Artificial intelligence-assisted colonoscopy:A review of current state of practice and research

Colonoscopy is an effective screening procedure in colorectal cancer prevention programs;however,colonoscopy practice can vary in terms of lesion detection,classification,and removal.Artificial intelligence(AI)-assisted decision support systems for endoscopy is an area of rapid research and development.The systems promise improved detection,classification,screening,and surveillance for colorectal polyps and cancer.Several recently developed applications for AIassisted colonoscopy have shown promising results for the detection and classification of colorectal polyps and adenomas.However,their value for real-time application in clinical practice has yet to be determined owing to limitations in the design,validation,and testing of AI models under real-life clinical conditions.Despite these current limitations,ambitious attempts to expand the technology further by developing more complex systems capable of assisting and supporting the endoscopist throughout the entire colonoscopy examination,including polypectomy procedures,are at the concept stage.However,further work is required to address the barriers and challenges of AI integration into broader colonoscopy practice,to navigate the approval process from regulatory organizations and societies,and to support physicians and patients on their journey to accepting the technology by providing strong evidence of its accuracy and safety.This article takes a closer look at the current state of AI integration into the field of colonoscopy and offers suggestions for future research.

The antibacterial activity of selected plants towards resistant bacteria isolated from clinical specimens

Objective:To evaluate the antibacterial activity of eight plants against methicillinresistant Staphylococcus aureus(MRSA),extended spectrum beta-lactamase and carbapenemase-resistant Enterobacteriaceae,which are the most prevalent causes of infections in inpatients.Methods:The antibacterial activity was calculated based on the minimum inhibitory concentration using Mueller-Hinton broth in a microdilution method.Results:The best antibacterial activity,calculated as minimum inhibitory concentration values,against MRSA was shown by the Kaempferia pandurata(Roxb)(K.pandurata)extract(256 μg/mL) and the Senna alata(S.alata) extract(512 μg/mL).Phytochemical screening of dried S.alata leaf and its extract showed the presence of flavonoids,alkaloids,saponins,quinones,tannins and sterols,while dried K.pandurata and its extract only showed the presence of flavonoids and sterols/triterpenoids.Conclusions:K.pandurata and S.alata have the potential to be developed as antibacterial agents,especially against MRSA strain,but further in vivo research and discovery of the mode of its action are still needed to shed light on the effects.

Recent Possibilities for the Diagnosis and Pharmacological Control of Pregnancy Loss in Dairy Cow

One of the most recent techniques for the diagnosis of EP （early pregnancy） in cattle on the farm is B-mode ultrasonography. Under field conditions, acceptable results may be achieved with ultrasonography from days 25 to 30 post-AI. The reliability of the test greatly depends on the frequency of the transducer used, the skill of the examiner, the criterion used for a positive PD （pregnancy diagnosis） and the position of the uterus in the pelvic inlet. Pregnancy protein assays （PAG, PSPB） may provide an alternative method to ultrasonography for determining EP or LEM/EFM （late embryonic/early foetal mortality） in the cow. Although early pregnancy factor is the earliest specific indicator for fertilization, its detection is entirely dependend on the use of the RIT （rosette inhibition test）, therefore its use in the field needs further inventions. Preventive pharmaceutical treatments with hCG （human chorionic gonadotropin）, GnRH （gonadotropin realising hormone）, PRID （progesterone-releasing intravaginal device） or CIDR （controlled internal drug release） inserts at different time periods at or post-AI may have some benefit in decreasing PL （pregnancy loss）, however further examinations are warranted to determine how and when these treatments may influence PL in the field.

Fixed bimonthly aflibercept in nave and switched neovascular age-related macular degeneration patients:one year outcomes

AIM: To determine real life clinical outcomes in poorly responsive and treatment-nave neovascular age-related macular degeneration(nv AMD) patients using bimonthly fixed dosing aflibercept regimen.METHODS: This was a retrospective study of 165 eyes with nv AMD started on aflibercept at Southampton Eye Unit between June 2013 and June 2014. Patients were either switched from pro re nata(PRN) ranibizumab/bevacizumab due to poor response(107 eyes), or treatment- nave( 58 eyes). Patients initially received 3-monthly intravitreal aflibercept injections followed by 2-monthly fixed doses. Clinic visits were scheduled at month 0, 4, 10 and 12. Mean change in best-corrected visual acuity(BCVA) and central retinal thickness(CRT)from baseline were assessed using the Wilcoxon signedrank test. The proportion of patients maintaining BCVA(<15 letters loss) at 12 mo was also evaluated.RESULTS: Mean BCVA change at month 12 was +3.29 and +4.67 letters in the switched and nave aflibercept groups respectively(P <0.01). BCVA was maintained in 95.3% of switched and 96.6% of nave patients. CRT at month 12 showed a decrease of -6.16 μm in the switched group and -35.36 μm in the nave group(P <0.01).Patients previously treated with ranibizumab/bevacizumab had on average received 7.4 ranibizumab/bevacizumab injections over 12.6 mo, attending 10 clinic visits. The fixed dosing aflibercept regimen required an average of 7.1 injections(nave group), 7.5 injections(switched group) and 4 clinic visits per year.CONCLUSION: Fixed bimonthly aflibercept is effective in both treatment-nave and poorly responsive nv AMD patients. Adopting a fixed dosing regimen can reduce patient burden without compromising on outcomes.

Prevalence of SLC22A4, SLC22A5 and CARD15 gene mutations in Hungarian pediatric patients with Crohn’s disease

AIM： To investigate the frequency of the common NOD2/CARD15 susceptibility variants and two functional polymorphisms of OCTN cation transporter genes in Hungarian pediatric patients with Crohn＇s disease （CD）. METHODS： A cohort of 19 unrelated pediatric and 55 unrelated adult patients with Crohn＇s disease and 49 healthy controls were studied. Genotyping of the three common CD-associated CARD15 variants （Arg702Trp, Gly908Arg and 2007finsC changes） with the SLC22A4 1672C→T, and SLC22A5 -207G→C mutations was performed by direct sequencing of the specific regions of these genes. RESULTS： At least one CARD15 mutation was present in 52.6% of the children and in 34.5% of the adults compared to 14.3% in controls. Surprisingly, strongly different mutation profile was detected in the pediatric versus adult patients. While the G908R and 1007finsC variants were 18.4% and 21.1% in the pediatric group, they were 1.82% and 11.8% in the adults, and were 1.02% and 3.06% in the controls, respectively. The R702W allele was increased approximately two-fold in the adult subjects, while in the pediatric group it was only approximately 64% of the controls （9.09% in the adults, 2.63% in pediatric patients, and 4.08% in the controls）. No accumulation of the OCTN variants was observed in any patient group versus the controls.CONCLUSION： The frequency of the NOD2/CARD15 susceptibility variants in the Hungarian pediatric CD population is high and the profile differs from the adult CD patients, whereas the results for SLC22A4 and SLC22A5 mutation screening do not confirm the assumption that the carriage of these genotypes means an obligatory susceptibility to CD.

Plasma carnitine ester profile in adult celiac disease patients maintained on long-term gluten free diet

AIM： To determine the fasting plasma carnitine ester in patients with celiac disease. METHODS： We determined the fasting plasma carnitine ester profile using ESI triple quadrupol mass spectrometry in 33 adult patients with biopsy-confirmed maturity onset celiac disease maintained on long term gluten free diet. RESULTS： The level of free camibine did not differ as the celiac disease patients were compared with the healthy controls, whereas the acetylcarnitine level was markedly reduced （4.703± 0.205 vs 10.227 ± 0.368 nmol/mL, P〈0.01）. The level of propionylcarnitine was 61.5%, butyrylcarnitine 56.9%, hexanoylcarnitine 75%, octanoylcarnitine 71.1%, octenoylcarnitine 52.1%, decanoylcarnitine 73.1%, cecenoylcarnitine 58.3%, lauroylcarnitine 61.5%, miristoylcarnitine 66.7%, miristoleylcarnitine 62.5% and oleylcarnitine 81.1% in the celiac disease patients compared to the control values, respectively （P〈0.01）. CONCLUSION： The marked decrease of circulating acetylcarnitine with 50-80 % decrease of 11 other carnitine esters shows that the carnitine ester metabolism can be influenced even in clinically asymptomatic and well being adult celiac disease patients, and gluten withdrawal alone does not necessarily normalize all elements of the disturbed carnitine homeostasis.

Clinicopathological features of small T1 colorectal cancers

BACKGROUND Although small colorectal neoplasms(<10 mm)are often easily resected endoscopically and are considered to have less malignant potential compared with large neoplasms(≥10 mm),some are invasive to the submucosa.AIM To clarify the clinicopathological features of small T1 colorectal cancers.METHODS Of 32025 colorectal lesions between April 2001 and March 2018,a total of 1152 T1 colorectal cancers resected endoscopically or surgically were included in this study and were divided into two groups by tumor size:a small group(<10 mm)and a large group(≥10 mm).We compared clinicopathological factors including lymph node metastasis(LNM)between the two groups.RESULTS The incidence of small T1 cancers was 10.1%(116/1152).The percentage of initial endoscopic treatment in small group was significantly higher than in large group(<10 mm 74.1%vs≥10 mm 60.2%,P<0.01).In the surgical resection cohort(n=798),the rate of LNM did not significantly differ between the two groups(small 12.3%vs large 10.9%,P=0.70).In addition,there were also no significant differences between the two groups in pathological factors such as histological grade,vascular invasion,or lymphatic invasion.CONCLUSION Because there was no significant difference in the rate of LNM between small and large T1 colorectal cancers,the requirement for additional surgical resection should be determined according to pathological findings,regardless of tumor size.

No association of the cytotoxic T-lymphocyte associated gene CTLA4 +49A/G polymorphisms with Crohn's disease and ulcerative colitis in Hungarian population samples

AIM： The goal of the current work was to analyse the prevalence of the ＋49A/G variant of the cytotoxic T-lymphocyte antigen 4 gene （CTLA4） in Hungarian patients with Crohn＇s disease （CD） and ulcerative colitis （UC）. METHODS： A total of 130 unrelated subjects with CD and 150 with UC, and 170 matched controls were genotyped for the single nucleotide polymorphism （SNP）. The genotypes were determined by using PCR/RFLP test. RESULTS： The G allele frequency and the prevalence of the GG genotype were 38.1% and 12.3% in the CD group, 40.6% and 18.6% in the UC patients, and 37.4% and 15.9% in the control group, respectively. CONCLUSION： The results of the current study show that carriage of the ＋49G SNP in heterozygous or in homozygous form does not confer risk either for CD or for UC in the Hungarian population.

Changes of plasma fasting carnitine ester profile in patients with ulcerative colitis

AIM： To determine the plasma carnitine ester profile in adult patients with ulcerative culitis （UC） and compared with healthy control subjects. METHOD： Using ESI triple quadrupole tandem mass spectrometry, the carnitine ester profile was measured in 44 patients with UC and 44 age- and sex-matched healthy controls. RESULTS： There was no significant difference in the fasting free carnitine level between the patients with UC and the healthy controls. The fasting propionyl- （0.331 ± 0.019 vs 0.392 ± 0.017 μmol/L）, butyryl- （0.219 ± 0.014 vs 0.265 ± 0.012）, and isovalerylcarniUne （0.111 ± 0.008 vs 0.134 ± 0.008） levels were decreased in the UC patients. By contrast, the level of octanoyl- （0.147 ± 0.009 vs 0.114 ± 0.008）, decanoyl- （0.180 ± 0.012 vs 0.137 ± 0.008）, myristoyl- （0.048 ± 0.003 vs 0.039 ± 0.003）, palmitoyl- （0.128 ± 0.006 vs 0.109 ± 0.004）, palmitoleyl- （0.042±0.003 vs 0.031 ± 0.002） and oleylcarnitine （0.183 ± 0.007 vs 0.163 ± 0.007; P 〈 0.05 in all comparisons） were increased in the patients with UC. CONCLUSION： Our data suggest selective involvement of the carnitine esters in UC patients, probably due to their altered metabolism.

Cross-sectional evaluation of circulating hepatitis B virus RNA and DNA: Different quasispecies?

BACKGROUND Different forms of pregenomic and other hepatitis B virus(HBV)RNA have been detected in patients’sera.These circulating HBV-RNAs may be useful for monitoring covalently closed circular DNA activity,and predicting hepatitis B eantigen seroconversion or viral rebound after nucleos(t)ide analog cessation.Data on serum HBV-RNA quasispecies,however,is scarce.It is therefore important to develop methodologies to thoroughly analyze this quasispecies,ensuring the elimination of any residual HBV-DNA.Studying circulating HBV-RNA quasispecies may facilitate achieving functional cure of HBV infection.AIM To establish a next-generation sequencing(NGS)methodology for analyzing serum HBV-RNA and comparing it with DNA quasispecies.METHODS Thirteen untreated chronic hepatitis B patients,showing different HBV-genotypes and degrees of severity of liver disease were enrolled in the study and a serum sample with HBV-DNA>5 Log10 IU/mL and HBV-RNA>4 Log10 copies/mL was taken from each patient.HBV-RNA was treated with DNAse I to remove any residual DNA,and the region between nucleotides(nt)1255-1611 was amplified using a 3-nested polymerase chain reaction protocol,and analyzed with NGS.Variability/conservation and complexity was compared between HBV-DNA and RNA quasispecies.RESULTS No HBV-DNA contamination was detected in cDNA samples from HBV-RNA quasispecies.HBV quasispecies complexity showed heterogeneous behavior among patients.The Rare Haplotype Load at 1%was greater in DNA than in RNA quasispecies,with no statistically significant differences(P=0.1641).Regarding conservation,information content was equal in RNA and DNA quasispecies in most nt positions[218/357(61.06%)].In 102 of the remaining 139(73.38%),HBV-RNA showed slightly higher variability.Sliding window analysis identified 4 hyper-conserved sequence fragments in each quasispecies,3 of them coincided between the 2 quasispecies:nts 1258-1286,1545-1573 and 1575-1604.The 2 hyper-variable sequence fragments also coincided:nts 1311-1344 and 1461-1485.Sequences between nts 1519-1543 and 1559-1587 were only hyper-conserved in HBV-DNA and RNA,respectively.CONCLUSION Our methodology allowed analyzing HBV-RNA quasispecies complexity and conservation without interference from HBV-DNA.Thanks to this,we have been able to compare both quasispecies in the present study.

Transient decrease in sound tolerance levels following hearing deprivation in normal-hearing subjects

Objective:To determine the circadian influence on sound sensitivity produced by temporal hearing deprivation in healthy normal human subjects.Design:Participants underwent bilateral earplugging before completion of anthropometry,the author's developed questionnaire,the Hamilton Anxiety and Depression Inventory,pure tone audiometry(PTA),stapedial reflex thresholds(SRT),distortion products otoacoustic emissions input/output(DPOAE-I/O),and uncomfortable loudness levels(ULLs).Afterward,the participants were randomly divided into group A,starting at 8:00 a.m.and finishing at 8:00 p.m.,and group B,starting at 4:00 p.m.and ending at 4:00 a.m.Serum cortisol levels and audiological test results were obtained at the beginning and end of the session and 24-h free urinary cortisol levels were measured.Study sample:Thirty healthy volunteers.Results:PTA was 2.68 and 3.33 dB HL in groups A and B,respectively,with no statistical difference between them.ULLs were significantly lower in group A compared to group B,with an average of 8.1 dB SPL in group A and 3.3 dB SPL in group B(p<0.0001).A SRT shift was observed in group A,with no difference in group B,and a night shift in DPOAE-I/O in group B.Conclusions:Reduced loudness tolerance is demonstrated during daytime hearing deprivation in contrast to nighttime;this may be due to increased central gain in the awake cortex.

Eosinophil associated genes in the inflammatory bowel disease 4 region:Correlation to inflammatory bowel disease revealed

AIM： To study the association between inflammatory bowel disease （IBD） and genetic variations in eosinophil protein X （EPX） and eosinophil cationic protein （ECP）. METHODS： DNA was extracted from ethylene diamine tetraacetic acid blood of 587 patients with Crohn＇s disease （CD）, 592 with ulcerative colitis （UC） and 300 healthy subjects. The EPX405 （G 〉 C, rs2013109）, ECP434 （G 〉 C, rs2073342） and ECP562 （G 〉 C, rs2233860） gene polymorphisms were analysed, by the 5＇-nuclease allelic discrimination assay. For de- termination of intracellular content of EPX and ECP in granulocytes, 39 blood samples was collected and extracted with a buffer containing cetyltrimethylam- monium bromide. The intracellular content of EPX was analysed using an enzyme-linked immunosorbent as- say. The intracellular content of ECP was analysed with the UniCAP system as described by the manufacturer. Statistical tests for calculations of results were χ2 test, Fisher＇s exact test, ANOVA, Student-Newman-Keuls test, and Kaplan-Meier survival curve with Log-rank test for trend, the probability values of P 〈 0.05 were considered statistically significant.RESULTS： The genotype frequency for males with UC and with an age of disease onset of ≥ 45 years （n = 57） was for ECP434 and ECP562, GG = 37%, GC = 60%, CC = 4% and GG = 51%, GC = 49%, CC = 0% respectively. This was significantly different from the healthy subject＇s genotype frequencies of ECP434 （GG = 57%, GC = 38%, CC = 5%; P = 0.010） and ECP562 （GG = 68%, GC = 29%,CC = 3%; P = 0.009）. The genotype frequencies for females, with an age of dis- ease onset of ≥ 45 years with CD （n = 62）, was for the ECP434 and ECP562 genotypes GG = 37%, GC =52%, CC = 11% and GG = 48%, GC = 47% and CC = 5% respectively. This was also statistically different from healthy controls for both ECP434 （P = 0.010） and ECP562 （P = 0.013）. The intracellular protein concen- tration of EPX and ECP was calculated in μg/10^6 eosi- nophils and then correlated to the EPX 405 genotypes. The protein content of EPX was highest in the patients with the CC genotype of EPX405 （GG = 4.65, GC = 5.93, and CC = 6.57） and for ECP in the patients with the GG genotype of EPX405 （GG = 2.70, GC = 2.47 and CC = 1.90）. ANOVA test demonstrated a difference in intracellular protein content for EPX （P = 0.009） and ECP （P = 0.022）. The age of disease onset was linked to haplotypes of the EPX405, ECP434 and ECP562 genotypes. Kaplan Maier curve showed a difference be- tween haplotype distributions for the females with CD （P = 0.003）. The highest age of disease onset was seen in females with the EPX405CC, ECP434GC, ECP562CC haplotype （34 years） and the lowest in females with the EPX405GC, ECP434GC, ECP562GG haplotype （21 years）. For males with UC there was also a difference between the highest and lowest age of the disease on- set （EPX405CC, ECP434CC, ECP562CC, mean 24 years vs EPX405GC, ECP434GC, ECP562GG, mean 34 years, P = 0.0009）. The relative risk for UC patients with ECP434 or ECP562-GC/CC genotypes to develop dys- plasia/cancer was 2.5 （95%CI： 1.2-5.4, P = 0.01） and 2.5 （95%CI： 1.1-5.4, P = 0.02） respectively, compared to patients carrying the GG-genotypes.

Computer Science Tools for Manual Editing of Computed Tomographic Images: Impact on the Quality of 3D Printed Models

Background: Three-dimensional printing (3DP) technologies are a trendsetting topic, also in the field of surgery. Preoperative planning for maxillofacial and neurological surgery, for instance, increasingly involves skull models obtained by 3DP. However, the cranial replicas currently used in this context have been shown to not reproduce the exact anatomy of the individual patient undergoing surgery. Objective: The present study aimed at investigating the extent to which manual editing, using current computer software tools, can improve skull models derived from medical images. Methods: Skull computed tomography (CT) was obtained on three cadavers and?sent to three institutions that provide preoperative 3DP services. Each institute independently?performed 3D reconstructions, including routine manual editing, and subsequently produced the replicas. The models were then qualitatively compared with the respective original skull. For?quantitative comparison surface scans of particular regions of interest were made and the deviations assessed using 3-matic software (Materialise, Leuven, Belgium). Results: Routine manual editing of CT images resulted in replicas that were clear improvements over automatically generated reconstructions. This was particularly the case for teeth artefacts and thin-walled entities (e.g. paranasal sinuses). Conversely, however, many anatomical structures remained incorrectly rendered (e.g. orbitae, pterygoid processes, and sella turcica). Extraosseous calcifications had regularly not been removed. After extensive manual editing, however, replicas were able to provide largely submillimeter accuracy (mean deviation 0.2496 mm;standard deviation ±0.2276 mm). Conclusions: This study confirms that manual editing with current computer science tools does improve the quality of CT-based 3D printed skull models. But, it also demonstrates that a number of structures remain largely incorrectly rendered when edited in the presently used surgical framework. Conversely, it shows that highly accurate replicas are feasible, provided that extensive manual editing is performed.

Sentinel Node in Cutaneous Squamous Cell Carcinoma of the Trunk and Extremities: Experience in a Latin American Reference Center

This paper aims to assess the use of the sentinel node technique in squamous cell carcinoma (SCC) of the trunk and extremities in a Latin American oncology reference center. The descriptive retrospective cohort study included 60 patients diagnosed with SCC of the trunk and extremities, submitted to surgical treatment of the primary tumor and sentinel node biopsy at the breast and soft tissue tumor services of the National Institute of Cancerology (Bogotá, Colombia) over a period of 6 years. The sentinel node was identified in 96.6% (58/60) of the patients. The sentinel node pathology report was negative in 81.7% (49), positive in 15% (9). There were no complications due to the procedure in 85% of the patients. The mean recurrence-free survival time was 8.3 months (CI 95% 5.0 to 11.5 months) in patients with positive sentinel node and 58.6 months (CI 95% 47.8 to 69.3 months) in patients with negative results. Only 4 of 49 patients (8.1%) with negative sentinel node had regional relapse. The study evidenced that the sentinel node technique in patients with high-risk SCC of the trunk and extremities is an adequate staging tool for the lymph node chain, with a low rate of associated complications. This opens an interesting opportunity for prospective cohort studies that can demonstrate statistically significant differences.

A combination extract of Renshen(Panax Ginseng),Yinyanghuo(Herba Epimedii Brevicornus),Yuanzhi(Radix Palygalae) and Jianghuang(Rhizoma Curcumae Longae) decreases glycogen synthase kinase 3β expression in brain cortex of APPV717I transgenic mice

OBJECTIVE： To investigate the neuroprotective mechanism of combination extract of Renshen （Ponax Ginseng）, Yinyanghuo （Herba Epimedii Brevi-comus）, Yuanzhi （Radix Palygalae） and Jianghuang （Rhizoma Curcumae Longae） （GEPT） in treating AI- zheimer＇s disease on the target of glycogen syn- thase kinase 3β（GSK-3β）. METHODS： Three-month-old APPV7171 transgenic mice were randomly divided into ten groups （n=12 per group） and intragastrically administrated vehi- cle or medicines： APP group was given 0.5% CMC, donepezil group was given donepezil （APP ＋ D group） （0.92 mg/kg-1. day-1）, and GEPT groups were given small dose of GEPT （APP＋Gs group） （0.075 g/ kg-1. day-1）, medium dose （APP＋Gm group） （0.15 g/ kg-1. day-1）, and large dose （APP＋GI group） （0.30 g/ kg-1. day-1） for 4 or 8 months, respectively. Three-month-old C57BL/6J mice as vehicle controls （n=12） were given 0.5% CMC for 4 or 8 months as well. The GSK-3β expression in the cortex of 7- and 11-month-old APPV7171 transgenic mice with and without GEPT or donepezil treatment and normal C57BL/6J mice were measured via Western blotting and Immunohistochemistry. RESULTS： Immunohistochemistry analysis showed significant increase of GSK-3β in the cerebral cortex of 7-month-old APP group （compare to control group P=0.003）, while the GSK-313 expression of donepezil or OEPT group were all significantly de-creased （Donepezil vs APP： P=0.041; GI vs APP： P=0.049, Gm vs APP： P=0.029, Gh vs APP： P=0.036）. Western blot analysis showed similar results. The densitometric measures of GSK-3β in APP mice in- creased significantly as compared with the control group （P=0.008）. And the GSK-3β expression indonepezil and GEPT groups were all decreased. There was significant difference between Gh group or donepezil group and the control group （P=0.05）. Similar findings were shown in the 11-month-old mice in each group, except for greater decrease of GSK-3β in the GEPT group. CONCLUSION： GEPT can effectively decrease the level of GSK-3β expression in the brain cortex of AP- PV7171 transgenic mice, and such effect is more sig- nificant in 11-month-old mice. This partially ex- plains the neuroprotecting mechanism of GEPT in preventing and treating of AD.

Reporting quality and effect size comparison in randomized controlled trials of bo's abdominal acupuncture using CONSORT statement and STRICTA

OBJECTIVE: To evaluate the reporting quality of randomized controlled trials(RCT) that compared Bo's abdominal acupuncture with conventional body acupuncture, and compare the efficacy and safetybetweenthembyperforminga Meta-analysis.METHODS: All RCTs comparing Bo's abdominalacupuncture with conventional body acupuncture were included. English and Chinese databases were searched from their respective inceptions to March 2014. The reporting quality was assessed according to the "Consolidated Standards of Reporting Trials"(CONSORT) checklist for parallel RCTs and the revised "Standards for Reporting Interventions in Clinical Trials of Acupuncture"(STRICTA). A Meta-analysis was conducted to synthesize the effect sizes,and publication bias was evaluated by the Egger linear regression test using Stata.RESULTS: Ninety-seven studies were included, of which most lacked adequate reporting information, and 80.4% showed that the efficacy of abdominal acupuncture is superior to conventional body acupuncture, especially for the following diseases:lumbar disc herniation, cervical spondylosis, omarthritis and cervical vertigo, except simple obesity.Effect-sizes were controversial when evaluating different outcomes.CONCLUSION: The international standard CONSORT statement and STRICTA guidelines should be strictly applied when reporting acupuncture RCTs in the future. Abdominal acupuncture appears to be more effective compared with conventional body acupuncture for some diseases. However, further high quality blind RCTs using validated outcomeindexesandstandardreportingarewarranted.

Activity of tamarindus indica pulp water extract in high carbohydrate diet rats as a treatment for obesity and insulin resistance

Obesity is often identified as a nutritional disorder, and this condition continues to be one of the most important yet preventable health hazards. It may be a complex group of diseases and should be characterized as a syndrome that results from an imbalance between energy intake and expenditure. Furthermore, obesity is associated with several diseases such as diabetes mellitus, atherosclerosis, cardiovascular diseases, osteoarthritis, and hypertension. In previous studies, we found that in Asia, especially in the Asean region, carbohydrates are heavily represented in the diet. Therefore, we used a high carbohydrate diet to induce obesity in rats. The aim of this study was to evaluate the potency of Tamarindus indica pulp as an anti-obesity agent in a high carbohydrate diet animal model. The antiobesity effect was evaluated in this in vivo model at doses of 75 mg/kg·bw and 225 mg/kg·bw. Treatment was started in week 3 and week 9, and biochemical characteristics were measured every 3 weeks. In the end of the study period, insulin resistance and adiponectin levels were measured. TIWE(Tamarindus indica water extract) at a dose of 75 mg/kg·bw showed better efficacy than at a dose of 225 mg/kg·bw, and treatment started on week 3 was better than treatment started on week 9. TIWE has an anti-obesity effect associated insulin resistance by increasing adiponectin levels and insulin sensitivity, which can impact body weight, triglyceride levels, blood glucose levels, and body fat.

Chip-based multimodal super-resolution microscopy for histological investigations of cryopreserved tissue sections

Histology involves the observation of structural features in tissues using a microscope.While diffraction-limited optical microscopes are commonly used in histological investigations,their resolving capabilities are insufficient to visualize details at subcellular level.Although a novel set of super-resolution optical microscopy techniques can fulfill the resolution demands in such cases,the system complexity,high operating cost,lack of multi-modality,and low-throughput imaging of these methods limit their wide adoption for histological analysis.In this study,we introduce the photonic chip as a feasible high-throughput microscopy platform for super-resolution imaging of histological samples.Using cryopreserved ultrathin tissue sections of human placenta,mouse kidney,pig heart,and zebrafish eye retina prepared by the Tokuyasu method,we demonstrate diverse imaging capabilities of the photonic chip including total internal reflection fluorescence microscopy,intensity fluctuation-based optical nanoscopy,single-molecule localization microscopy,and correlative light-electron microscopy.Our results validate the photonic chip as a feasible imaging platform for tissue sections and pave the way for the adoption of super-resolution high-throughput multimodal analysis of cryopreserved tissue samples both in research and clinical settings.

关于心脏手术中自体血回收有效性随机试验的荟萃分析

背景在心脏手术中可以通过自体血回收来避免输注同种异体血。另外已有人提出，血液中的碎片可能会增加卒中或神经意识功能障碍的风险，因此，清除回收血中的碎片可改善患者的预后。在此研究中，我们试图通过系统性回顾已发表的随机控制性试验进行荟萃分析，明确在心脏手术中自体血回收的整体安全性和有效性。方法全面检索找出关于所有有关心脏手术中应用自体血回收技术的所有随机试验。截止到2008年11月的MEDLINE、Cochrane图书馆、EMBASE和摘要资料库均被检索完全。将所有心脏手术中应用自体血回收技术与未应用自体血回收技术进行比较，并且报道至少一个明确的临床结果的随机试验均被列为研究对象。随机效应模型被用来依次计算比值比（OR，95％可信区间）、二分法加权平均差（WMD，95％可信区间）和连续变量。结果包括2282例患者在内的31个随机试验最终被作为研究对象进行荟萃分析。在心脏手术中，进行手术中自体血回收减少了接触同种异体异基因血制品（比值比0．63，95％可信区间：0．43—0．94，P=0．02）及红细胞（比值比0．60，95％可信区间：0．39—0．92，P=0．02）的概率，也降低了平均每例患者输注同种异体异基因血制品的总量（加权平均差-256ml，95％可信区间：-416--95ml，P=0．002）。但在以下几个方面进行自体血回收组与未进行自体血回收组之间并无差异，包括：院内死亡率（比值比0．65，95％可信区间：0．25—1．68，P=0．37）、手术后卒中或短暂缺血性发作（比值比0．59，95％可信区间：0．20～1．76，P=0．34）、房颤（比值比0．92，95％可信区间：0．69—1．23，P=0．56）、肾功能衰竭（比值比0．86，95％可信区间：0．41—1．80，P=0．70）、感染（比值比1．25，95％可信区间：0．75—2．10，P=0．39）、接受新鲜冰冻血浆治疗（比值比1．16，95％可信区间：0．82—1．66，P=0．40）以及接受血小板输注治疗（比值比0．90，95％可信区间：0．63—1．28，P=0．55）。结论现有的证据表明应用自体血回收技术可减少心脏手术中患者异体血制品或红细胞的输注。进一步的分析认为，只有在收集失血和（或）剩余机血，或在整个手术过程中应用自体血回收技术才是有利的。如果只在体外循环期间用自体血回收技术作为心内吸引，则对于血液保护没有明显效应且增加新鲜冰冻血浆的输注。