A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and wei...A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, spaceoccupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo Over Stitch, Trans Oral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoB arrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons(Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and Sati Sphere. The Aspire Assist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo Over Stitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery.展开更多
针对胃部内窥镜图像中的小尺度息肉检测精度不高的问题,提出了一种改进的SSD(Single Shot Multi Box Detector)算法。首先在SSD网络的池化层设计最大池化Dropout,使神经元稀疏化,然后在反向传播求损失函数梯度时,引入基于权重衰减的正...针对胃部内窥镜图像中的小尺度息肉检测精度不高的问题,提出了一种改进的SSD(Single Shot Multi Box Detector)算法。首先在SSD网络的池化层设计最大池化Dropout,使神经元稀疏化,然后在反向传播求损失函数梯度时,引入基于权重衰减的正则化技术以降低模型的复杂度,最后通过反卷积进行特征融合,使图像特征得以充分利用,解决内窥镜图像中小尺度物体检测不足的问题。实验表明,所提出的方法对胃部息肉具有良好的检测效果,相对于传统SSD算法,提高了5%的胃部息肉检测的平均精度(mAP)。展开更多
目的探讨在超重及肥胖患者中血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平变化及意义。方法58例体重正常者和24例超重及肥胖者常规测量血压、体重、身高、腰围、臀围,计算体重指数(BMI)、腰臀比(WHR)。抽取空...目的探讨在超重及肥胖患者中血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平变化及意义。方法58例体重正常者和24例超重及肥胖者常规测量血压、体重、身高、腰围、臀围,计算体重指数(BMI)、腰臀比(WHR)。抽取空腹静脉血检测其IL-6、CRP、TNF-α的水平。结果在超重及肥胖者中,BMI、WHR、收缩压、餐后2h血糖、三酰甘油、空腹胰岛素、IL-6水平[(21.16±10.85 VS 15.79±3.45)μg/ml,P=0.023]、CRP水平[(3.77±10.4 VS 1.70±0.65)mg/L,P=0.036]均高于正常体重组,而舒张压、TNF-α[(49.99±35.61 VS 38.30±20.70)ng/ml,P=0.074]的水平在两组间无统计学意义。在超重及肥胖患者中,IL-6、CRP、TNF-α与肥胖相关指数(BMI、WHR)正相关(P<0.05);IL-6、CRP分别与餐后2h血糖和空腹胰岛素水平正相关(P<0.05和P<0.01)。结论在超重及肥胖人群中存在着部分炎症指标的异常,提示超重及肥胖与炎症密切相关。展开更多
文摘A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, spaceoccupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo Over Stitch, Trans Oral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoB arrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons(Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and Sati Sphere. The Aspire Assist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo Over Stitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery.
文摘针对胃部内窥镜图像中的小尺度息肉检测精度不高的问题,提出了一种改进的SSD(Single Shot Multi Box Detector)算法。首先在SSD网络的池化层设计最大池化Dropout,使神经元稀疏化,然后在反向传播求损失函数梯度时,引入基于权重衰减的正则化技术以降低模型的复杂度,最后通过反卷积进行特征融合,使图像特征得以充分利用,解决内窥镜图像中小尺度物体检测不足的问题。实验表明,所提出的方法对胃部息肉具有良好的检测效果,相对于传统SSD算法,提高了5%的胃部息肉检测的平均精度(mAP)。
文摘目的探讨在超重及肥胖患者中血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平变化及意义。方法58例体重正常者和24例超重及肥胖者常规测量血压、体重、身高、腰围、臀围,计算体重指数(BMI)、腰臀比(WHR)。抽取空腹静脉血检测其IL-6、CRP、TNF-α的水平。结果在超重及肥胖者中,BMI、WHR、收缩压、餐后2h血糖、三酰甘油、空腹胰岛素、IL-6水平[(21.16±10.85 VS 15.79±3.45)μg/ml,P=0.023]、CRP水平[(3.77±10.4 VS 1.70±0.65)mg/L,P=0.036]均高于正常体重组,而舒张压、TNF-α[(49.99±35.61 VS 38.30±20.70)ng/ml,P=0.074]的水平在两组间无统计学意义。在超重及肥胖患者中,IL-6、CRP、TNF-α与肥胖相关指数(BMI、WHR)正相关(P<0.05);IL-6、CRP分别与餐后2h血糖和空腹胰岛素水平正相关(P<0.05和P<0.01)。结论在超重及肥胖人群中存在着部分炎症指标的异常,提示超重及肥胖与炎症密切相关。
