This editorial discusses a case report recently published in the World Journal of Clinical Cases.The report describes the clinical presentation,imaging,diagnosis,and treatment of a patient with tuberous sclerosis comp...This editorial discusses a case report recently published in the World Journal of Clinical Cases.The report describes the clinical presentation,imaging,diagnosis,and treatment of a patient with tuberous sclerosis complex(TSC)combined with primary lymphedema(PLE).Additionally,it retrospectively analyzes the data of 16 previously reported cases of children with TSC combined with PLE to summarize the epidemiology,genetic diagnosis,and current main treatments of these patients.The report also speculates on the pathological and physiological mechanisms underlying TSC combined with PLE.TSC combined with PLE is rare;therefore,the report provides a theoretical basis for understanding the pathophysiological mechanisms and treatment options for patients with TSC and PLE.Comprehensive clinical management of TSC is essential due to the diverse and multiorgan nature of its manifestations,often requiring a multidisciplinary approach for newly diagnosed cases.展开更多
This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a...This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced stage.Two main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial neoplasia.In the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic lesions.Nevertheless,the survival rate still remains poor,and alternative screening methods are under investigation.Endoscopic retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its role.Probably a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early diagnosis.Biomarkers could help to predict and follow the progression of early pancreatic lesions.However,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.展开更多
This paper aims at re-examining the properties of the-celebrated Goodwin model in econmics.We improve the results of Flaschel by applying the bifurcation method of Iooss and Joseph. It isshown that under appropriate c...This paper aims at re-examining the properties of the-celebrated Goodwin model in econmics.We improve the results of Flaschel by applying the bifurcation method of Iooss and Joseph. It isshown that under appropriate conditions endogeneous limit cycles appear after structural changeshave teken place in the economic system.展开更多
BACKGROUND Dietary supplement(DS)usage among United States adults has significantly increased.Patients with steatotic liver disease(SLD)may have unique moti-vations to take DS in light of their liver condition and co-...BACKGROUND Dietary supplement(DS)usage among United States adults has significantly increased.Patients with steatotic liver disease(SLD)may have unique moti-vations to take DS in light of their liver condition and co-morbidities.AIM To characterize DS use in SLD patients and explore motivations for their use.METHODS Adults≥18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied.SLD was defined using consensus criteria,combining clinical indicators with elastography thresholds.The DS Questionnaire(DSQ)was used to record participants’use of DSQ.Sample weights were applied to estimate national prevalence.RESULTS Of 2413 participants with SLD,1058 reported using DS,for an estimated prevalence of 44.8%[standard error(SE)2.4]with an average of 2.6(SE 0.2)DS per person.Among SLD participants taking DSQ,53.2%(SE 3.3)reported using non-vitamin/non-mineral ones,with an average of 1.8(SE 0.1)such supplements per person.DS users were more likely to be female,have higher levels of education,and have greater food security(P<0.02 for all).The most common motivations for using DS were to follow doctor’s advice(36.7%,SE 1.8),to improve overall health(22.1%,SE 2.0),and to maintain health(19.2%,SE 1.9).CONCLUSION Nearly half of individuals with SLD report taking DS.This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.展开更多
BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains ina...BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.展开更多
BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of...BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.展开更多
BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this th...BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.展开更多
AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National ...AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.展开更多
Purpose: There is a significant rise in mortality rates from breast and cervical cancers in Low- and Middle-Income Countries. In Ghana, approximately 4482 women are diagnosed with these diseases at advanced stages. Un...Purpose: There is a significant rise in mortality rates from breast and cervical cancers in Low- and Middle-Income Countries. In Ghana, approximately 4482 women are diagnosed with these diseases at advanced stages. Unfortunately, the early detection rate for these cancers is low compared to other women’s health services. This situation underscores the need to identify the locations of reproductive-age women who have not been screened for these cancers, to implement targeted public health interventions. This study aims to pinpoint these women’s locations for tailored interventions. Method: Bivariate analysis assessed the relationship between the independent and outcome variables. Hot spot analysis and Kriging Ordinary interpolation were employed to pinpoint the locations of these women. Results: Breast cancer examination and cervical cancer test rates were low, with a strong association between the two screening services. Several significant variables were identified: place of residence (p Conclusion: Low participation in these screening services was related to women’s age and the outreach efforts of fieldworkers. Breast and cervical cancer screenings are interconnected and could be combined to improve attendance rates. The Community-based Health Planning and Services (CHPS) implementation strategy could be cost-effective for screening women through targeted interventions, especially in identified clusters.展开更多
BACKGROUND Cardiovascular health(CVH)plays a crucial role in overall health,but its association with metabolic-associated fatty liver disease(MAFLD)remains unclear.AIM To investigate the relationship between CVH,measu...BACKGROUND Cardiovascular health(CVH)plays a crucial role in overall health,but its association with metabolic-associated fatty liver disease(MAFLD)remains unclear.AIM To investigate the relationship between CVH,measured using Life’s Essential 8(LE8)and Life’s Simple 7(LS7),and the prevalence of MAFLD.METHODS This cross-sectional study had a sample of 2234 individuals,representing approximately 120 million individuals in the United States.Baseline parameters were compared between the LE8 and LS7 groups.Logistic regression models were used to evaluate the relationship between LE8,LS7,and MAFLD,while taking into account confounding factors.The investigation employed restricted cubic splines to investigate non-linear associations.Subgroup analyses and sensitivity studies were performed to evaluate the strength and reliability of the results.RESULTS Higher LE8 and LS7 scores were significantly associated with a decreased risk of MAFLD,even after controlling for demographic,socioeconomic,and clinical variables.This association demonstrated a non-linear pattern,with the most dramatic risk reduction observed at higher CVH levels.Individual CVH components,notably healthy behaviors and factors,exhibited strong relationships with MAFLD.Subgroup analyses indicated consistent relationships across several demographics.Sensitivity tests utilizing other MAFLD definitions validated the robustness of the findings.CONCLUSION Higher adherence to CVH criteria,as indicated by LE8 and LS7 scores,is associated with a significantly lower risk of MAFLD.These results emphasize the need to advance CVH to control and avoid MAFLD.展开更多
The Palace Museum inventories its collection For the first time in history, curators of the Palace Museum have finally inven- toried the museum’s vast collection. After seven years of painstaking work, the museum fin...The Palace Museum inventories its collection For the first time in history, curators of the Palace Museum have finally inven- toried the museum’s vast collection. After seven years of painstaking work, the museum finally released the results of its first comprehensive inventory on January 26, showing that the museum houses 1,807,558 items.展开更多
The critical examination of scientific evidence is crucial in attempting to distinguish genuine science from“junk science”and provides judges with an important basis upon which to determine the credibility of expert...The critical examination of scientific evidence is crucial in attempting to distinguish genuine science from“junk science”and provides judges with an important basis upon which to determine the credibility of expert witnesses giving scientific evidence.From studying the law in the USA,we learn that the process for examining scientific evidence in court is based upon full discovery of the proposed evidence before trial and the availability of expert witnesses at trial to testify orally and be examined and cross‑examined.Empirical studies suggest that the opportunities to critically examine scientific evidence in Chinese courts are not so freely available.Discovery is neglected,thus limiting the effectiveness of cross‑examination,and current rules do not encourage oral testimony or effective cross‑examination.To solve these problems,the disclosure duty should be put on the prosecution,rather than on the defendant.Scientific evidence should be discovered.Disclosure must include the basis,process,material relied upon,and methods of forensic appraisals.In the trial process,the prosecution has transferred the case file to court,where the defendant will be able to copy the scientific evidence.The neutrality of expert assistants established by article 192 of the new Criminal Procedural Law should be strengthened.展开更多
BACKGROUND Tuberous sclerosis complex(TSC)and primary lymphedema(PLE)are both rare diseases,and it is even rarer for both to occur in the same patient.In this work,we have provided a detailed description of a patient&...BACKGROUND Tuberous sclerosis complex(TSC)and primary lymphedema(PLE)are both rare diseases,and it is even rarer for both to occur in the same patient.In this work,we have provided a detailed description of a patient's clinical presentation,imaging findings,and treatment.And a retrospective analysis was conducted on 14 published relevant case reports.CASE SUMMARY A 16-year-old male came to our hospital for treatment due to right lower limb swelling.This swelling is already present from birth.The patient’s memory had been progressively declining.Seizures had occurred 1 year prior at an unknown frequency.The patient was diagnosed with TSC combined with PLE through multimodal imaging examination:Computed tomography,magnetic resonance imaging,and lymphoscintigraphy.The patient underwent liposuction.The swelling of the patient's right lower limb significantly improved after surgery.Epilepsy did not occur.after taking antiepileptic drugs and sirolimus.CONCLUSION TSC with PLE is a rare and systemic disease.Imaging can detect lesions of this disease,which are important for diagnosis and treatment.展开更多
Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Hea...Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.展开更多
AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career...AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.展开更多
Objective Because of the limited number of studies and small sample sizes,whether metabolic syndrome(MS)leads to the occurrence and progression of osteoporosis and the possible underlying mechanisms require further in...Objective Because of the limited number of studies and small sample sizes,whether metabolic syndrome(MS)leads to the occurrence and progression of osteoporosis and the possible underlying mechanisms require further investigation.This study aimed to investigate the association between MS and osteoporosis,along with its influencing factors.Methods This observational cross-sectional study included 139,470 individuals aged≥18 years who underwent health examinations from September 2014 to March 2022.Based on bone mineral density(BMD)screening results,the participants were categorized into a suspected osteoporosis or non-osteoporosis group(control).Participants were further divided into those who met 0 MS criteria,1 MS criterion,2 MS criteria,and≥3 MS criteria(MS group).Participants who had undergone health examinations at least twice formed the follow-up cohort;a self-matched analysis was performed on those with follow-up periods≥5 years and unchanged MS grouping.Results Several examination indicators in the suspected osteoporosis group showed statistically significant differences compared with the control group.The proportion of suspected osteoporosis in the MS group was significantly increased compared with that in the 0 MS criteria group(odds ratio[OR]:1.215,Z=29.11,P<0.001,95%confidence interval:1.199-1.231).After adjusting for age,sex,smoking,and alcohol consumption,the 2 MS criteria group and MS group still had OR values>1(P<0.001).In the follow-up cohort,the proportion of suspected osteoporosis increased gradually with an increase in the number of MS criteria met at baseline and during each follow-up visit(P<0.05),with the highest proportion observed in the MS group.However,the proportion of suspected osteoporosis did not increase significantly over time in the different MS groups(P>0.05).In the follow-up cohort,the proportion of individuals transitioning from normal BMD to suspected osteoporosis was higher in the MS group after≥5 years of follow-up compared with the group meeting 0 MS criteria(0.08%versus 1.15%,χ^(2)=10.76,P=0.001).There was no significant difference in BMD values for the 0 MS criteria group after 5 years(P>0.05),whereas the other three groups experienced a significant decrease in BMD values after 5 years(P<0.05).Conclusion MS is an independent risk factor for osteoporosis,and the effect of risk factors related to MS on osteoporosis may exceed that of aging alone.The specific mechanisms warrant further investigation.展开更多
This editorial elaborates on the current and future applications of linear endoscopic ultrasound(EUS),a substantial diagnostic and therapeutic modality for various anatomical regions.The scope of endosonographic asses...This editorial elaborates on the current and future applications of linear endoscopic ultrasound(EUS),a substantial diagnostic and therapeutic modality for various anatomical regions.The scope of endosonographic assessment is broad and,among other factors,allows for the evaluation of the mediastinal anatomy and related pathologies,such as mediastinal lymphadenopathy and the staging of central malignant lung lesions.Moreover,EUS assessment has proven more accurate in detecting small lesions missed by standard imaging examinations,such as computed tomography or magnetic resonance imaging.We focus on its current uses in the mediastinum,including lung and esophageal cancer staging,as well as evaluating mediastinal lymphadenopathy and submucosal lesions.The editorial also explores future perspectives of EUS in mediastinal examination,including ultrasound-guided therapies,artificial intelligence integration,advancements in mediastinal modalities,and improved diagnostic approaches for various mediastinal lesions.展开更多
BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who compl...BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who complained of abdominal pain.The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder,ovary,and uterus.The patient underwent emergency laparotomy per-formed by gynecologists,but it was discovered that the cystic tumor originated from the jejunum.Gastrointestinal surgeons were then called in to perform a cystectomy.Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery.The patient had an uneventful postoperative recovery.CONCLUSION Mesenteric lymphangiomas can cause abdominal pain,and imaging techniques can help determine their characteristics,location,and size.Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.展开更多
BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and...BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and painless method for the diagnosis of gastric tumors.AIM To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric tumors.METHODS The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological examination.RESULTS Among 42 patients with gastric tumors enrolled in the study,the diagnostic accordance rate was 95.2%for oral contrast-enhanced ultrasonography(n=40)and 90.5%for electronic gastroscopy(n=38)compared with postoperative pathological examination.The Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy,and there was no significant difference between them(P=0.397).For the TNM staging of gastric tumors,the accuracy rate of oral contrast enhanced ultrasonography was 81.9%for the overall T staging and 50%,77.8%,100%,and 100%for T1,T2,T3,and T4 staging,respectively.The sensitivity and specificity were both 100%for stages T3 and T4.The diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%,80%,100%,and 100%for stages N0,N1-N3,M0,and M1,respectively.CONCLUSION The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy,and it could be used as the preferred method for the early screening of gastric tumors.展开更多
文摘This editorial discusses a case report recently published in the World Journal of Clinical Cases.The report describes the clinical presentation,imaging,diagnosis,and treatment of a patient with tuberous sclerosis complex(TSC)combined with primary lymphedema(PLE).Additionally,it retrospectively analyzes the data of 16 previously reported cases of children with TSC combined with PLE to summarize the epidemiology,genetic diagnosis,and current main treatments of these patients.The report also speculates on the pathological and physiological mechanisms underlying TSC combined with PLE.TSC combined with PLE is rare;therefore,the report provides a theoretical basis for understanding the pathophysiological mechanisms and treatment options for patients with TSC and PLE.Comprehensive clinical management of TSC is essential due to the diverse and multiorgan nature of its manifestations,often requiring a multidisciplinary approach for newly diagnosed cases.
文摘This editorial is a commentary on the case report by Furuya et al focusing on the challenging diagnosis of early pancreatic adenocarcinoma and new tools for an earlier diagnosis.Currently,pancreatic cancer still has a poor prognosis,mainly due to late diagnosis in an advanced stage.Two main precancerous routes have been identified as pathways to pancreatic adenocarcinoma:The first encompasses a large group of mucinous cystic lesions:intraductal papillary mucinous neoplasm and mucinous cystic neoplasm,and the second is pancreatic intraepithelial neoplasia.In the last decade the focus of research has been to identify high-risk patients,using advanced imaging techniques(magnetic resonance cholangiopancreatography or endoscopic ultrasonography)which could be helpful in finding“indirect signs”of early stage pancreatic lesions.Nevertheless,the survival rate still remains poor,and alternative screening methods are under investigation.Endoscopic retrograde cholangiopancreatography followed by serial pancreatic juice aspiration cytology could be a promising tool for identifying precursor lesions such as intraductal papillary mucinous neoplasm,but confirming data are still needed to validate its role.Probably a combination of cross-sectional imaging,endoscopic techniques(old and new ones)and genetic and biological biomarkers also in pancreatic juice)could be the best solution to reach an early diagnosis.Biomarkers could help to predict and follow the progression of early pancreatic lesions.However,further studies are needed to validate their diagnostic reliability and to establish diagnostic algorithms to improve prognosis and survival in patients with pancreatic cancer.
文摘This paper aims at re-examining the properties of the-celebrated Goodwin model in econmics.We improve the results of Flaschel by applying the bifurcation method of Iooss and Joseph. It isshown that under appropriate conditions endogeneous limit cycles appear after structural changeshave teken place in the economic system.
基金Supported by The National Institutes of Health,No.K24AG080021,No.R01AG059183,and No.P30DK026743.
文摘BACKGROUND Dietary supplement(DS)usage among United States adults has significantly increased.Patients with steatotic liver disease(SLD)may have unique moti-vations to take DS in light of their liver condition and co-morbidities.AIM To characterize DS use in SLD patients and explore motivations for their use.METHODS Adults≥18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied.SLD was defined using consensus criteria,combining clinical indicators with elastography thresholds.The DS Questionnaire(DSQ)was used to record participants’use of DSQ.Sample weights were applied to estimate national prevalence.RESULTS Of 2413 participants with SLD,1058 reported using DS,for an estimated prevalence of 44.8%[standard error(SE)2.4]with an average of 2.6(SE 0.2)DS per person.Among SLD participants taking DSQ,53.2%(SE 3.3)reported using non-vitamin/non-mineral ones,with an average of 1.8(SE 0.1)such supplements per person.DS users were more likely to be female,have higher levels of education,and have greater food security(P<0.02 for all).The most common motivations for using DS were to follow doctor’s advice(36.7%,SE 1.8),to improve overall health(22.1%,SE 2.0),and to maintain health(19.2%,SE 1.9).CONCLUSION Nearly half of individuals with SLD report taking DS.This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.
文摘BACKGROUND The weight-to-waist index(WWI)serves as an innovative metric specifically designed to assess central obesity.However,the relationship between WWI and the prevalence of post-stroke depression(PSD)remains inadequately explored in the literature.AIM To elucidate the relationship between WWI and PSD.METHODS Data from the National Health and Nutrition Examination Survey 2005 to 2018 were analyzed.Multivariable logistic regression models and propensity score matching were utilized to investigate the association between WWI and PSD,with adjustments for potential confounders.The restricted cubic spline statistical method was applied to explore non-linear associations.RESULTS Participants with elevated WWI values had a significantly greater risk of developing PSD.Specifically,individuals in the higher WWI range exhibited more than twice the likelihood of developing PSD compared to those with lower WWI values(odds ratio=2.21,95%confidence interval:1.84-2.66,P<0.0001).After propensity score matching,the risk of PSD remained significantly elevated(odds ratio=1.43,95%confidence interval:1.09-1.88,P=0.01).Tertile analysis revealed that participants in the highest WWI tertile faced a significantly higher risk of PSD compared to those in the lowest tertile.Restricted cubic spline analysis further revealed a non-linear association,with the risk of PSD plateauing at higher WWI values.CONCLUSION There is a significant association between elevated WWI and increased risk of PSD.Thus,regular depression screening should be implemented in stroke patients with elevated WWI to enhance patient outcomes.
基金Supported by Sanming Project of Medicine in Shenzhen,No.SZZYSM202202010。
文摘BACKGROUND The triglyceride glucose-body mass index(TyG-BMI)is a novel indicator of insulin resistance(IR).Obstructive sleep apnea(OSA)is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep;however,the relationship between these two conditions remains unexplored.We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.AIM To assess the association between TyG-BMI and OSA in adults in the United States.METHODS A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018.TyGBMI was calculated as Ln[triglyceride(mg/dL)×fasting blood glucose(mg/dL)/2]×BMI.Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence.To identify potential nonlinear relationships,we combined Cox proportional hazard regression with smooth curve fitting.We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.RESULTS We included 16794 participants in the final analysis.Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence.After adjusting for all covariates,TyG-BMI was positively correlated with the prevalence of OSA(odds ratio:1.28;95%confidence interval:1.17,1.40;P<0.001);no significant nonlinear relationship was observed.Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes.The correlation between TyG-BMI and OSA was influenced by age,sex,smoking status,marital status,hypertensive stratification,and obesity;these subgroups played a moderating role between TyGBMI and OSA.Even after adjusting for all covariates,there was a positive association between TYG-BMI and OSA prevalence.CONCLUSION A higher TyG-BMI index is linked to higher chances of developing OSA.As TyG-BMI is an indicator of IR,managing IR may help reduce the risk of OSA.
基金This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Gannan Medical University(approval No.EFYJ20240113007).
文摘BACKGROUND Identification of myocardial injury has traditionally relied on high-sensitivity troponin T(hs-TnT)levels exceeding the 99th percentile threshold.However,patients with detectable hs-TnT levels below this threshold represent a heterogeneous group with an inadequately characterized risk profile.AIM To investigate the association between hs-TnT levels below the 99th percentile and the presence of diabetic kidney disease(DKD)in patients with diabetes mellitus.METHODS This study analyzed data from the National Health and Nutrition Examination Survey obtained between 1999 and 2004,focusing on adults with type 2 diabetes mellitus.Serum hs-TnT concentrations were evaluated.DKD was defined as impaired glomerular filtration rate(<60 mL/minute/1.73 m^(2)),proteinuria(urinary albumin-to-creatinine ratio of≥30 mg/g),or both conditions in patients with diabetes mellitus.Weighted multivariable logistic regression analysis and restricted cubic spline analyses were employed to examine the independent association between hs-TnT and DKD,with the likelihood ratio test being used to evaluate nonlinearity.RESULTS The study included 2505 patients with a mean age of 55.02(standard error:0.72)years,of whom 44.87%were females.Among the participants,909(32.34%)were diagnosed with DKD.Multivariable logistic regression analysis indicated that,compared to the lowest tertile of hs-TnT(<5.93 ng/L),tertile 2(5.94-9.79 ng/L)had an odds ratio of 1.25(95%confidence interval:0.77-2.02,P=0.350),while tertile 3(9.80-21.88 ng/L)had an odds ratio of 2.07(95%confidence interval:1.13-3.80,P=0.022),with a significant trend(P for trend=0.022).Smoothed curve fitting demonstrated a linear association between hs-TnT levels and DKD in the overall population(P=0.061 for nonlinearity)and in male(P=0.136 for nonlinearity)and female(P=0.067 for nonlinearity)subgroups.Further stratification and sensitivity analyses yielded consistent conclusions.CONCLUSION Our study findings suggest that in individuals with type 2 diabetes,detectable hs-TnT levels below the 99th percentile are associated with DKD.
基金Supported by the National Natural Science Foundation of China(No.82074500)CACMS Innovation Fund(No.CI2021A02605)+1 种基金Administration of Traditional Chinese Medicine of Zhejiang Province(No.2024ZR029)Science and Technology Program of Wenzhou City(No.Y2023210).
文摘AIM:To assess the relationship between dietary inflammatory index(DII)and prevalence of glaucoma among individuals aged 40y and above in the United States.METHODS:Participants were drawn from 2 cycles of the National Health and Nutrition Examination Survey(NHANES,2005-2008)for a cross-sectional study.DII was calculated from 24-hour dietary recall questionnaire conducted by experienced researchers and data analyzed in R according to the NHANES user guide,“Stratified Multi-stage Probability Sampling”.The relationship between DII and glaucoma was evaluated by multi-factor logistic regression analysis and the existence of a non-linear association examined by restricted cubic spline(RCS)analysis.RESULTS:A total of 5359 subjects were included and the cross-sectional analysis weighted to represent the US population of 109 million.DII was elevated in glaucoma patients(P<0.001)and smoking and alcohol use contributed to significant differences(P<0.001).DII correlated negatively with Healthy Eating Index(HEI)-2015(Spearman rank correlation coefficient,r=-0.49).RCS analysis showed a linear relationship between DII and glaucoma risk(P of non-linear relationship=0.575).CONCLUSION:An increased DII is strongly associated with high risk of glaucoma and diet-induced inflammation should be controlled to delay glaucoma progression.
文摘Purpose: There is a significant rise in mortality rates from breast and cervical cancers in Low- and Middle-Income Countries. In Ghana, approximately 4482 women are diagnosed with these diseases at advanced stages. Unfortunately, the early detection rate for these cancers is low compared to other women’s health services. This situation underscores the need to identify the locations of reproductive-age women who have not been screened for these cancers, to implement targeted public health interventions. This study aims to pinpoint these women’s locations for tailored interventions. Method: Bivariate analysis assessed the relationship between the independent and outcome variables. Hot spot analysis and Kriging Ordinary interpolation were employed to pinpoint the locations of these women. Results: Breast cancer examination and cervical cancer test rates were low, with a strong association between the two screening services. Several significant variables were identified: place of residence (p Conclusion: Low participation in these screening services was related to women’s age and the outreach efforts of fieldworkers. Breast and cervical cancer screenings are interconnected and could be combined to improve attendance rates. The Community-based Health Planning and Services (CHPS) implementation strategy could be cost-effective for screening women through targeted interventions, especially in identified clusters.
基金Supported by The Science Foundation of 925th Hospital,No.2023[3]and No.2022[3/4]The Guizhou Provincial Health Commission Science and Technology Fund,No.gzwkj2023-135。
文摘BACKGROUND Cardiovascular health(CVH)plays a crucial role in overall health,but its association with metabolic-associated fatty liver disease(MAFLD)remains unclear.AIM To investigate the relationship between CVH,measured using Life’s Essential 8(LE8)and Life’s Simple 7(LS7),and the prevalence of MAFLD.METHODS This cross-sectional study had a sample of 2234 individuals,representing approximately 120 million individuals in the United States.Baseline parameters were compared between the LE8 and LS7 groups.Logistic regression models were used to evaluate the relationship between LE8,LS7,and MAFLD,while taking into account confounding factors.The investigation employed restricted cubic splines to investigate non-linear associations.Subgroup analyses and sensitivity studies were performed to evaluate the strength and reliability of the results.RESULTS Higher LE8 and LS7 scores were significantly associated with a decreased risk of MAFLD,even after controlling for demographic,socioeconomic,and clinical variables.This association demonstrated a non-linear pattern,with the most dramatic risk reduction observed at higher CVH levels.Individual CVH components,notably healthy behaviors and factors,exhibited strong relationships with MAFLD.Subgroup analyses indicated consistent relationships across several demographics.Sensitivity tests utilizing other MAFLD definitions validated the robustness of the findings.CONCLUSION Higher adherence to CVH criteria,as indicated by LE8 and LS7 scores,is associated with a significantly lower risk of MAFLD.These results emphasize the need to advance CVH to control and avoid MAFLD.
文摘The Palace Museum inventories its collection For the first time in history, curators of the Palace Museum have finally inven- toried the museum’s vast collection. After seven years of painstaking work, the museum finally released the results of its first comprehensive inventory on January 26, showing that the museum houses 1,807,558 items.
基金Research funds project of Ministry of Justice P.R.C(Grant No.14SFB30019)China Post Doctor Science Research Funds Special Aid Project(Grant No.2015T80420)ECUPL science research funds project(Grant No.A‑3101‑14‑144512).
文摘The critical examination of scientific evidence is crucial in attempting to distinguish genuine science from“junk science”and provides judges with an important basis upon which to determine the credibility of expert witnesses giving scientific evidence.From studying the law in the USA,we learn that the process for examining scientific evidence in court is based upon full discovery of the proposed evidence before trial and the availability of expert witnesses at trial to testify orally and be examined and cross‑examined.Empirical studies suggest that the opportunities to critically examine scientific evidence in Chinese courts are not so freely available.Discovery is neglected,thus limiting the effectiveness of cross‑examination,and current rules do not encourage oral testimony or effective cross‑examination.To solve these problems,the disclosure duty should be put on the prosecution,rather than on the defendant.Scientific evidence should be discovered.Disclosure must include the basis,process,material relied upon,and methods of forensic appraisals.In the trial process,the prosecution has transferred the case file to court,where the defendant will be able to copy the scientific evidence.The neutrality of expert assistants established by article 192 of the new Criminal Procedural Law should be strengthened.
基金Supported by National Natural Science Foundation of China,No.61876216.
文摘BACKGROUND Tuberous sclerosis complex(TSC)and primary lymphedema(PLE)are both rare diseases,and it is even rarer for both to occur in the same patient.In this work,we have provided a detailed description of a patient's clinical presentation,imaging findings,and treatment.And a retrospective analysis was conducted on 14 published relevant case reports.CASE SUMMARY A 16-year-old male came to our hospital for treatment due to right lower limb swelling.This swelling is already present from birth.The patient’s memory had been progressively declining.Seizures had occurred 1 year prior at an unknown frequency.The patient was diagnosed with TSC combined with PLE through multimodal imaging examination:Computed tomography,magnetic resonance imaging,and lymphoscintigraphy.The patient underwent liposuction.The swelling of the patient's right lower limb significantly improved after surgery.Epilepsy did not occur.after taking antiepileptic drugs and sirolimus.CONCLUSION TSC with PLE is a rare and systemic disease.Imaging can detect lesions of this disease,which are important for diagnosis and treatment.
基金funded by the grants from the National Key Research and Development Program of China[2021YFC2301503,2022YFC2302900]the National Natural and Science Foundation of China[82171739,82171815,81873884]。
文摘Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.
文摘AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.
文摘Objective Because of the limited number of studies and small sample sizes,whether metabolic syndrome(MS)leads to the occurrence and progression of osteoporosis and the possible underlying mechanisms require further investigation.This study aimed to investigate the association between MS and osteoporosis,along with its influencing factors.Methods This observational cross-sectional study included 139,470 individuals aged≥18 years who underwent health examinations from September 2014 to March 2022.Based on bone mineral density(BMD)screening results,the participants were categorized into a suspected osteoporosis or non-osteoporosis group(control).Participants were further divided into those who met 0 MS criteria,1 MS criterion,2 MS criteria,and≥3 MS criteria(MS group).Participants who had undergone health examinations at least twice formed the follow-up cohort;a self-matched analysis was performed on those with follow-up periods≥5 years and unchanged MS grouping.Results Several examination indicators in the suspected osteoporosis group showed statistically significant differences compared with the control group.The proportion of suspected osteoporosis in the MS group was significantly increased compared with that in the 0 MS criteria group(odds ratio[OR]:1.215,Z=29.11,P<0.001,95%confidence interval:1.199-1.231).After adjusting for age,sex,smoking,and alcohol consumption,the 2 MS criteria group and MS group still had OR values>1(P<0.001).In the follow-up cohort,the proportion of suspected osteoporosis increased gradually with an increase in the number of MS criteria met at baseline and during each follow-up visit(P<0.05),with the highest proportion observed in the MS group.However,the proportion of suspected osteoporosis did not increase significantly over time in the different MS groups(P>0.05).In the follow-up cohort,the proportion of individuals transitioning from normal BMD to suspected osteoporosis was higher in the MS group after≥5 years of follow-up compared with the group meeting 0 MS criteria(0.08%versus 1.15%,χ^(2)=10.76,P=0.001).There was no significant difference in BMD values for the 0 MS criteria group after 5 years(P>0.05),whereas the other three groups experienced a significant decrease in BMD values after 5 years(P<0.05).Conclusion MS is an independent risk factor for osteoporosis,and the effect of risk factors related to MS on osteoporosis may exceed that of aging alone.The specific mechanisms warrant further investigation.
文摘This editorial elaborates on the current and future applications of linear endoscopic ultrasound(EUS),a substantial diagnostic and therapeutic modality for various anatomical regions.The scope of endosonographic assessment is broad and,among other factors,allows for the evaluation of the mediastinal anatomy and related pathologies,such as mediastinal lymphadenopathy and the staging of central malignant lung lesions.Moreover,EUS assessment has proven more accurate in detecting small lesions missed by standard imaging examinations,such as computed tomography or magnetic resonance imaging.We focus on its current uses in the mediastinum,including lung and esophageal cancer staging,as well as evaluating mediastinal lymphadenopathy and submucosal lesions.The editorial also explores future perspectives of EUS in mediastinal examination,including ultrasound-guided therapies,artificial intelligence integration,advancements in mediastinal modalities,and improved diagnostic approaches for various mediastinal lesions.
文摘BACKGROUND Cystic lymphangioma is a rare benign tumor that affects the lymphatic system.Mesenteric lymphangiomas in the small bowel are extremely uncommon.CASE SUMMARY We present a 21-year-old female patient who complained of abdominal pain.The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder,ovary,and uterus.The patient underwent emergency laparotomy per-formed by gynecologists,but it was discovered that the cystic tumor originated from the jejunum.Gastrointestinal surgeons were then called in to perform a cystectomy.Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery.The patient had an uneventful postoperative recovery.CONCLUSION Mesenteric lymphangiomas can cause abdominal pain,and imaging techniques can help determine their characteristics,location,and size.Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.
文摘BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and painless method for the diagnosis of gastric tumors.AIM To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric tumors.METHODS The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological examination.RESULTS Among 42 patients with gastric tumors enrolled in the study,the diagnostic accordance rate was 95.2%for oral contrast-enhanced ultrasonography(n=40)and 90.5%for electronic gastroscopy(n=38)compared with postoperative pathological examination.The Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy,and there was no significant difference between them(P=0.397).For the TNM staging of gastric tumors,the accuracy rate of oral contrast enhanced ultrasonography was 81.9%for the overall T staging and 50%,77.8%,100%,and 100%for T1,T2,T3,and T4 staging,respectively.The sensitivity and specificity were both 100%for stages T3 and T4.The diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%,80%,100%,and 100%for stages N0,N1-N3,M0,and M1,respectively.CONCLUSION The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy,and it could be used as the preferred method for the early screening of gastric tumors.
