Diagnostic Accuracy of JES Classification for Prediction of Invasion Depth in Superficial Esophageal Squamous Carcinoma: Meta-Analysis.

Prediction of the depth of invasion in superficial oesophageal squamous carcinoma (SESC) is an important factor for choosing the treatment. Recently, the Japan Esophageal Society (JES) designed a magnifying endoscopy classification based on the Inoue and Arima classifications. The aim of this study was to conduct a meta-analysis of the published literature on JES classification. Meta-Disc version 1.4, Review Manager 5.4 as well as stata 14.0 were used. The analysis combined sensitivity and specificity with the respective 95% CI, to draw a summary receiver operating characteristic curve (SROC), and estimated the area under curve (AUC) for overdiagnosis and underdiagnosis for each type B. Eight studies were included in the meta-analysis comprising 1279 patients. Type B1 has high sensitivity (0.86, 95%CI: 0.83-0.88) and specificity (0.84, 95%CI: 0.81-0.88) for the prediction of EP/LPM classifications. The AUC was calculated to be 0.92 with a high proportion of underdiagnosis (17%). The sensitivity and specificity of type B2 were 0.66 (95% CI, 0.6-0.72) and 0.84 (95% CI, 0.82-0.86) respectively. The overdiagnosis and underdiagnosis of type B2 were 14% and 39%. Type B3, sensitivity was low (0.49, 95% CI: 0.41-0.56), with high specificity and AUC (specificity: 0.99; AUC: 0.95). JES classification is a useful and reliable modality for predicting the depth of invasion of SESC, but other modalities should be considered for additional assessment when type B2 is detected. Key Words: JES classification, Superficial oesophageal squamous carcinoma, Depth of invasion, Magnifying endoscopy, Meta-analysis.

Species and structural diversity of trees at the structural type level.

BACKGROUND: Species and structural diversity are important for understanding the formation of forest communities, key ecological processes, and improving forest ecological functions and services, but their spatial characteristics have received little attention. Based on the spatial relationships among neighbouring trees, we proposed to divide trees within a structural unit into 15 structural types, and used the univariate distributions of the uniform angle index (W), mingling (M), and dominance (U), along with four common species diversity indices, to analyse the diversity of structural types in natural forests near the Tropic of Cancer. RESULTS: Only a portion of clumped class maintained aggregation, most exhibited a random pattern. Species mixture increased exponentially across distribution classes, and abundance and richness exhibited an initial increase followed by a slight decrease. The distribution patterns of mixture classes varied from highly clustered to random, and M distributions gradually shifted from an inverted J-shaped curve to a J-shaped curve. Abundance and richness exhibited an exponential distribution, whereas the Shannon-Wiener index increased linearly. The W distribution of differentiation classes approximated a normal distribution, whereas M distributions exhibited a J shape. The U distribution of each structure type was approximately 0.2. CONCLUSIONS: These results reveal the species and structural diversity characteristics of trees at the structural type level and expand our knowledge of forest biodiversity. The new method proposed here should significantly contribute to biodiversity monitoring efforts in terrestrial ecosystems, and suggests that higher standards for the simulation and reconstruction of stand structure, as well as thinning in near-natural forests, is warranted.

Effect of Reinforced Video by WeChat on Adenoma Detection Rate for Colonoscopy.

OBJECTIVE: To evaluate the influence of reinforced educational video through smartphone WeChat on adenoma detection rate (ADR). STUDY DESIGN: Randomised controlled study. Place and Duration of the Study: Department of Gastroenterology, Xiantao First People's Hospital affiliated to Yangtze University, Hubei, China, from May 2020 to December 2021. METHODOLOGY: All participants received written instructions regarding bowel preparation and diet before colonoscopy. After randomisation, patients in video group received educational videos through WeChat, two days before the colonoscopy. The primary endpoint was ADR. The secondary outcomes were polyp detection rate (PDR), quality of bowel preparation, adverse events, and satisfaction with preparation. RESULTS: Five-hundred and sixty-four patients were included in the study (284 in video group and 280 in non-video group). ADR was similar in both groups without significant difference (26.4% vs. 23.2%, p=0.38). PDR was not different among the two groups (31.7% vs. 30.4%). The total cleansing score and percentage of adequate bowel preparation in the video group were higher compared with non-video group (p<0.05). Moreover, patient satisfaction was also higher in video group (p=0.048), and the incidence of adverse events in both groups was similar. CONCLUSION: The availability of a supplementary educational video before colonoscopy was insufficient to improve ADR and PDR, but offered benefits on bowel preparation quality and patient satisfaction. KEY WORDS: Video, Adenoma detection rate, Bowel preparation, Colonoscopy.

The effect of using simethicone with or without N-acetylcysteine before gastroscopy: A meta-analysis and systemic review.

BACKGROUND/AIM: To assess the efficacy and safety of simethicone with or without N-acetylcysteine (NAC) as premedications before gastroscopy. MATERIALS AND METHODS: We searched EMBASE, PubMed, Cochrane library and Web of Science database for randomized clinical controlled trials regarding simethicone ± NAC as oral drinking agents before gastroscopy. Statistical software RevMan5.3 was used for statistical analysis. RESULTS: Ten randomized clinical trials that fulfilled the inclusion criteria were further pooled into a meta-analysis, which included 5,750 patients. The rate of positive findings in simethicone plus NAC group was higher than that in water group (risk ratio [RR] =1.31, 95%CI: 1.12-1.53, P = 0.0006) with high level of evidence. There was no significant difference on the rate of positive findings when comparing simethicone with simethicone plus NAC (RR = 1.02, 95%CI: 0.90-1.16, P = 0.71) and with water (RR = 1.13, 95%CI: 0.82-1.55, P = 0.46), respectively. Simethicone plus NAC showed better total mucosal visibility score than simethicone alone (MD = -0.14 (-0.25, -0.03), P = 0.01) without obvious heterogeneity. Both simethicone plus NAC and simethicone alone offer more benefit than water. The procedure time in simethicone group was shorter than that in water group (MD = -1.23 (-1.51, -0.96), P < 0.00001). Regarding adverse events, there was no significant difference in simethicone and water group (RR = 0.45, 95%CI: 0.2-1.0, P = 0.05, I2 = 0%). CONCLUSIONS: As premedication of gastroscopy, simethicone plus NAC offers more benefit on positive findings and total mucosal visibility score.