An assessment system for clinical and biological interpretability in ulcerative colitis.

Ulcerative colitis (UC) is a serious inflammatory bowel disease (IBD) with high morbidity and mortality worldwide. As the traditional diagnostic techniques have various limitations in the practice and diagnosis of early ulcerative colitis, it is necessary to develop new diagnostic models from molecular biology to supplement the existing methods. In this study, we developed a machine learning-based synthesis to construct an artificial intelligence diagnostic model for ulcerative colitis, and the correctness of the model is verified using an external independent dataset. According to the significantly expressed genes related to the occurrence of UC in the model, an unsupervised quantitative ulcerative colitis related score (UCRScore) based on principal coordinate analysis was established. The UCRScore is not only highly generalizable across UC bulk cohorts at different stages, but also highly generalizable across single-cell datasets, with the same effect in terms of cell numbers, activation pathways and mechanisms. As an important role of screening genes in disease occurrence, based on connectivity map analysis, 5 potential targeting molecular compounds were identified, which can be used as an additional supplement to the therapeutic of UC. Overall, this study provides a potential tool for differential diagnosis and assessment of bio-pathological changes in UC at the macroscopic level, providing an opportunity to optimize the diagnosis and treatment of UC.

Security and Radical Assessment in Open, Laparoscopic, Robotic Colorectal Cancer Surgery: A Comparative Study.

PURPOSE: This retrospective study was designed to assess the safety and effectiveness of open, laparoscopic, robotic colorectal cancer surgery. METHODS: Three hundred patients with colorectal cancer who underwent curative resection in the First Affiliated Hospital of Zhengzhou University between February 2014 and May 2016 were included. Patients were classified into open surgery group, laparoscopic surgery group, and robot-assisted group. RESULTS: The blood loss in laparoscopic surgery group was less than that in open surgery group, and the blood loss in robot-assisted group less was than the open surgery group. The number of lymph node dissection in robot-assisted group was significantly larger than that in the open group ( P < .05). The distance between the lower edge of the tumor group and the distal margin in robotic group was longer than that of the laparoscopic surgery group and the open group ( P < .05). Three (2.8%) cases of urinary retention occurred in the open surgery group, 4 (3.92%) cases in the laparoscopic surgery group, and 1 (1.1%) case in the robot-assisted group, while 2 (1.87%) cases of sexual dysfunction occurred in the open surgery group, 2 (1.96%) cases in the laparoscopic surgery group, and 1 (1.1%) case in the robot-assisted group. The urinary retention and sexual dysfunction rate did not differ between the 3 groups ( P > .05), but the minimally invasive group showed a certain advantage over the open group. CONCLUSION: Compared to the traditional open surgery, minimally invasive surgery (especially in robot-assisted group) has advantages such as less intraoperative bleeding, rapid postoperative recovery, and radical cure; open group, laparoscopic surgery group, and robot-assisted group have a similar incidence of postoperative complications, but reduction in the incidence of anastomotic leakage and intestinal obstruction. Robot-assisted group has the potential advantage for pelvic autonomic nerve protection.

Simplified assessment of segmental gastrointestinal transit time with orally small amount of barium.

OBJECTIVE: To determine the effectiveness and advantage of small amount of barium in the measurement of gastrointestinal transmission function in comparison with radio-opaque pallets. METHODS: Protocal 1: 8 healthy volunteers (male 6, female 2) with average age 40±6.1 were subjected to the examination of radio-opaque pellets and small amount of barium with the interval of 1 week. Protocol 2: 30 healthy volunteers in group 1 (male 8, female 22) with average age 42.5±8.1 and 50 patients with chronic functional constipation in group 2 (male 11, female 39) with average age 45.7±7.8 were subjected to the small amount of barium examination. The small amount of barium was made by 30 g barium dissolved in 200 ml breakfast. After taking breakfast which contains barium, objectives were followed with abdominal X-ray at 4, 8, 12, 24, 48, 72, 96 h until the barium was evacuated totally. RESULTS: Small amount of barium presented actual chyme or stool transit. The transit time of radio-opaque pallets through the whole gastrointestinal tract was significantly shorter than that of barium (37±8 h vs. 47±10 h, P<0.05) in healthy people. The transit times of barium in constipation patients were markedly prolonged in colon (61.1±22 vs. 37.3±11, P<0.01) and rectum (10.8±3.7 vs. 2.3±0.8 h, P<0.01) compared with unconstipated volunteers. Transit times in individual gastrointestinal segments were also recorded by using small amount of barium, which allowed identifying the subtypes of constipation. CONCLUSION: The small amount barium examination is a convenient and low cost method to provide the most useful and reliable information on the transmission function of different gastrointestinal segments and able to classify the subtypes of slow transit constipation.