童的一般资料并进行多因素分析。结果在1090例学龄前儿童中,完成全程接种的有824例,部分接种的有166例,无接种的有100例,接种率为90.83%。Logistic回归分析显示,家长文化程度、本地区居住时间、家长职业、家庭月收入等为影响2022年栖霞市手足口病疫苗接种率的重要因素(P<0.05)。发生疑似预防接种异常反应15例,发生率为1.38%,都在48 h内进行了及时报告,及时报告率为100.00%。一般反应13例,占86.67%;常规反应1例,占6.67%;偶合症1例,占6.67%,均未发生接种事故、心因性反应、疫苗质量事故等。治愈14例,好转1例,未出现任何后遗症。结论2022年栖霞市手足口病疫苗接种率有待提高,家长文化程度、本地区居住时间、家长职业、家庭月收入为影响接种率的主要因素,依然存在疑似预防接种异常反应,都及时进行了报告,多为一般反应,预后转归效果都比较高。

Intratympanic corticosteroids in Ménière's disease:A mini-review

This article reviews the effectiveness of intratympanic corticosteroids for vertigo control in Meniere's disease at 2-years follow-up according to the guidelines expressed by the American Academy of Otolaryngology-Head & Neck Surgery. Despite the increased use of intratympanic corticosteroids for vertigo control in Meniere's disease there is debate as to their effectiveness, particularly compared to gentamicin. Even so,after just a single course of injections, corticosteroids can reliably provide complete vertigo control(Class A) at 2-years in about 50% of cases as indicated in a recent double-blind randomized controlled clinical trial(Patel et al., 2016). But the effectiveness of intratympanic corticosteroids truly increases when treatment is provided 'as-needed', whereby complete vertigo control is established in up to 91% of cases. On the basis of available literature, there is good evidence to recommend the use of intratympanic steroid treatment for vertigo control in Meniere's disease, but patients must be monitored for non-response. The rationale for treating patients as-needed and the possible reasons for corticosteroid nonresponse are discussed.

A substantial incidence of silent short segment endoscopically suspected esophageal metaplasia in an adult Japanese primary care practice

AIM: To determine the incidence and characteristics of endoscopically suspected esophageal metaplasia (ESEM) in a primary adult care institution. METHODS: Eight hundred and thirty two consecutive individuals (mean age, 67.6 years) undergoing upper gastrointestinal endoscopy between January 2009 and December 2010 were included in this study. The diagnosis of ESEM was based on the criteria proposed by the Japan Esophageal Society, and was classified as long segment ESEM (3 cm or more) or short segment ESEM (< 3cm). Short segment ESEM was further divided into circumferential and partial types. Age, gender, hiatus hernia, esophagitis, gastroesophageal reflux disease (GERD)-suggested symptoms, and antacid medications were recorded as background factors. Esophagitis was graded according to the Los Angeles classification. Hiatus hernia was divided into absent and at least partially present. RESULTS: Long and short segment ESEM were found in 0 and 184 (22.1%) patients, respectively (mean age of short segment ESEM patients, 68.3 years). Male gender and hiatus hernia were shown to be significant factors affecting short segment ESEM by both univariate (P = 0.03 and P = 9.9x10-18) and multivariate [Odds ratio (OR) = 1.45; P = 0.04, and OR = 43.3; P = 1.5x10-7)] analyses. Two thirds of patients with short segment ESEM did not have GERD-suggested symptoms. There was no correlation between short segment ESEM and GERD-suggested symptoms. CONCLUSION: The incidence of short segment ESEM in our community practice seems higher than assumed in Asian countries. As GERD-suggested symptoms are a poor predictor of ESEM, endoscopists should bear in mind that silent short segment ESEM does exist and, in fact, was found in the majority of our patients.

Tongue-like Barrett's esophagus is associated with gastroesophageal reflux disease

AIM:To test this hypothesis of barrett esophagus (BE) classified into two types and to further determine if there was any correlation between the shape of endoscopically suspected esophageal metaplasia (ESEM), prevalence of reflux esophagitis (RE) and heartburn. METHODS: A total of 6504 Japanese who underwent endoscopy for their annual stomach check-up were enrolled in this study. BE was detected without histological confirmation that is ESEM. We originally classified cases of ESEM into 3 types based on its shape: Tongue-like (T type), Dome-like (D type) and Wave-like (W type) ESEM. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a one-month period. RESULTS: ESEM was observed in 10.3% of 6504 subjects (ESEM < 1 cm, 9.4%; 1 cm ≤ ESEM < 3 cm, 1.7%; ESEM ≥ 3 cm, 0.5%). The frequency of ESEM was significantly higher in males compared with female subjects. Statistical analysis showed that the prevalence of heartburn and RE were significantly higher in the T type ESEM than in the W type ESEM (P < 0.05). CONCLUSION: The T type ESEM was strongly associated with reflux symptoms and RE whereas the W type ESEM was not associated with GERD.

基于医院临床数据中心的可疑呼吸道传染病发现与预测模型构建

目的通过构建基于临床数据中心的可疑呼吸道传染病发现与预测模型,实现对可疑传染病的发现与预测。方法选取某三甲医院的临床数据,基于历史传染病数据进行病历结构化建模,构建呼吸道传染病知识图谱,利用XGboost算法和知识图谱推理技术形成发现与预测合并决策模型,并使用医院历史数据做交叉验证,得到准确度较高的模型。结果发现与预测模型的平均查准率为92.55%,查全率为91.49%,综合F1值为92.01%,均优于单独的知识图谱模型或XGboost模型,将模型与医院的电子病历系统和临床辅助决策系统进行集成,应用于对真实临床病例的预测。结论该方法能够很好地针对新发可疑呼吸道传染病进行预测,辅助医院及时启动传染病应急预案,减少传染病发生早期时医务人员的感染概率。