Identification of chronic non-atrophic gastritis and intestinal metaplasia stages in the Correa's cascade through machine learning analyses of SERS spectral signature of non-invasively-collected human gastric fluid samples.

The progression of gastric cancer involves a complex multi-stage process, with gastroscopy and biopsy being the standard procedures for diagnosing gastric diseases. This study introduces an innovative non-invasive approach to differentiate gastric disease stage using gastric fluid samples through machine-learning-assisted surface-enhanced Raman spectroscopy (SERS). This method effectively identifies different stages of gastric lesions. The XGBoost algorithm demonstrates the highest accuracy of 96.88% and 91.67%, respectively, in distinguishing chronic non-atrophic gastritis from intestinal metaplasia and different subtypes of gastritis (mild, moderate, and severe). Through blinded testing validation, the model can achieve more than 80% accuracy. These findings offer new possibilities for rapid, cost-effective, and minimally invasive diagnosis of gastric diseases.

Quantitative Polymerase Chain Reaction (qPCR)-Based Rapid Diagnosis of Helicobacter pylori Infection and Antibiotic Resistance.

Helicobacter pylori is a major human pathogen that infects approximately half of the global population and is becoming a serious health threat due to its increasing antibiotic resistance. It is the causative agent of chronic active gastritis, peptic ulcer disease, and gastric cancer and has been classified as a Group I Carcinogen by the International Agency for Research on Cancer. Therefore, the rapid and accurate diagnosis of H. pylori and the determination of its antibiotic resistance are important for the efficient eradication of this bacterial pathogen. Currently, H. pylori diagnosis methods mainly include the urea breath test (UBT), the antigen test, the serum antibody test, gastroscopy, the rapid urease test (RUT), and bacterial culture. Among them, the first three detection methods are noninvasive, meaning they are easy tests to conduct. However, bacteria cannot be retrieved through these techniques; thus, drug resistance testing cannot be performed. The last three are invasive examinations, but they are costly, require high skills, and have the potential to cause damage to patients. Therefore, a noninvasive, rapid, and simultaneous method for H. pylori detection and drug resistance testing is very important for efficiently eradicating H. pylori in clinical practice. This protocol aims to present a specific procedure involving the string test in combination with quantitative polymerase chain reaction (qPCR) for the rapid detection of H. pylori infection and antibiotic resistance. Unlike bacterial cultures, this method allows for easy, rapid, noninvasive diagnosis of H. pylori infection status and drug resistance. Specifically, we used qPCR to detect rea for H. pylori infection and mutations in the 23S rRNA and gyrA genes, which encode resistance against clarithromycin and levofloxacin, respectively. Compared to routinely used culturing techniques, this protocol provides a noninvasive, low-cost, and time-saving technique to detect H. pylori infection and determine its antibiotic resistance using qPCR.

Comprehensive Evaluation of Visual Function in Patients With Orbital Fracture by Visual Electrophysiology and Visual Field Examination.

OBJECTIVE: At present, the effect of the visual electrophysiology and vision field examination in patients with orbital blowout fracture is rarely studied. So, the authors investigate the value of visual electrophysiology and vision field examination in the diagnosis of ocular contusion. METHODS: The position and range of fracture of 81 patients were determined by computed tomography (CT) scanning. Visual evoked potential (VEP), electroretinogram (ERG), and mfERG were vision field examination detected in 81 patients and the results were compared with those of contralateral healthy eyes. In addition, visual electrophysiology and vision field examination in diagnosis of eye contusion was analyzed and the correlation of the VEP, ERG, mfERG injury duration, and visual acuity was further analyzed. RESULTS: The visual acuity of orbital fractures was significantly decreased compared with that in the uninjured eyes (t = 2.181, P = 0.032). Compared injured eyes and normal eyes in 54 patients, b wave of Max-ERG and Cone-ERG implied value extension (t = -2.426, P = 0.025; t = -2.942, P = 0.014), P-VEP P100 Peak duration and amplitude significantly extended (t = 3.162, P = 0.007; t = 9.314, P = 0.000), and F-VEP P1 amplitude decreased significantly (t = 3.362, P = 0.004). mfERG showed that the injured eye central reaction was significantly decreased (t = 8.727, P = 0.000). There was a significant correlation between P-VEP P100 amplitude and visual acuity (r = 0.067, P = 0.000). But there was no significant correlation between the P100 peak value, amplitude of P-VEP, mfERG central reaction, and injured days, respectively. There was significant difference between 2 groups with average visual acuity and mean defect value (t = 3.253, 3.461, P = 0.006, 0.003). There was statistical means the difference in P-VEP abnormal group, visual field abnormal group, and combined detection abnormal groups, the abnormal rate increased significantly (χ = 3.931, P < 0.01). CONCLUSION: Orbital floor fracture can lead to optic nerve damage and also may be associated with decreased macular function. The combination analysis of visual electrophysiology and vision field examination is beneficial to early diagnosis of ocular trauma and can improve the positive rate in clinic practice.

Postoperative Improvement of Diplopia and Extraocular Muscle Movement in Patients With Reconstructive Surgeries for Orbital Floor Fractures.

OBJECTIVE: With orbital floor fracture incidence rates increasing year by year, many patients require surgical treatment to improve diplopia, limitation of extraocular muscle movement (EOM), enophthalmos, and midface appearance. With the use of high-density polyethylene, titanium screws, titanium plate, and titanium mesh to repair an orbital floor fracture, enophthalmos and midfacial deformity correction procedures have made great progress. However, attenuating diplopia and the limitation of EOM are still difficult problems to prevent. METHODS: The clinical data of 92 patients with reconstructive surgeries after orbital floor fracture were prospectively studied. The position, range of fracture, and incarceration of extraocular muscles were determined by computed tomography scanning. A Hess screen and a synoptophore examination were used to determine the EOM and diplopia. The Hess area ratio (HAR%) and the grade of diplopia were measured before and 1, 3, and 6 months after surgery. Diplopia was evaluated, and the severity was recorded accordingly. RESULTS: Diplopia rates in patients with simple orbital floor fracture showed a significant difference preoperatively and postoperatively at 1 and 3 months (P < 0.05) compared with diplopia rates at 6 months and 12 months after operation, which had no significant difference (P > 0.05). There was a statistically significant difference (P < 0. 05) among patients with an orbital floor fracture who had an operation within 3 weeks or more than 3 months after injury. Compared with preoperative and postoperative findings at 1 and 3 months, the limitation of EOM in patients with orbital floor fractures had a significant difference (P < 0.05); however, compared with 3 and 6 months after operation, there was no significant difference (P > 0.05). There was a statistically significant difference (P < 0.05) in patients with orbital floor fractures having had an operation within 3 weeks and more than 3 months after injury. The difference of improvement for diplopia after operation among HAR% < 65%, 65% ≤ HAR% ≤ 85%, and HAR% >85% groups were statistically significant (P <0.05). Postsurgically, the HAR% of the patients was improved, and the difference of HAR% between patients before and after the operation was statistically significant (P < 0.05). CONCLUSION: Surgical management can effectively improve diplopia and EOM disorder of patients with orbital floor fractures. Improvement statistics were calculated by a Hess screen and a synoptophore. Hess area ratio is a useful method to convert the Hess screen into a numerical value and can therefore be used to compare patients in clinical treatment of orbital wall fracture.

[Three-dimensionally preformed titanium mesh plates for posttraumatic complex orbital bone fracture reconstruction].

OBJECTIVE: To evaluate the outcomes of the clinical application of three-dimensionally preformed titanium mesh plates for posttraumatic complex orbital bone fracture reconstruction. METHODS: Thirteen patients (13 eyes) manifested with complex orbital fractures (including orbital-zygomatic-maxillary bone fracture in 6 patients, nasal-orbital-ethmoid bone fracture in 5 patients and complex multiple periorbital bone fracture in other 2 patients) underwent the reconstructive surgery by using three-dimensionally preformed titanium mesh plates. Eight cases underwent high density porous polyethylene implantation simultaneously. Evaluation of enophthalmos, eyeball movement, and orbit CT scan were taken pre- and post-operatively. RESULTS: The average enophthalmos was (3.9 ± 1.7) mm and the position of the affected eyeball was (3.1 ± 2.6) mm bellow the contralateral side preoperatively. Twelve patients suffered from eyeball movement restriction, including grade I in 4 cases, grade II in 7 cases and grade III in 2 cases. During the 3 to 6 months post operative follow-up, enophthalmos was completely corrected in 10 patients while the other 3 patients had residual 1.0 mm enophthalmos. The affected eyeballs were repositioned in 8 cases and 3 cases had residual 1 mm lower position and 2 cases with a 1 mm higher positioned eyeball. Eye movement was not restricted in 8 patients, whereas 3 patients had grade I movement restriction and 2 patients had grade II movement restriction. There were no rejection, infection and other complications during follow-up. CONCLUSIONS: Three-dimensionally preformed titanium mesh plates can be used to reconstruct posttraumatic complex orbital bone fractures in order to improve the orbital volume and to correct enophthalmos effectively.