Impact of body mass index on the development of pocket hematoma：A retrospective study in Chinese people

BackgroundPocket hematoma 是与心血管的可植入的电子设备(CIED ) 联系的主要复杂并发症之一培植。在 CIED implantation.MethodsThe 学习是在二个病人(2.2%) 开发了严重袖珍 hematoma 要求的第三级的 hospital.ResultsTwenty 收到在 2008 和 2012 之间的 CIED 培植的 972 个病人的回顾的评论以后，这研究的目的是在袖珍 hematoma 的出现上评估身体团索引(BMI ) 的影响重新干预。hematoma 率(4.6% ， n = 15 ) 有 < 的 BMI 的病人；23 kg/m 2 与有 ≥ 的 BMI 的病人的相比是显著地更高的；23 kg/m 2(1.1% ， n = 7， P <；0.001 ) 。在 multivariate 回归分析， BMI <；23.0 kg/m 2 可以与严重袖珍 hematoma 的发展被联系。在 BMI 的 1.0 kg/m 2 的增加与 hematoma 形成的更低的发生被联系(或：0.84；95% CI：0.74-0.95；P = 0.006 ).ConclusionBMI <；23 kg/m 2 与袖珍 hematoma 的更高的发生被联系，要求重新干预。当病人们与更低的 BMI 时，大照顾必须被拿的数据支持收到了 CIED 培植。

Hotspots and frontiers of the relationship between gastric cancer and depression:A bibliometric study

BACKGROUND A significant relationship between gastric cancer(GC)and depression has been found in the last 20 years.However,there is no comprehensive information that helps researchers find popular and potential research directions on GC and depression.AIM To determine the research status and hotspots by bibliometric analysis of relevant publications on the relationship between GC and depression.METHODS We used the Web of Science Core Collection to search and collate the literature on GC and depression from 2000 to 2022 on 31 May,2023.Then,visualization analysis was performed using VOSviewer software(version 1.6.19)and the Bibliometrix package in R software.RESULTS We retrieved 153 pertinent publications from 2000 to 2022.The annual publication count showed an overall upward trend.China had the most prominent publications and significant contributions to this field(n=64,41.83%).Before 2020,most studies focused on“the effect of GC on the development and progression of depression in patients.”The latest research trends indicate that“the effect of depression on the occurrence and development of GC and its mechanism”will receive more attention in the future.CONCLUSION The study of“the effect of depression on the occurrence and development of GC and its mechanism”has emerged as a novel research theme over the past two years,which may become a research hotspot in this field.This study provides new insights into the hotpots and frontiers of the relationship between GC and depression,potentially guiding researchers toward hot research topics in the future.

Effect of anti-VEGF treatment on retinopathy of prematurity in Zone Ⅱ Stage 3^+

AIM： To evaluate the effect of intravitreal ranibizumab injection for retinopathy of prematurity（ROP） in Zone Ⅱ Stage 3^＋.METHODS： Data was collected for ROP patients with Zone Ⅱ Stage 3^＋ who received intravitreal ranibizumab injections between October 2014 and Janu ary 2017 at the Department of Ophthalmology in our hospital. No prior laser or other intravitreal treatment was done. Prior to the intervention and at each follow-up visit, fundus examination was performed. Gestational age at birth, sex, birth weight, ROP zone, ROP stage, post menstrual age（PMA） at treatment, and follow-up pe riod were recorded. The final clinical status of the retina was evaluated for each patient. The primary outcome mea sures included ROP recurrences requiring re-treatment, complete or incomplete peripheral vascularization.RESULTS： Eighty-six eyes of 46 premature infants with Zone Ⅱ Stage 3~＋ ROP were enrolled in the study. The mean gestational age at birth was 28.18±1.67（range： 25 to 33）wk and the mean birth weight was 1070.57±226.85（range： 720.00 to 1650.00） g. The mean PMA at treatment was 38.32±2.99（range： 32.29 to 46.00）wk. Seventy-one eyes（82.56%） were treated success fully with intravitreal ranibizumab as monotherapy. Fifteen eyes（17.44%） developed recurrent disease. The mean interval between the treatment and retreatment was 5.96±3.22（range： 1.86 to 11.71）wk. All eyes vascularized into zone Ⅲ at the end of the study and among them 62 eyes（72.09%） achieved complete vascu larization.CONCLUSION： Intravitreal ranibizumab injection is an effective treatment in Zone Ⅱ Stage 3^＋ ROP patients. More patients with longer follow-up duration are necessary to confirm the safety and efficacy of this treatment.

Effects of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors on COVID-19

BACKGROUND The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2,the causative agent of coronavirus disease 2019(COVID-19),by September 13.AIM The aim was to investigate whether long-term use of renin-angiotensin-aldosterone system(RAAS)inhibitors for the treatment of hypertension aggravates the performance of COVID-19 patients with hypertension.METHODS This was a retrospective analysis of lung computed tomography(CT)data and laboratory values of COVID-19 patients with hypertension who were admitted to Huoshenshan Hospital,Wuhan,Hubei Province,between February 18 and March 31,2020.Patients were divided into two groups.Group A included 19 people who were long-term users of RAAS inhibitors for hypertension;and group B included 28 people who were randomly selected from the database and matched with group A by age,sex,basic diseases,and long-term use of other antihypertensive drugs.All patients underwent a series of CT and laboratory tests.We compared the most severe CT images of the two groups and the laboratory examination results within 2 d of the corresponding CT images.RESULTS The time until the most severe CT images from the onset of COVID-19 was 30.37±14.25 d group A and 26.50±11.97 d in group B.The difference between the two groups was not significant(t=1.01,P=0.32).There were no significant differences in blood laboratory values,C-reactive protein,markers of cardiac injury,liver function,or kidney function between the two groups.There was no significant difference in the appearance of the CT images between the two groups.The semiquantitative scores of each involved lobe were 11.84±5.88 in group A and 10.36±6.04 group B.The difference was not significantly different(t=0.84,P=0.41).CONCLUSION Chest CT is an important imaging tool to monitor the characteristics of COVID-19 and the degree of lung injury.Chronic use of RAAS inhibitors is not related to the severity of COVID-19,and it does not worsen the clinical process.

RASSF1A methylation as a biomarker for detection of colorectal cancer and hepatocellular carcinoma

BACKGROUND Studies have validated the potential of methylated cell-free DNA as a biomarker in various tumors,and methylated DNA in plasma may be a potential biomarker for cancer.AIM To evaluate the diagnostic value of RASSF1A methylation in plasma for colorectal cancer(CRC)and hepatocellular carcinoma(HCC).METHODS A total of 92 CRC patients,67 colorectal polyp(CRP)patients,63 HCC patients,and 66 liver cirrhosis(LC)patients were enrolled.The plasma DNA was subjected to DNA extraction,double-strand DNA concentration determination,bisulfite conversion,purification,single-strand DNA concentration determination,and digital polymerase chain reaction(PCR)detection.The methylation rate was calculated.The diagnostic value was evaluated by the area under the curve(AUC).RESULTS The age and sex in the CRC and CRP groups and the HCC and LC groups were also matched.The DNA methylation rate of RASSF1A in plasma in the CRC group was 2.87±1.80,and that in the CRP group was 1.50±0.64.DNA methylation of RASSF1A in plasma showed a significant difference between the CRC and CRP groups.The AUC of RASSF1A methylation for discriminating the CRC and CRP groups was 0.82(0.76-0.88).The AUCs of T1,T2,T3 and T4 CRC and CRP were 0.83(0.72-0.95),0.87(0.78-0.95),0.86(0.77-0.95),and 0.75(0.64-0.85),respectively.The DNA methylation rate of RASSF1A in plasma in the HCC group was 4.45±2.93,and that in the LC group was 2.46±2.07.DNA methylation of RASSF1A in plasma for the HCC and LC groups showed a significant difference.The AUC of RASSF1A methylation for discriminating the HCC and LC groups was 0.70(0.60-0.79).The AUCs of T1,T2,T3 and T4 HCC and LC were 0.80(0.61,1.00),0.74(0.59-0.88),0.60(0.42-0.79),and 0.68(0.53-0.82),respectively.CONCLUSION RASSF1A methylation in plasma detected by digital PCR may be a potential biomarker for CRC and HCC.

Timing of convalescent plasma therapy-tips from curing a 100-yearold COVID-19 patient using convalescent plasma treatment: A case report

BACKGROUND Convalescent plasma therapy is used for the treatment of critically ill patients for newly discovered infectious diseases,such as coronavirus disease 2019(COVID-19)pneumonia,under the premise of lacking specific treatment drugs and corresponding vaccines.But the best timing application of plasma therapy and whether it is effective by antiviral and antibiotic treatment remain unclear.CASE SUMMARY We describe a patient with COVID-19,a 100-year-old,high-risk,elderly male who had multiple underlying diseases such as stage 2 hypertension(very high-risk group)and infectious pneumonia accompanied by chronic obstructive pulmonary disease and emphysema.We mainly describe the diagnosis,clinical process,and treatment of the patient,including the processes of two plasma transfusion treatments.CONCLUSION This provides a reference for choosing the best timing of convalescent plasma treatment and highlights the effectiveness of the clinical strategy of plasma treatment in the recovery period of patients with COVID-19 pneumonia.

Evaluation of the diagnostic value of serum-based proteomics for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.

Early detection of colorectal cancer based on circular DNA and common clinical detection indicators

BACKGROUND Colorectal cancer(CRC) is the third most common cancer worldwide, and it is the second leading cause of death from cancer in the world, accounting for approximately 9% of all cancer deaths. Early detection of CRC is urgently needed in clinical practice.AIM To build a multi-parameter diagnostic model for early detection of CRC.METHODS Total 59 colorectal polyps(CRP) groups, and 101 CRC patients(38 early-stage CRC and 63 advanced CRC) for model establishment. In addition, 30 CRP groups,and 62 CRC patients(30 early-stage CRC and 32 advanced CRC) were separately included to validate the model. 51 commonly used clinical detection indicators and the 4 extrachromosomal circular DNA markers NDUFB7, CAMK1D, PIK3CD and PSEN2 that we screened earlier. Four multi-parameter joint analysis methods:binary logistic regression analysis, discriminant analysis, classification tree and neural network to establish a multi-parameter joint diagnosis model.RESULTS Neural network included carcinoembryonic antigen(CEA), ischemia-modified albumin(IMA),sialic acid(SA), PIK3CD and lipoprotein a(LPa) was chosen as the optimal multi-parameter combined auxiliary diagnosis model to distinguish CRP and CRC group, when it differentiated 59CRP and 101 CRC, its overall accuracy was 90.8%, its area under the curve(AUC) was 0.959(0.934,0.985), and the sensitivity and specificity were 91.5% and 82.2%, respectively. After validation,when distinguishing based on 30 CRP and 62 CRC patients, the AUC was 0.965(0.930-1.000), and its sensitivity and specificity were 66.1% and 70.0%. When distinguishing based on 30 CRP and 32early-stage CRC patients, the AUC was 0.960(0.916-1.000), with a sensitivity and specificity of 87.5% and 90.0%, distinguishing based on 30 CRP and 30 advanced CRC patients, the AUC was 0.970(0.936-1.000), with a sensitivity and specificity of 96.7% and 86.7%.CONCLUSION We built a multi-parameter neural network diagnostic model included CEA, IMA, SA, PIK3CD and LPa for early detection of CRC, compared to the conventional CEA, it showed significant improvement.

Exploration of pathogenic microorganism within the small intestine of necrotizing enterocolitis

Background Necrotizing enterocolitis(NEC)is the most common severe gastrointestinal emergency in neonates.We designed this study to identify the pathogenic microorganisms of NEC in the microbiota of the small intestine of neonates.Methods Using the 16S ribosomal DNA(rDNA)sequencing method,we compared and analyzed the structure and diversity of microbiotas in the intestinal feces of different groups of neonates:patients undergoing jejunostomy to treat NEC(NP group),neonates undergoing jejunostomy to treat other conditions(NN group),and neonates with NEC undergoing conservative treatment(NC group).We took intestinal feces and saliva samples from patients at different time points.Results The beta diversities of the NP,NN,and NC groups were all similar.When comparing the beta diversities between different time points in the NP group,we found similar beta diversities at time points El to E3 but significant differences between the E2-E3 and E4 time points:the abundances of Klebsiella and Enterococcus(Proteobacteria)were higher at the E1-E3 time points;the abundance of Escherichia-Shigella(Proteobacteria)increased at the E2 time point,and the abundance of Klebsiella decreased significantly,whereas that of Streptococcus increased significantly at the E4 time point.Conclusions Our results suggest that the pathological changes of intestinal necrosis in the small intestine of infants with NEC are not directly caused by excessive proliferation of pathogenic bacteria in the small intestine.The sources of microbiota in the small intestine of neonates,especially in premature infants,may be affected by multiple factors.

An online diabetic retinopathy screening tool for patients with type 2 diabetes

AIM:To develop a useful diabetic retinopathy(DR)screening tool for patients with type 2 diabetes mellitus(T2DM).METHODS:A DR prediction model based on the Logistic regression algorithm was established on the development dataset containing 778 samples(randomly assigned to the training dataset and the internal validation dataset at a ratio of 7:3).The generalization capability of the model was assessed using an external validation dataset containing 128 samples.The DR risk calculator was developed through We Chat Developer Tools using Java Script,which was embedded in the We Chat Mini Program.RESULTS:The model revealed risk factors(duration of diabetes,diabetic nephropathy,and creatinine level)and protective factors(annual DR screening and hyperlipidemia)for DR.In the internal and external validation,the recall ratios of the model were 0.92 and 0.89,respectively,and the area under the curve values were 0.82 and 0.70,respectively.CONCLUSION:The DR screening tool integrates education,risk prediction,and medical advice function,which could help clinicians in conducting DR risk assessments and providing recommendations for ophthalmic referral to increase the DR screening rate among patients with T2DM.

化学药及中草药的代谢与转运:从分子到疾病

Detailed ADME (absorption, distribution, metabolism and excretion) evaluation is required in the preclinical stage of drug development. The preclinical ADME data may be extrapolated to humans and some predictions may be made with the application of proper pharmacokinetic and pharmacodynamic principles. Novel drugs with validated drug targets and favorable ADME properties are being sought by drug scientists, and oral administration is becoming a major delivery approach for many drugs due to its great safety, reduced cost, improved quality of life, and the potential for improved efficacy. The incorporation of herbal therapy into the main stream medical-care system has been encouraged by World Health Organization (WHO). Chinese herbal medicines may represent an important group of multi-component therapeutics suitable for the management of diseases with networked abnormalities such as cancer and diabetes. However, the disposition pathways, pharmacological targets and safety profiles of most Chinese herbal medicines are unknown or not well characterized. The evidence for the use of Chinese herbal medicines as effective and safe multi-component therapeutics is not established. The quality control and standardization of these natural products still constitute a major challenge in their evidence-based clinical application. Recently, there is an increased interest in the incorporation of systems biology approaches and combined use of preclinical and clinical models in understanding the complex disposition pathways, multiple targets and toxicities of Chinese herbal medicines. Like synthetic drugs, Chinese herbal medicines are subject to similar ADME processes in the body like synthetic drugs. However, data are scant on the ADME of most Chinese herbal medicines. Thus, it is important to characterize ADME for both drugs and Chinese herbal medicines. My research team and collaborators have synthesized several small molecule novel compounds for cancer treatment, including 5,6-dimethylxanthenone-4-acetic acid (DMXAA, an antiangiogenic agent and TNF-( inducer) and SYUIQ-5, a novel telomerase inhibitor. The metabolic pathways and transport properties of both DMAA and SYUIQ-5 have been characterized. We have also investigated the metabolism and transport of the major active components of several commonly used Chinese herbal medicines, such as Danshen (Salvia miltiorrhiza) and ginkgo (Ginkgo biloba) using a combination of in vitro and in vivo models. It is believed that ADME studies are necessary and important for both synthetic drugs and Chinese herbal medicines in an attempt to establish their efficacy and safe-ty profiles.

Droplet digital polymerase chain reaction assay for methylated ring finger protein 180 in gastric cancer

BACKGROUND Gastric cancer(GC)is one of the most prevalent malignant tumors that endangers human health.Early diagnosis is essential for improving the prognosis and survival rate of GC patients.Ring finger protein 180(RNF180)is involved in the regulation of cell differentiation,proliferation,apoptosis,and tumorigenesis,and aberrant hypermethylation of CpG islands in the promoter is strongly associated with the occurrence and development of GC.Thus,methylated RNF180 can be used as a potential biomarker for GC diagnosis.AIM To use droplet digital polymerase chain reaction(ddPCR)to quantify the methylation level of the RN180 gene.A reproducible ddPCR assay to detect methylated RNF180 from trace DNA was designed and optimized.METHODS The primer and probe were designed and selected,the conversion time of bisulfite was optimized,the ddPCR system was adjusted by primer concentration,amplification temperature and amplification cycles,and the detection limit of ddPCR was determined.RESULTS The best conversion time for blood DNA was 2 h 10 min,and that for plasma DNA was 2 h 10 min and 2 h 30 min.The results of ddPCR were better when the amplification temperature was 56°C and the number of amplification cycles was 50.Primer concentrations showed little effect on the assay outcome.Therefore,the primer concentration could be adjusted according to the reaction system and DNA input.The assay required at least 0.1 ng of input DNA.CONCLUSION In summary,a ddPCR assay was established to detect methylated RNF180,which is expected to be a new diagnostic biomarker for GC.

Liver resection for hepatocellular carcinoma larger than 10 cm: A multi-institution long-term observational study

BACKGROUND The treatment of hepatocellular carcinoma(HCC)≥10 cm remains a challenge.AIM To consolidate the role of surgical resection for HCC larger than 10 cm.METHODS Eligible HCC patients were identified from the Chang Gung Research Database,the largest multi-institution database,which collected medical records of all patients from Chang Gung Memorial Foundation.The surgical outcome of HCC≥10 cm(L-HCC)was compared to that of HCC<10 cm(S-HCC)(model 1).The survival of L-HCC after either liver resection or transarterial chemoembolization(TACE)was also analyzed(model 2).The long-term risks of all-cause mortality and recurrence were assessed to consolidate the role of surgery for L-HCC.RESULTS From January 2004 to July 2015,a total of 32403 HCC patients were identified from the Chang Gung Research Database.Among 3985 patients who received liver resection,3559(89.3%)had S-HCC,and 426 had L-HCC.The L-HCC patients had a worse disease-free survival(0.27 for L-HCC vs 0.40 for S-HCC)and overall survival(0.18 for L-HCC vs 0.45 for S-HCC)than the S-HCC after liver resection(both P<0.001).However,the surgical and long-term outcome of resected L-HCC had improved dramatically in the recent decades.After adjusting for covariates,surgery could provide a better outcome for L-HCC than TACE(adjusted hazard ratio of all-cause mortality:0.46,95%confidence interval:0.38-0.56 for surgery).Subgroup analysis stratified by different stages showed similar trend of survival benefit among L-HCC patients receiving surgery.CONCLUSION Our study demonstrated an improving surgical outcome for HCC larger than 10 cm.Under selected conditions,surgery is better than TACE in terms of disease control and survival and should be performed.Due to inferior survival,a subclassification within T1 stage should be considered.Future studies are mandatory to confirm our findings.

Lu Xun＇s View of the Awakening of the Chinese People--Was There Really an ＂Epistemological Break＂？

It has been argued that, starting in the late 1920s, Lu Xun＇s intellectual development underwent a significant transformation constituting what the French Marxist philosopher Louis Althusser has termed an ＂epistemological break.＂ Some of the explicitly more positive comments about the masses that Lu Xun made in his later years have been used to demonstrate this point. However, the existence of such a ＂break＂ is still debatable, and a detailed examination of Lu Xun＇s apparently optimistic comments reveals that Lu Xun possessed a more sophisticated understanding of the masses and the Chinese people. His understanding was informed by the concept of ＂national character.＂ This paper attempts to demonstrate the consistency of Lu Xun＇s view of the masses and the Chinese people and to resolve an apparent self-contradiction in Lu Xun＇s arguments.

Intravitreally injected ranibizumab versus photodynamic therapy for CNV secondary to choroidal osteoma:a 7-year follow-up case report

Dear Editor,We present a case of bilateral choroidal neovascularization(CNV)secondary to choroidal osteoma involving the macula and investigate the effect of intravitreal injection of ranibizumab and photodynamic therapy(PDT)in a sevenyear follow-up.Informed consent for patient information and images to be published was obtained from the patient included in the study based on the Declaration of Helsinki,which was approved by the Ethics Committee of Southwest Hospital.

Blood index panel for gastric cancer detection

BACKGROUND Gastric cancer is a common malignant tumor.Early detection and diagnosis are crucial for the prevention and treatment of gastric cancer.AIM To develop a blood index panel that may improve the diagnostic value for discriminating gastric cancer and gastric polyps.METHODS Thirteen tumor-related detection indices,38 clinical biochemical indices and 10 cytokine indices were examined in 139 gastric cancer patients and 40 gastric polyp patients to build the model.An additional 68 gastric cancer patients and 22 gastric polyp patients were enrolled for validation.After area under the curve evaluation and univariate and multivariate analyses.RESULTS Five tumor-related detection indices,12 clinical biochemical indices and 1 cytokine index showed significant differences between the gastric cancer and gastric polyp groups.Carbohydrate antigen(CA)724,phosphorus(P)and ischemia-modified albumin(IMA)were included in the blood index panel,and the area under the curve(AUC)of the index panel was 0.829(0.754,0.905).After validation,the AUC was 0.811(0.700,0.923).Compared to the conventional index CA724,the blood index panel showed significantly increased diagnostic value.CONCLUSION We developed an index model that included CA724,P and IMA to discriminate the gastric cancer and gastric polyp groups,which may be a potential diagnostic method for clinical practice.

Detection rates of adenomas,advanced adenomas,and colorectal cancers among the opportunistic colonoscopy screening population:a single-center,retrospective study

Background: Colorectal cancer (CRC) screening is effective in reducing CRC incidence and mortality. The aim of this study was to retrospectively determine and compare the detection rate of adenomas, advanced adenomas (AAs) and CRCs, and the number needed to screen (NNS) of individuals in an average-risk Chinese population of different ages and genders. Methods: This was a retrospective study performed at the Institute of Health Management, Chinese People’s Liberation Army General Hospital. Colonoscopy results were analyzed for 53,152 individuals finally enrolled from January 2013 to December 2019. The detection rate of adenomas, AAs, or CRCs was computed and the characteristics between men and women were compared using chi-squared test. Results: The average age was 48.8 years (standard deviation [SD], 8.5 years) for men and 50.0 years (SD, 9.0 years) for women, and the gender rate was 66.27% (35,226) vs . 33.73% (17,926). The detection rates of adenomas, AAs, serrated adenomas, and CRCs were 14.58% (7750), 3.09% (1641), 1.23% (653), and 0.59% (313), respectively. Men were statistically significantly associated with higher detection rates than women in adenomas (17.20% [6058/35,226], 95% confidence interval [CI] 16.74-17.53% vs . 9.44% [1692/17,926], 95% CI 8.94-9.79%, P < 0.001), AAs (3.72% [1309], 95% CI 3.47-3.87% vs . 1.85% [332], 95% CI 1.61-2.00%, P < 0.001), and serrated adenomas (1.56% [548], 95% CI 1.43-1.69% vs . 0.59% [105], 95% CI 0.47-0.70%, P < 0.001). The detection rate of AAs in individuals aged 45 to 49 years was 3.17% (270/8510, 95% CI 2.80-3.55%) in men and 1.69% (69/4091, 95% CI 1.12-1.86%) in women, and their NNS was 31.55 (95% CI 28.17-35.71) in men and 67.11 (95% CI 53.76-89.29) in women. The NNS for AAs in men aged 45 to 49 years was close to that in women aged 65 to 69 years (29.07 [95% CI 21.05-46.73]). Conclusions: The detection rates of adenomas, AAs, and serrated adenomas are high in the asymptomatic population undergoing a physical examination and are associated with gender and age. Our findings will provide important references for effective population-based CRC screening strategies in the future.

On Zhang Jingsheng＇s Sexual Discourse： Women＇s Liberation and Translated Discourses on Sexual Differences in 1920s China

This article explores and re-evaluates Zhang Jingsheng＇s views on sex education and aesthetic education, as revealed in his book Sexual Histories and in articles that he published in the journal New Culture. His endorsement of sex education and aesthetic education constructed a sexual discourse, advocating the redefinition- of Chinese men and women＇s gender and sexuality through knowledge/power. Zhang Jingsheng highly valued eugenics and ＂aesthetic sexual intercourse,＂ and he attempted to use sex education to improve Chinese people＇s innate physical weakness and their ＂androgynous＂ sexual characteristics. By prescribing an aesthetic education that covered all fundamental aspects of life, he also attempted to remedy what he saw as the inadequate or inverted models of masculinity and femininity available to Chinese men and women. Furthermore, by collecting and analyzing articles solicited for Sexual Histories and letters addressed to New Culture, he discussed how to cure the sexual perversions that were associated with Chinese men and women＇s sexualities. Finally, this article compares the contents of New Culture with the discourses （in Chinese and other languages） on sexual difference published in other Chinese journals in the 1920s, including how the discourses on sexual difference by Havelock Ellis and Edward Carpenter were translated into the modern Chinese context. The article concludes that the contributors to New Culture held unified opinions on the issues of homosexuality and women＇s liberation. Thus, in comparison with journals such as The Chinese Educational Review, The Ladies ＇Journal, and New Women, New Culture was less tolerant of divergent opinions. Although Zhang supported sexual liberation, he nonetheless sought to eliminate homosexuality from the aesthetic society that he envisioned. His idea of sexual liberation tended to signify women＇s liberation and excluded a homosexual agenda because he was homophobic. For most of the May Fourth Generation, including Zhang Jingsheng,sexual and women＇s liberation were not equivalent to self-liberation. Instead, the concepts of sexual liberation and women＇s liberation were invoked to re-code the bodies of Chinese men and women, with the aim of creating a ＂Strong Breed to Rescue the Nation.＂