Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Metho...Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.展开更多
Acute appendicitis is a common surgical emergency.It is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid hyperplasia.For over a century,appendectomy has been the primary trea...Acute appendicitis is a common surgical emergency.It is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid hyperplasia.For over a century,appendectomy has been the primary treatment for acute appendicitis.Abraham Groves performed the first open appendectomy in 1883.In 1983,Kurt Semm completed the first laparoscopic appendectomy,heralding a new era in appendectomy.However,appendectomy is associated with certain complications and a rate of negative appendectomies.Studies have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson’s disease,but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer,gallstones,and cardiovascular disease.With the recognition that the appendix is not a vestigial organ and the advancement of endoscopic technology,Liu proposed the endoscopic retrograde appendicitis therapy.It is an effective minimally invasive alternative for treating uncomplicated acute appendicitis.Our team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of appendicitis.This article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.展开更多
Endoscopic remission is the primary long-term therapeutic goal in inflammatory bowel disease(IBD).The assessment of this therapeutic target typically relies on white light endoscopy(WLE)combined with histological samp...Endoscopic remission is the primary long-term therapeutic goal in inflammatory bowel disease(IBD).The assessment of this therapeutic target typically relies on white light endoscopy(WLE)combined with histological sampling.Nonetheless,distinguishing between endoscopic mild,patchy inflammation and quiescent disease can be challenging,and discrepancies have been observed between endoscopic and histological disease activity,mainly when using WLE.Recent advances in endoscopic technologies are gradually transforming clinical practice.Dye-based chromoendoscopy and virtual chromoendoscopy are currently available in the endoscopist armamentarium,enhancing the assessment of mucosal architecture and vascular patterns,improving the visualisation of patchy inflammation and helping detect subtle dysplastic colonic lesions.Moreover,novel advanced tools,including probe-based confocal laser endomicroscopy and endocytoscopy,offer the remarkable ability to investigate the deep aspect of the gastrointestinal tract in real time,including the structure and function of the intestinal barrier and inflammatory-related alterations.Thus,these techniques can bridge the gap between endoscopy and histology,enabling the integration of novel treat-to-target strategies associated with more favourable outcomes.Artificial intelligence(AI)represents a further step forward in overcoming the limitations associated with endoscopy,including subjectivity and the requirement for expertise.Their implementation in clinical practice may enable standardised,accurate and rapid disease assessment.Moreover,AI can aid in accurately predicting responses to therapy and disease outcomes by stratifying patients’risks,thereby advancing us towards patient-centred personalised medicine.This narrative review summarises the available advanced endoscopic technologies and their integration with AI to assess IBD activity,define promising therapeutic targets and predict long-term outcomes.展开更多
Obesity,with its increasing morbidity and prevalence,is now a worldwide public health problem.Obesity and its related comorbidities impose a heavy burden on societal health and the economy.The practice of bariatric su...Obesity,with its increasing morbidity and prevalence,is now a worldwide public health problem.Obesity and its related comorbidities impose a heavy burden on societal health and the economy.The practice of bariatric surgery has evolved from its early surgical procedures,many of which are no longer routine operations.With clinical practice,research,and experience,bariatric surgery has gradually become an important last resort for the control of weight and obesity-related metabolic diseases in moderately and severely obese patients.However,there is still room for further improvements in bariatric surgical procedures,especially with regard to long-term issues and complications.Endoscopic weight loss technology has developed rapidly in recent years.The advantages of this technology include minimal invasiveness,an obvious weight loss effect,and few complications,thus filling the gap between medications and lifestyle adjustments and surgical treatment of obesity.Endoscopic weight loss technology may even replace surgical bariatric procedures.This review summarized the current status of bariatric metabolic surgery and newly developed bariatric endoscopic procedures.展开更多
文摘Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.
基金Supported by the Construction Fund of Key Medical Disciplines of Hangzhou,No.0020200026Key R&D Program of Zhejiang Province,No.2023C03054.
文摘Acute appendicitis is a common surgical emergency.It is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid hyperplasia.For over a century,appendectomy has been the primary treatment for acute appendicitis.Abraham Groves performed the first open appendectomy in 1883.In 1983,Kurt Semm completed the first laparoscopic appendectomy,heralding a new era in appendectomy.However,appendectomy is associated with certain complications and a rate of negative appendectomies.Studies have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson’s disease,but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer,gallstones,and cardiovascular disease.With the recognition that the appendix is not a vestigial organ and the advancement of endoscopic technology,Liu proposed the endoscopic retrograde appendicitis therapy.It is an effective minimally invasive alternative for treating uncomplicated acute appendicitis.Our team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of appendicitis.This article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.
文摘Endoscopic remission is the primary long-term therapeutic goal in inflammatory bowel disease(IBD).The assessment of this therapeutic target typically relies on white light endoscopy(WLE)combined with histological sampling.Nonetheless,distinguishing between endoscopic mild,patchy inflammation and quiescent disease can be challenging,and discrepancies have been observed between endoscopic and histological disease activity,mainly when using WLE.Recent advances in endoscopic technologies are gradually transforming clinical practice.Dye-based chromoendoscopy and virtual chromoendoscopy are currently available in the endoscopist armamentarium,enhancing the assessment of mucosal architecture and vascular patterns,improving the visualisation of patchy inflammation and helping detect subtle dysplastic colonic lesions.Moreover,novel advanced tools,including probe-based confocal laser endomicroscopy and endocytoscopy,offer the remarkable ability to investigate the deep aspect of the gastrointestinal tract in real time,including the structure and function of the intestinal barrier and inflammatory-related alterations.Thus,these techniques can bridge the gap between endoscopy and histology,enabling the integration of novel treat-to-target strategies associated with more favourable outcomes.Artificial intelligence(AI)represents a further step forward in overcoming the limitations associated with endoscopy,including subjectivity and the requirement for expertise.Their implementation in clinical practice may enable standardised,accurate and rapid disease assessment.Moreover,AI can aid in accurately predicting responses to therapy and disease outcomes by stratifying patients’risks,thereby advancing us towards patient-centred personalised medicine.This narrative review summarises the available advanced endoscopic technologies and their integration with AI to assess IBD activity,define promising therapeutic targets and predict long-term outcomes.
基金National Natural Science Foundation of China(No. 82027801)National Key R&D Program of China(No. 2017YFC0113600)
文摘Obesity,with its increasing morbidity and prevalence,is now a worldwide public health problem.Obesity and its related comorbidities impose a heavy burden on societal health and the economy.The practice of bariatric surgery has evolved from its early surgical procedures,many of which are no longer routine operations.With clinical practice,research,and experience,bariatric surgery has gradually become an important last resort for the control of weight and obesity-related metabolic diseases in moderately and severely obese patients.However,there is still room for further improvements in bariatric surgical procedures,especially with regard to long-term issues and complications.Endoscopic weight loss technology has developed rapidly in recent years.The advantages of this technology include minimal invasiveness,an obvious weight loss effect,and few complications,thus filling the gap between medications and lifestyle adjustments and surgical treatment of obesity.Endoscopic weight loss technology may even replace surgical bariatric procedures.This review summarized the current status of bariatric metabolic surgery and newly developed bariatric endoscopic procedures.
