With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming a...With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.展开更多
BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high ma...BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high malignant potential,HPs have a low risk of potential harm,whereas sporadic FGPs have no malignant potential.It is not enough to determine the type and displacement of a polyp by biopsy alone;therefore,some polyps may require an extensive biopsy or complete resection.AIM To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.METHODS This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.RESULTS In a series of 10000 patients who underwent upper gastrointestinal endoscopy,384(3.84%)had GPs.There were 98 males(25.5%)and 286 females(74.5%).The mean age of patients was 62.8±10.4(36-75)years.The frequencies of HPs,APs,and FGPs were 88.5%,5.2%,and 2.1%,respectively.The polyp size of 274 patients(71.3%)was≤1 cm.Polyps were found in 262 cases(68.2%).The most common sites for polyps were the lumen and body of the intestine.Endoscopic polypectomy was performed in 128 patients.Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.CONCLUSION The incidence of GPs was low.HPs were the most common types of GPs.Of note,as GPs have the potential to develop into adenocarcinoma or precancerous lesions,we suggest that appropriate GP resection technology(e.g.,biopsy forceps or mesenchymal resection)be applied.展开更多
Colorectal polyps remain a significant health concern because they can develop into cancer.Therefore,accurate assessment and diagnosis of polyps,along with appropriate treatment decisions,are crucial in preventing com...Colorectal polyps remain a significant health concern because they can develop into cancer.Therefore,accurate assessment and diagnosis of polyps,along with appropriate treatment decisions,are crucial in preventing complications or malignant transformation.Some polyps are classified as complex polyps,which means they fail to elevate due to a scar from a previously removed polyp or can be determined by a scoring system like the size/morphology/site/access score,which considers factors like site,morphology,size,and access.Management of complex colorectal polyps involves various options,including endoscopic and surgical approaches.Endoscopic mucosal resection(EMR)may be challenging in scarred polyps,as inadequate lifting can result in incomplete resection or recurrence.As a more advanced alternative,endoscopic submucosal dissection(ESD)is suitable for larger lesions,enabling en-bloc resection even in complex cases with EMR.However,ESD requires expertise and is more time-consuming than EMR,often necessitating hospitalization due to its complexity.Endoscopic full-thickness resection could be a viable alternative for managing scarred polyps.Endoscopic powered resection,either alone or in combination with other modalities,can also be used to achieve less extensive resection.Managing complications during the procedure or post-procedurally is equally important,as bleeding or perforations can be fatal.Careful patient selection based on individual profiles and risk factors,along with the identification of any signs of malignancy,is crucial before treatment to avoid negative post-treatment outcomes.展开更多
In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and the...In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and their prevalence remains unclear.Most GBPs in children are benign,and although the risk of malignancy is influenced by polyp size,growth rate,and morphology,specific criteria for the pediatric population are lacking.Management,therefore,is based on adult guidelines,with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation,while surveillance is applied to asymptomatic patients with smaller polyps.Further research is needed to develop pediatric-specific guidelines for the management of GBPs.This review discusses the classification,diagnosis,risk factors,and management of pediatric GBPs.展开更多
Gastric polyps are commonly detected during upper gastrointestinal endoscopy.They are most often benign and rarely become malignant.Nevertheless,adequate knowledge,diagnostic modalities,and management strategies shoul...Gastric polyps are commonly detected during upper gastrointestinal endoscopy.They are most often benign and rarely become malignant.Nevertheless,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.展开更多
This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundance...This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundances of Klebsiella,Parvimonas,and Clostridium increase,while those of Bifidobacterium and Lactoba-cillus decrease.This dysbiosis may promote the formation and recurrence of polyps.Similar microbial changes have also been observed in colorectal cancer,inflammatory bowel disease,autism spectrum disorder,and metabolic syndrome,indicating the role of increased pathogens and decreased probiotics in these conditions.Regulating the gut microbiota,particularly by increasing probiotic levels,may help prevent polyp recurrence and promote gut health.This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.展开更多
BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk...BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk factors for recurrence remain unknown.AIM To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.METHODS Overall,362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included.We screened basic demographic data,clinical and polyp characteristics,surgery-related information,and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses.The multivariate analysis results were used to construct a nomogram prediction model,internally validated using Bootstrapping,with performance evaluated using area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS CP re-occurred in 166(45.86%)of the 362 patients within 1 year post-surgery.Multivariate logistic regression analysis showed that age(OR=1.04,P=0.002),alcohol consumption(OR=2.07,P=0.012),Helicobacter pylori infection(OR=2.34,P<0.001),polyp number>2(OR=1.98,P=0.005),sessile polyps(OR=2.10,P=0.006),and adenomatous pathological type(OR=3.02,P<0.001)were independent risk factors for post-surgery recurrence.The nomogram prediction model showed good discriminatory(AUC=0.73)and calibrating power,and decision curve analysis showed that the model had good clinical benefit at risk probabilities>20%.CONCLUSION We identified multiple independent risk factors for short-term recurrence after endoscopic surgery.The nomogram prediction model showed a certain degree of differentiation,calibration,and potential clinical applicability.展开更多
Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data dat...Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.展开更多
BACKGROUND Inflammatory fibroid polyps(IFPs)are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors.IFPs can occur in any part of the gastrointestinal tract but are most preval...BACKGROUND Inflammatory fibroid polyps(IFPs)are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors.IFPs can occur in any part of the gastrointestinal tract but are most prevalent in the stomach,particularly in the gastric antrum.With a low incidence in clinical practice and a lack of distinct endoscopic features,the preoperative diagnosis rate of IFP is disappointingly low,often leading to missed diagnoses or misdiagnoses.CASE SUMMARY A 43-year-old man,hospitalized with abdominal pain and distension,underwent his first gastroscopy in 2020,which revealed chronic superficial erosive gastritis.From 2021 to 2022,his condition progressed from antral ulcers to a 2.0 cm gastric antrum bulge of an unclear nature.After proton pump inhibitor treatment,the lesion shrank but did not heal completely.Following a thorough assessment using magnifying endoscopy with narrow-band imaging,gastric-enhanced computed tomography,and endoscopic ultrasonography,endoscopic submucosal dissection was performed on the identified lesion.A subsequent postoperative pathological examination conclusively diagnosed the lesion as an IFP.At 6 months follow-up,no recurrence or metastasis was observed,with good mucosal scar healing.CONCLUSION Through using multiple diagnostic and therapeutic test results,an IFP with an unusual morphology could be identified.展开更多
Colorectal cancer(CRC)is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide.In this regard,CRC screening is one of the most important issues in modern preventive medicine...Colorectal cancer(CRC)is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide.In this regard,CRC screening is one of the most important issues in modern preventive medicine.Colorectal polyps are potential predictors of CRC,and therefore represent one of the leading targets for screening colonoscopy.The difficulty of analyzing the information obtained during colonoscopy,including the size,location,shape,type of polyps,the need to standardize morphological data,determines that recently a number of works have promoted the opinion on the advisability of using various artificial intelligence(AI)methods to improve the effectiveness of endoscopic screening for CRC.At the same time,they point to a number of errors and methodological problems in the use of AI systems for the diagnosis of colorectal polyps.In this regard,the interpretation of the work of Shi et al,devoted to the use of a machine learning-based predictive model for monitoring the results of colorectal polypectomy,is undoubtedly interesting.In our opinion,the prospects for using AI to assess endoscopic screening for CRC look certainly positive,but the road to its widespread use will not be easy.展开更多
OBJECTIVE:To investigate the therapeutic effects of Chinese medicine Weifuchun(WFC,胃复春)on gastric fundic gland polyps(FGPs).METHODS:FGPs organoids were constructed with patients-derived samples.The morphology and s...OBJECTIVE:To investigate the therapeutic effects of Chinese medicine Weifuchun(WFC,胃复春)on gastric fundic gland polyps(FGPs).METHODS:FGPs organoids were constructed with patients-derived samples.The morphology and size of FGPs organoids were detected using bright-field imaging.Effective components and corresponding potential targets of WFC were screened using multiple opensource databases and research on Traditional Chinese Medicine or compound formulas.Core genes were identified through protein-protein interaction networks.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses of the core genes were conducted.The interactions between main components and core targets were analyzed through the Ferr Db database.The expressions of core targets were detected by quantitative real-time polymerase chain reaction(q RT-PCR).RESULTS:After WFC treatment,the number and size of FGPs organoids were significantly reduced.Twenty nine active drug components and 162 candidate targets of WFC for treating FGPs were identified,including 37 targets related to ferroptosis.Quercetin,Glaucocalyxin B,Melissoidesin U,Melissoidesin O,Hesperetin,Glaucocalyxin A,Angustifolin,Melissoidesin M,Di-n-octyl phthalate,and beta-sitosterol were identified as the main active compounds.SRC proto-oncogene,non-receptor tyrosine kinase,signal transducer and activator of transcription 3,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta,phosphoinositide-3-kinase regulatory subunit 1,and AKT serine/threonine kinase 1 were identified as the primary targets.KEGG pathways related to carcinogenesis,cell proliferation and metabolism,and oxidative stress.WFC promoted FGPs organoids'death and could be reversed by ferroptosis inhibitor of Erastin.The q RT-PCR results showed that WFC treatment could regulate the m RNA expression levels of solute carrier family 7 member 11,acyl-Co A synthetase long chain family member 4,and arachidonate 15-lipoxygenase,type B.CONCLUSION:WFC may exert its therapeutic effects by inducing ferroptosis in FGPs cells.展开更多
BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has ass...BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has assessed the relationship between TN and adenomatous colonic polyps.AIM To assess the association between adenomatous colonic polyps,thyroid-stimulating hormone,and TN.METHODS We searched PubMed,MEDLINE,Cochrane Library,EBSCO,and the first 100 articles in Google for articles published in English from inception until April 2025.We included prospective cohorts,retrospective studies,case-control studies,and cross-sectional studies.The keywords thyroid nodules,adenomatous colon polyps,thyroid volume,metabolic syndrome,insulin resistance,and thyroid malignancy were used.RESULTS Out of 237 articles,25 full texts were reviewed,and 5 full texts were included in the final meta-analysis.No relationship was found between TN,colonic polyps,and thyroid-stimulating hormone levels[odd ratio(OR):1.78,95%confidence interval(CI):0.55-5.74,P=0.33].Colonic polyps were more common among patients with TN when addressing heterogeneity(OR:0.42,95%CI:0.30-0.52,P<0.001 and OR:0.08,95%CI:0.70-0.86,P=0.85).CONCLUSION TN were similar among patients with and without adenomatous colonic polyps.However,TN was more common among colon polyps when addressing the heterogeneity.Thyroid-stimulating hormone was not different between those with and without TN.Age,sex,adiposity,and smoking effects might explain the higher rate observed by the included studies.Further studies controlling for the same are needed.展开更多
BACKGROUNDColorectal cancer(CRC)typically progresses from benign colorectal polyps,whichrepresent a precursor to malignancy.Identifying the factors influencing thisprogression is crucial for early intervention and pre...BACKGROUNDColorectal cancer(CRC)typically progresses from benign colorectal polyps,whichrepresent a precursor to malignancy.Identifying the factors influencing thisprogression is crucial for early intervention and prevention.Although genetic andenvironmental factors have been widely studied,the role of lifestyle factors suchas physical activity,diet,smoking,sleep,and stress remains underexplored,especially in patients with early stage CRC or polyps.Recent evidence suggeststhat lifestyle behaviors may influence cancer progression by modulating inflammatorypathways,metabolic health,and immune function.For instance,highlevels of physical activity are linked to a reduced risk of CRC development,whereas poor dietary habits,smoking,and inadequate sleep have all beenimplicated in increased cancer risk and progression.Moreover,early-stage CRCpatients,who are often asymptomatic or have minimal symptoms,may particularlybenefit from lifestyle modifications to slow disease progression andimprove overall prognosis.The gap in understanding the specific influence ofthese lifestyle factors on colorectal polyps and early stage cancer progressionunderscores the need for comprehensive studies.By assessing several modifiablelifestyle factors and their association with disease progression,clinicians canidentify practical intervention points.These interventions could ultimately reducethe need for more aggressive treatments and improve the long-term outcomes inaffected patients.AIMTo investigate the association between lifestyle factors and disease progression inpatients with colorectal polyps and early stage cancer.METHODSIn this observational study conducted from January 2022 to December 2023,werecruited 120 patients with colorectal polyps or early stage cancer from Jiangshan People's Hospital.Lifestyle factors,including physical activity,dietary patterns,smoking status,sleep quality,andstress levels,were assessed using validated questionnaires.Disease progression was evaluated using standardizedfollow-up colonoscopies and pathological examinations.Cox proportional hazards models were used to analyzethe association between lifestyle factors and disease progression after adjusting for potential confounders.RESULTSDuring the median follow-up of 18.4 months,42(35.0%)patients experienced disease progression.High levels ofphysical activity were associated with reduced progression risk[adjusted hazard ratio(HR)0.55,95%confidenceinterval(CI):0.38-0.80,P=0.002]compared to low activity levels.High adherence to a healthy dietary patternshowed similar protective effects(adjusted HR 0.62,95%CI:0.43-0.89,P=0.009).Current smoking(adjusted HR1.92,95%CI:1.35-2.73,P<0.001)and poor sleep quality(adjusted HR 1.38,95%CI:1.05-1.82,P=0.021)wereassociated with increased progression risk.The impact of lifestyle factors was particularly pronounced in patientsyounger than 60 years and those with multiple polyps at baseline.CONCLUSIONThis study demonstrated significant associations between lifestyle factors and disease progression in colorectalpolyps and early stage cancer.Physical activity,dietary patterns,smoking status,and sleep quality have emergedas key modifiable factors influencing disease progression.These findings support the integration of lifestyleassessments and modifications in the clinical management of patients with colorectal neoplasia.展开更多
BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrason...BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrasonography(EUS),but atypical EUS features have also been reported.Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations.At present,there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages.We hypothesize that gastric IFPs at different pathological stages may have different EUS features.AIM To describe EUS features of gastric IFPs and compare with their pathological characteristics.METHODS Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected.All patients underwent preoperative EUS.We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.RESULTS Most gastric IFPs showed medium-low echo(67.9%),homogeneous echo(90.6%),and unclear boundaries(83%),and involved the second and third layers of the gastric wall(69.8%)under EUS.The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP.Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo.Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo.Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity.The accuracy of EUS in diagnosing gastric IFPs was 66.0%(35/53),and the accuracy in determining the origin layer of gastric IFPs was 73.4%(39/53).CONCLUSION Gastric IFPs at different pathological stages have different EUS features.In order to improve the diagnostic rate,it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.展开更多
BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the p...BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the patient,operators,and the tools used.The use of artificial intelligence(AI)in colonoscopy has gained popularity by assisting endoscopists in the detection and characterization of polyps.AIM To evaluate the diagnostic performance of AI-assisted colonoscopy[computer assisted diagnosis(CAD)eye function]for colorectal polyp characterization.METHODS This study used a cross-sectional design conducted at the Gastrointestinal Endoscopy Center of Dr.Cipto Mangunkusumo Hospital in January-May 2024 on adult patients with suspected colorectal polyps.RESULTS A total of 60 patients with 100 polyps were involved in this study.Based on the results of the examination,it was found that the AI CAD eye function examination had a sensitivity of 79.17%,specificity of 75.00%,positive predictive value(PPV)of 89.06%,negative predictive value(NPV)of 58.33%,and accuracy of 78.00%.In polyps with diminutive size,sensitivity was 86.27%,specificity was 60.00%,PPV was 95.65%,NPV was 30.00%,and accuracy was 83.93%.Meanwhile,in polyps with non-diminutive size,sensitivity was 61.90%,specificity was 78.26%,PPV was 72.22%,NPV was 69.23%,and accuracy was 70.45%.In polyps on the left side of the colon,sensitivity was 78.85%,specificity was 81.25%,PPV was 93.18%,NPV was 54.17%,and accuracy was 79.41%.Meanwhile,in rightsided polyps the sensitivity was 80.00%,specificity was 66.67%,PPV was 80.00%,NPV was 66.67%,and accuracy was 75.00%.In sessile polyps the sensitivity was 81.54%,specificity was 50.00%,PPV was 91.38%,NPV was 29.41%,and accuracy was 77.33%.Meanwhile,in non-sessile polyps,the sensitivity was 57.14%,specificity was 88.89%,PPV was 66.67%,NPV was 84.21%,and accuracy was 80.00%.CONCLUSION AI CAD eye function examination had a high sensitivity value in diminutive,sessile polyps and right-sided polyps and a high specificity in non-diminutive,non-sessile polyps and left-sided polyps.展开更多
This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total ...This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.展开更多
Objective:To investigate the efficacy of Buyang Huanwu Decoction in preventing the recurrence of advanced colonic adenomatous polyps after surgery.Methods:A total of 160 patients who underwent endoscopic treatment for...Objective:To investigate the efficacy of Buyang Huanwu Decoction in preventing the recurrence of advanced colonic adenomatous polyps after surgery.Methods:A total of 160 patients who underwent endoscopic treatment for advanced adenomatous polyps of the large intestine at the First People’s Hospital of Jintan,Changzhou,between March 2022 and March 2024 were enrolled in this study.The patients were randomly divided into an intervention group and a control group using a random number table.The control group received routine postoperative care,while the intervention group received Buyang Huanwu Decoction,starting one month after surgery.The decoction was administered warm,twice daily(200 ml per dose),one dose per day,for a total treatment duration of three months.Results:Before the intervention,there were no significant differences between the two groups in terms of TCM syndrome scores,and serum levels of G-17,IL-18,IL-6,COX2,and CRP(P>0.05).After the intervention,both groups showed a decrease in TCM syndrome scores and serum levels of G-17,IL-18,IL-6,COX2,and CRP compared to pre-intervention values.The intervention group demonstrated a significantly greater reduction(P<0.05).Three months after the intervention,there was no significant difference in polyp recurrence rates between the two groups(P>0.05).However,six and twelve months after the intervention,the recurrence rates in the intervention group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions was compared between two groups of patients.The intervention group had an incidence of 12.5%,while the control group had an incidence of 6.25%,with no statistically significant difference(P>0.05).Conclusion:Buyang Huanwu Decoction has significant efficacy in preventing the recurrence of advanced colonic adenomatous polyps after surgery.It improves TCM syndrome scores,reduces oncogenic and inflammatory factors,significantly lowers postoperative polyp recurrence rates,and demonstrates good safety.It is a promising treatment for clinical promotion and application.展开更多
OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical ...OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.展开更多
Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderl...Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.展开更多
文摘With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.
基金Supported by the Shaanxi Province Traditional Chinese Medicine Research and Innovation Talent Plan Project,No.TZKN-CXRC-16Project of Shaanxi Administration of Traditional Chinese Medicine,No.SZYKJCYC-2025-JC-010+2 种基金Shaanxi Province Outstanding TCM Talents Training Project Training Object in 2025Xi’an Science and Technology Plan Project,No.23YXYJ0162Shaanxi Province Key Research and Development Plan Project-Social Development Field,No.S2025-YF-YBSF-0391.
文摘BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high malignant potential,HPs have a low risk of potential harm,whereas sporadic FGPs have no malignant potential.It is not enough to determine the type and displacement of a polyp by biopsy alone;therefore,some polyps may require an extensive biopsy or complete resection.AIM To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.METHODS This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.RESULTS In a series of 10000 patients who underwent upper gastrointestinal endoscopy,384(3.84%)had GPs.There were 98 males(25.5%)and 286 females(74.5%).The mean age of patients was 62.8±10.4(36-75)years.The frequencies of HPs,APs,and FGPs were 88.5%,5.2%,and 2.1%,respectively.The polyp size of 274 patients(71.3%)was≤1 cm.Polyps were found in 262 cases(68.2%).The most common sites for polyps were the lumen and body of the intestine.Endoscopic polypectomy was performed in 128 patients.Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.CONCLUSION The incidence of GPs was low.HPs were the most common types of GPs.Of note,as GPs have the potential to develop into adenocarcinoma or precancerous lesions,we suggest that appropriate GP resection technology(e.g.,biopsy forceps or mesenchymal resection)be applied.
文摘Colorectal polyps remain a significant health concern because they can develop into cancer.Therefore,accurate assessment and diagnosis of polyps,along with appropriate treatment decisions,are crucial in preventing complications or malignant transformation.Some polyps are classified as complex polyps,which means they fail to elevate due to a scar from a previously removed polyp or can be determined by a scoring system like the size/morphology/site/access score,which considers factors like site,morphology,size,and access.Management of complex colorectal polyps involves various options,including endoscopic and surgical approaches.Endoscopic mucosal resection(EMR)may be challenging in scarred polyps,as inadequate lifting can result in incomplete resection or recurrence.As a more advanced alternative,endoscopic submucosal dissection(ESD)is suitable for larger lesions,enabling en-bloc resection even in complex cases with EMR.However,ESD requires expertise and is more time-consuming than EMR,often necessitating hospitalization due to its complexity.Endoscopic full-thickness resection could be a viable alternative for managing scarred polyps.Endoscopic powered resection,either alone or in combination with other modalities,can also be used to achieve less extensive resection.Managing complications during the procedure or post-procedurally is equally important,as bleeding or perforations can be fatal.Careful patient selection based on individual profiles and risk factors,along with the identification of any signs of malignancy,is crucial before treatment to avoid negative post-treatment outcomes.
文摘In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and their prevalence remains unclear.Most GBPs in children are benign,and although the risk of malignancy is influenced by polyp size,growth rate,and morphology,specific criteria for the pediatric population are lacking.Management,therefore,is based on adult guidelines,with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation,while surveillance is applied to asymptomatic patients with smaller polyps.Further research is needed to develop pediatric-specific guidelines for the management of GBPs.This review discusses the classification,diagnosis,risk factors,and management of pediatric GBPs.
文摘Gastric polyps are commonly detected during upper gastrointestinal endoscopy.They are most often benign and rarely become malignant.Nevertheless,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.
文摘This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundances of Klebsiella,Parvimonas,and Clostridium increase,while those of Bifidobacterium and Lactoba-cillus decrease.This dysbiosis may promote the formation and recurrence of polyps.Similar microbial changes have also been observed in colorectal cancer,inflammatory bowel disease,autism spectrum disorder,and metabolic syndrome,indicating the role of increased pathogens and decreased probiotics in these conditions.Regulating the gut microbiota,particularly by increasing probiotic levels,may help prevent polyp recurrence and promote gut health.This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
文摘BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk factors for recurrence remain unknown.AIM To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.METHODS Overall,362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included.We screened basic demographic data,clinical and polyp characteristics,surgery-related information,and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses.The multivariate analysis results were used to construct a nomogram prediction model,internally validated using Bootstrapping,with performance evaluated using area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS CP re-occurred in 166(45.86%)of the 362 patients within 1 year post-surgery.Multivariate logistic regression analysis showed that age(OR=1.04,P=0.002),alcohol consumption(OR=2.07,P=0.012),Helicobacter pylori infection(OR=2.34,P<0.001),polyp number>2(OR=1.98,P=0.005),sessile polyps(OR=2.10,P=0.006),and adenomatous pathological type(OR=3.02,P<0.001)were independent risk factors for post-surgery recurrence.The nomogram prediction model showed good discriminatory(AUC=0.73)and calibrating power,and decision curve analysis showed that the model had good clinical benefit at risk probabilities>20%.CONCLUSION We identified multiple independent risk factors for short-term recurrence after endoscopic surgery.The nomogram prediction model showed a certain degree of differentiation,calibration,and potential clinical applicability.
文摘Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.
基金Supported by Shandong Province Traditional Chinese Medicine Science and Technology Youth Project,No:2021Q057.
文摘BACKGROUND Inflammatory fibroid polyps(IFPs)are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors.IFPs can occur in any part of the gastrointestinal tract but are most prevalent in the stomach,particularly in the gastric antrum.With a low incidence in clinical practice and a lack of distinct endoscopic features,the preoperative diagnosis rate of IFP is disappointingly low,often leading to missed diagnoses or misdiagnoses.CASE SUMMARY A 43-year-old man,hospitalized with abdominal pain and distension,underwent his first gastroscopy in 2020,which revealed chronic superficial erosive gastritis.From 2021 to 2022,his condition progressed from antral ulcers to a 2.0 cm gastric antrum bulge of an unclear nature.After proton pump inhibitor treatment,the lesion shrank but did not heal completely.Following a thorough assessment using magnifying endoscopy with narrow-band imaging,gastric-enhanced computed tomography,and endoscopic ultrasonography,endoscopic submucosal dissection was performed on the identified lesion.A subsequent postoperative pathological examination conclusively diagnosed the lesion as an IFP.At 6 months follow-up,no recurrence or metastasis was observed,with good mucosal scar healing.CONCLUSION Through using multiple diagnostic and therapeutic test results,an IFP with an unusual morphology could be identified.
文摘Colorectal cancer(CRC)is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide.In this regard,CRC screening is one of the most important issues in modern preventive medicine.Colorectal polyps are potential predictors of CRC,and therefore represent one of the leading targets for screening colonoscopy.The difficulty of analyzing the information obtained during colonoscopy,including the size,location,shape,type of polyps,the need to standardize morphological data,determines that recently a number of works have promoted the opinion on the advisability of using various artificial intelligence(AI)methods to improve the effectiveness of endoscopic screening for CRC.At the same time,they point to a number of errors and methodological problems in the use of AI systems for the diagnosis of colorectal polyps.In this regard,the interpretation of the work of Shi et al,devoted to the use of a machine learning-based predictive model for monitoring the results of colorectal polypectomy,is undoubtedly interesting.In our opinion,the prospects for using AI to assess endoscopic screening for CRC look certainly positive,but the road to its widespread use will not be easy.
基金the National Administration of Traditional Chinese Medicine Letter([2022]-1)Dongzhimen Hospital Horizontal Project:Exploring the Effects of Weifuchun on Key Mechanisms of Different Types of Gastric Polyps based on Human Organoid Culture Technology(No.HX-DZM-202239)the Qihuang Talent Program for Renowned Physician Cultivation at Beijing University of Chinese Medicine(No.Y2023A06)。
文摘OBJECTIVE:To investigate the therapeutic effects of Chinese medicine Weifuchun(WFC,胃复春)on gastric fundic gland polyps(FGPs).METHODS:FGPs organoids were constructed with patients-derived samples.The morphology and size of FGPs organoids were detected using bright-field imaging.Effective components and corresponding potential targets of WFC were screened using multiple opensource databases and research on Traditional Chinese Medicine or compound formulas.Core genes were identified through protein-protein interaction networks.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses of the core genes were conducted.The interactions between main components and core targets were analyzed through the Ferr Db database.The expressions of core targets were detected by quantitative real-time polymerase chain reaction(q RT-PCR).RESULTS:After WFC treatment,the number and size of FGPs organoids were significantly reduced.Twenty nine active drug components and 162 candidate targets of WFC for treating FGPs were identified,including 37 targets related to ferroptosis.Quercetin,Glaucocalyxin B,Melissoidesin U,Melissoidesin O,Hesperetin,Glaucocalyxin A,Angustifolin,Melissoidesin M,Di-n-octyl phthalate,and beta-sitosterol were identified as the main active compounds.SRC proto-oncogene,non-receptor tyrosine kinase,signal transducer and activator of transcription 3,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta,phosphoinositide-3-kinase regulatory subunit 1,and AKT serine/threonine kinase 1 were identified as the primary targets.KEGG pathways related to carcinogenesis,cell proliferation and metabolism,and oxidative stress.WFC promoted FGPs organoids'death and could be reversed by ferroptosis inhibitor of Erastin.The q RT-PCR results showed that WFC treatment could regulate the m RNA expression levels of solute carrier family 7 member 11,acyl-Co A synthetase long chain family member 4,and arachidonate 15-lipoxygenase,type B.CONCLUSION:WFC may exert its therapeutic effects by inducing ferroptosis in FGPs cells.
文摘BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has assessed the relationship between TN and adenomatous colonic polyps.AIM To assess the association between adenomatous colonic polyps,thyroid-stimulating hormone,and TN.METHODS We searched PubMed,MEDLINE,Cochrane Library,EBSCO,and the first 100 articles in Google for articles published in English from inception until April 2025.We included prospective cohorts,retrospective studies,case-control studies,and cross-sectional studies.The keywords thyroid nodules,adenomatous colon polyps,thyroid volume,metabolic syndrome,insulin resistance,and thyroid malignancy were used.RESULTS Out of 237 articles,25 full texts were reviewed,and 5 full texts were included in the final meta-analysis.No relationship was found between TN,colonic polyps,and thyroid-stimulating hormone levels[odd ratio(OR):1.78,95%confidence interval(CI):0.55-5.74,P=0.33].Colonic polyps were more common among patients with TN when addressing heterogeneity(OR:0.42,95%CI:0.30-0.52,P<0.001 and OR:0.08,95%CI:0.70-0.86,P=0.85).CONCLUSION TN were similar among patients with and without adenomatous colonic polyps.However,TN was more common among colon polyps when addressing the heterogeneity.Thyroid-stimulating hormone was not different between those with and without TN.Age,sex,adiposity,and smoking effects might explain the higher rate observed by the included studies.Further studies controlling for the same are needed.
文摘BACKGROUNDColorectal cancer(CRC)typically progresses from benign colorectal polyps,whichrepresent a precursor to malignancy.Identifying the factors influencing thisprogression is crucial for early intervention and prevention.Although genetic andenvironmental factors have been widely studied,the role of lifestyle factors suchas physical activity,diet,smoking,sleep,and stress remains underexplored,especially in patients with early stage CRC or polyps.Recent evidence suggeststhat lifestyle behaviors may influence cancer progression by modulating inflammatorypathways,metabolic health,and immune function.For instance,highlevels of physical activity are linked to a reduced risk of CRC development,whereas poor dietary habits,smoking,and inadequate sleep have all beenimplicated in increased cancer risk and progression.Moreover,early-stage CRCpatients,who are often asymptomatic or have minimal symptoms,may particularlybenefit from lifestyle modifications to slow disease progression andimprove overall prognosis.The gap in understanding the specific influence ofthese lifestyle factors on colorectal polyps and early stage cancer progressionunderscores the need for comprehensive studies.By assessing several modifiablelifestyle factors and their association with disease progression,clinicians canidentify practical intervention points.These interventions could ultimately reducethe need for more aggressive treatments and improve the long-term outcomes inaffected patients.AIMTo investigate the association between lifestyle factors and disease progression inpatients with colorectal polyps and early stage cancer.METHODSIn this observational study conducted from January 2022 to December 2023,werecruited 120 patients with colorectal polyps or early stage cancer from Jiangshan People's Hospital.Lifestyle factors,including physical activity,dietary patterns,smoking status,sleep quality,andstress levels,were assessed using validated questionnaires.Disease progression was evaluated using standardizedfollow-up colonoscopies and pathological examinations.Cox proportional hazards models were used to analyzethe association between lifestyle factors and disease progression after adjusting for potential confounders.RESULTSDuring the median follow-up of 18.4 months,42(35.0%)patients experienced disease progression.High levels ofphysical activity were associated with reduced progression risk[adjusted hazard ratio(HR)0.55,95%confidenceinterval(CI):0.38-0.80,P=0.002]compared to low activity levels.High adherence to a healthy dietary patternshowed similar protective effects(adjusted HR 0.62,95%CI:0.43-0.89,P=0.009).Current smoking(adjusted HR1.92,95%CI:1.35-2.73,P<0.001)and poor sleep quality(adjusted HR 1.38,95%CI:1.05-1.82,P=0.021)wereassociated with increased progression risk.The impact of lifestyle factors was particularly pronounced in patientsyounger than 60 years and those with multiple polyps at baseline.CONCLUSIONThis study demonstrated significant associations between lifestyle factors and disease progression in colorectalpolyps and early stage cancer.Physical activity,dietary patterns,smoking status,and sleep quality have emergedas key modifiable factors influencing disease progression.These findings support the integration of lifestyleassessments and modifications in the clinical management of patients with colorectal neoplasia.
文摘BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrasonography(EUS),but atypical EUS features have also been reported.Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations.At present,there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages.We hypothesize that gastric IFPs at different pathological stages may have different EUS features.AIM To describe EUS features of gastric IFPs and compare with their pathological characteristics.METHODS Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected.All patients underwent preoperative EUS.We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.RESULTS Most gastric IFPs showed medium-low echo(67.9%),homogeneous echo(90.6%),and unclear boundaries(83%),and involved the second and third layers of the gastric wall(69.8%)under EUS.The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP.Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo.Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo.Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity.The accuracy of EUS in diagnosing gastric IFPs was 66.0%(35/53),and the accuracy in determining the origin layer of gastric IFPs was 73.4%(39/53).CONCLUSION Gastric IFPs at different pathological stages have different EUS features.In order to improve the diagnostic rate,it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.
文摘BACKGROUND The gold standard for colorectal polyp screening is currently colonoscopy,but the miss rate is still high and the adenoma detection rate and polyp detection rate are still low.The risk factors include the patient,operators,and the tools used.The use of artificial intelligence(AI)in colonoscopy has gained popularity by assisting endoscopists in the detection and characterization of polyps.AIM To evaluate the diagnostic performance of AI-assisted colonoscopy[computer assisted diagnosis(CAD)eye function]for colorectal polyp characterization.METHODS This study used a cross-sectional design conducted at the Gastrointestinal Endoscopy Center of Dr.Cipto Mangunkusumo Hospital in January-May 2024 on adult patients with suspected colorectal polyps.RESULTS A total of 60 patients with 100 polyps were involved in this study.Based on the results of the examination,it was found that the AI CAD eye function examination had a sensitivity of 79.17%,specificity of 75.00%,positive predictive value(PPV)of 89.06%,negative predictive value(NPV)of 58.33%,and accuracy of 78.00%.In polyps with diminutive size,sensitivity was 86.27%,specificity was 60.00%,PPV was 95.65%,NPV was 30.00%,and accuracy was 83.93%.Meanwhile,in polyps with non-diminutive size,sensitivity was 61.90%,specificity was 78.26%,PPV was 72.22%,NPV was 69.23%,and accuracy was 70.45%.In polyps on the left side of the colon,sensitivity was 78.85%,specificity was 81.25%,PPV was 93.18%,NPV was 54.17%,and accuracy was 79.41%.Meanwhile,in rightsided polyps the sensitivity was 80.00%,specificity was 66.67%,PPV was 80.00%,NPV was 66.67%,and accuracy was 75.00%.In sessile polyps the sensitivity was 81.54%,specificity was 50.00%,PPV was 91.38%,NPV was 29.41%,and accuracy was 77.33%.Meanwhile,in non-sessile polyps,the sensitivity was 57.14%,specificity was 88.89%,PPV was 66.67%,NPV was 84.21%,and accuracy was 80.00%.CONCLUSION AI CAD eye function examination had a high sensitivity value in diminutive,sessile polyps and right-sided polyps and a high specificity in non-diminutive,non-sessile polyps and left-sided polyps.
文摘This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.
基金Special research and development project of the off-campus teaching base of Jiangsu Medical Vocational College(Project No.:20229121)National Famous and Old Chinese Medicine Doctors’Inheritance Studio Construction Project of the National Administration of Traditional Chinese Medicine(Project No.:SATCM Human Education Development[2011]No.41)The Third National Medical Master Inheritance Studio and National Famous Chinese Medicine Doctors’Inheritance Studio Construction Project of the National Administration of Traditional Chinese Medicine(Project No.:SATCM Human Education Office Letter[2018]No.119)。
文摘Objective:To investigate the efficacy of Buyang Huanwu Decoction in preventing the recurrence of advanced colonic adenomatous polyps after surgery.Methods:A total of 160 patients who underwent endoscopic treatment for advanced adenomatous polyps of the large intestine at the First People’s Hospital of Jintan,Changzhou,between March 2022 and March 2024 were enrolled in this study.The patients were randomly divided into an intervention group and a control group using a random number table.The control group received routine postoperative care,while the intervention group received Buyang Huanwu Decoction,starting one month after surgery.The decoction was administered warm,twice daily(200 ml per dose),one dose per day,for a total treatment duration of three months.Results:Before the intervention,there were no significant differences between the two groups in terms of TCM syndrome scores,and serum levels of G-17,IL-18,IL-6,COX2,and CRP(P>0.05).After the intervention,both groups showed a decrease in TCM syndrome scores and serum levels of G-17,IL-18,IL-6,COX2,and CRP compared to pre-intervention values.The intervention group demonstrated a significantly greater reduction(P<0.05).Three months after the intervention,there was no significant difference in polyp recurrence rates between the two groups(P>0.05).However,six and twelve months after the intervention,the recurrence rates in the intervention group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions was compared between two groups of patients.The intervention group had an incidence of 12.5%,while the control group had an incidence of 6.25%,with no statistically significant difference(P>0.05).Conclusion:Buyang Huanwu Decoction has significant efficacy in preventing the recurrence of advanced colonic adenomatous polyps after surgery.It improves TCM syndrome scores,reduces oncogenic and inflammatory factors,significantly lowers postoperative polyp recurrence rates,and demonstrates good safety.It is a promising treatment for clinical promotion and application.
基金Beijing Natural Science Foundation:Research on the Mechanism of Chaiqi Decoction in Improving Vascular Endothelial Injury in Metabolic Syndrome by Regulating Pyroptosis via miR-21(No.7212181)。
文摘OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.
文摘Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.
