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Traditional laser-induced breakdown spectroscopy (LIBS) always fails to directly detect target in aqueous solution due to rapid quenching of emitted light and adsorption of pulse energy by surrounding water. A method is proposed for the in situ underwater LIBS analysis of Cr(VI) in aqueous solution freed from the common problems mentioned above by combining a gas-assisted localized liquid discharge apparatus with electrosorption for the first time. In this approach, the introduction of the gas-assisted localized liquid discharge apparatus provides an instantaneous gaseous environment for underwater LIBS measurement (that is, the transfer of sampling matrix is not needed from aqueous solution to dry state). The preconcentration of Cr(VI) is achieved by electrosorption with a positive potential applied around adsorbents, which can promote the adsorption of Cr(VI) and inhibit that of the coexisting cations leading to a good anti-interference. Amino groups functionalized chitosan-modified graphene oxide (CS-GO) is utilized for Cr(VI) enrichment, which can be protonated to form NH3+ in acidic condition promoting the adsorption toward Cr(VI) by electrostatic attraction. The highest detection sensitivity of 5.15 counts µg-1 L toward Cr(VI) is found for the optimized electrosorption potential (EES = 1.5 V) and electrosorption time (tES = 600 s) without interference from coexisting metal ions. A corresponding limit of detection (LOD) of 12.3 µg L-1 (3σ method) is achieved, which is amazingly improved by 2 or even 3 orders of magnitude compared to the previous reports of LIBS.
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In order to improve the detection sensitivity and spectral characteristic of laser-induced breakdown spectroscopy (LIBS), re-heating orthogonal dual-pulse configuration is adopted to analyze Fe, Pb, Ca and Mg contained in the sample and soil sample contained different concentrations of heavy mental Cr. Variation relationship between spectral intensity, signal-to-background(SBR) of four characteristic spectral lines Feâ ï¼404.581 nmï¼Pbâ ï¼405.78 nmï¼Caâ ï¼422.67 nm and Mgâ ï¼518.361 nm and time interval of two laser pulses is discussed, the best time interval of two laser pulses is obtained 1.0 µs. In the condition of single pulse and dual-pulse, the enhancement factor of spectral intensity of four characteristic spectral lines Feâ ï¼404.581 nmï¼Pbâ ï¼405.78 nmï¼Caâ ï¼422.67 nm and Mgâ ï¼518.361 nm is respectively 2.23ï¼2.31ï¼2.42 and 2.10; The time evolution characteristic of spectral intensity of characteristic spectral lines Feâ ï¼404.581 nm and Caâ ï¼422.67 nm is considered, and also the variation relationship between spectral acquisition delay time and SBR of four characteristic spectral lines, dual-pulse can prolong decay time of spectral intensity and improve the SBR of characteristic spectral lines; time evolution characteristic of plasma temperature and electron density is compared in the condition of single pulse and dual-pulse, maximum elevation of plasma temperature is found to be 730 K, and the maximum increase of electron density is 1.8×1016 cm-3. The limits of detection of heavy mental Cr are obtained 38 and 20 µg·g-1 respectively in condition of single and double pulse, limit of detection of Cr is reduced approximately 2 times by the condition of re-heating orthogonal dual pulse. Results above indicate that re-heating orthogonal dual-pulse can improve detection sensibility and spectral characteristic of LIBS technique, which provides an effective method for decreasing the limit of detection of elements.
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In order to improve the detection sensitivity of laser-induced breakdown spectroscopy (LIBS) and lower the limit of the detection of elements, LIBS combined with Aluminum electrode enrichment method is adopted to analyze heavy metals such as Pb,Cdand Ni in the water. The relationship between the characteristic spectral intensity and the key parameters-voltage of electrode method is discussed, the spectral intensity increases first and then decreases with the increase of voltage. The spectral intensity reaches the maximum value when the enrichment voltage is 1.2 V while the optimal enrichment voltage value is 1.2 V. The stability of characteristic spectral lines of heavy metals is studied, and the relative standard deviation(RSD) of spectral intensity of Pb, Cd and Ni is 5.98ï¼ ï¼4.25 ï¼ and 5.27ï¼ respectively, the result shows that the spectral line obtained by this method has high stability. A series of samples in the range of 0~0.13 mg·L-1 are prepared and quantitatively analyzed, the limit of detection of Pb, Cd and Ni is obtained 1.2ï¼3.1 and 1.7 ppb respectively. The above result shows that LIBS combined with aluminum electrode enrichment method can effectively improve the stability of characteristic spectral lines and lower the limit of detection of Pb,Cd and Ni. This research also provides a method to further improve detection sensitivity of LIBS and analysis ability of heavy metal in the water.
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Soil classification is an important research content in soil science field. It is the basis of soil survey and resource evaluation which is important to agricultural production. There are many soil classification standards all over the world. China has two kinds of classifications including soil genetic classification and soil system classification. There are great differences between different types of soil elements, so it is feasible for soil classification to use laser induced breakdown spectroscopy. Laser induced breakdown spectroscopy (LIBS) is a new element analysis technology which uses a laser pulse with high energy density to ablate samples. LIBS has been used in many fields including environmental protection and industrial production control. It can directly reflect the difference of element content in different soils. The experimental setup including an Nd: YAG laser, a spectrometer, a computer and a rotating platform. In the experiment 7 kinds of soil (red soil, brick red soil, lateritic red soil, paddy soil, cinnamon, alluvial soil and alpine meadow soil) including 25 samples were used. All soil samples were grinded and sieved before the experiment. Under the same experimental condition, the temperatures of the plasma created by the laser pulses on the surface of the different soil samples have great differences. The lateritic red soil had the highest temperature, and the alpine meadow soil had the lowest. But it was not enough to form the basis for classification. Therefore six constant elements including Si, Fe, Al, Mg, Ca and Ti were selected and their spectral line intensity were treated as classification index. Principal component analysis (PCA) was used to simplify the classification process. The PCA method could simplify the 6 indexes to few independent indexes which could also reflect the spectral information of the 6 elements. The original spectral data was processed by Matlab. The process consisted of spectral background removal, characteristic spectrum identify and extraction. The classification results showed a three--dimensional figure. Except alpine meadow soil which varied in element concentrations 6 kinds of soils achieved good classification. The brick red soil and lateritic red soil varied in PC1, but their PC2s and PC3s were the same. The two kinds of soil overlapped with each other and they couldn't be separated. Back-propagation artificial network was also used to achieve soil classification. The classification results were the same with the PCA. Some brick red soil and lateritic red soil samples were identified inaccurately. When the PC1, 2, 3 were used as the input of the BP-neural network, the classification had much better accuracy because less input improved the performance of the BP-neural network. Only one alpine meadow soil sample was identified to cinnamon soil. When the plasma temperature was also taken into account, all the soil samples could be distinguished. The results showed that LIBS could be used to classify soils based on their element content differences. The PCA, soil plasma temperature and BP-neural network were useful tools to achieve soil classification. The LIBS provides a useful tool for general detailed soil survey and rational utilization of soil.
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The structures of bacterial cells are analyzed in this paper. The scattering components of individual cell were divided into two parts including external structure and internal structure. The interpretation model of bacteria about scattering light is established. The model is used to analyze the scattering light of Escherichia coli in the region of 400~900 nm. The average size of external structure and the internal structure can be obtained, and the ratio of the two parts is also obtained. According to the relationship of the optical density of single cell and the overall measurement, the concentration of bacterial can be obtained quickly. The maximum difference in all the concentrations of the bacteria repeated measurements is 1.83%; compared with the plate culture method, the measurement results were in the same order of magnitude, with relative error of 3.43%. The scattering light of Escherichia coli and Klebsiella pneumoniae are analyzed in different growth stages, the curves of the concentration and the size of the two species bacteria over time are obtained. The results can provide a quick way for the study of bacterial growth and technical support for rapid detection of bacteria in the water.
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Bactérias , Escherichia coli , Klebsiella pneumoniae , Espalhamento de Radiação , Água , Microbiologia da ÁguaRESUMO
Polycyclic Aromatic Hydrocarbons (PAHs) have been widely investigated in environmental field, for most of them are mutagenic (carcinogenic, teratogenic, mutagenic). The influence of delay time and gate width on the time-resolved fluorescence spectroscopy of fluoranthene in ethanol was studied in this paper. Furthermore, laser induced time-resolved fluorescence spectroscopy of fluoranthene with different concentration were also researched. According to the results, fluorescence kinetics decay curves and fluorescence lifetime of fluoranthene matched. The research results showed that there was closely relationship between the fluorescence spectrum of fluoranthene and the delay time and gate width of detector. When the delay time was fixed, the fluorescence intensity of fluoranthene grew increased as the gate width increased. When the gate width was fixed, the fluorescence intensity of fluoranthene increased first and then decreased with the delay time increases. The process of the attenuation of fluorescence intensity of fluoranthene with time delay conformed to the exponential decay process. The stepwise dilution of fluoranthene ethanol solution was also studied. With increasing dilution, the fitting of fluoranthene fluorescence lifetime increased. The results of this paper can provide a technical basis for the detection of PAHs in the environment, due to the different characteristics of the fluorescent substance having fluorescence lifetime.
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Extensive use of pesticides has a significant impact on the environment. Carbaryl, whose residues stay in the surface water, is one of the most widely used broad spectrum insecticides in agriculture. It is important to understand carbaryl spectral characteristics and detection methods. The characteristic of excitation-emission three-dimensional spectra of carbaryl is studied. By changing the concentration of methanol in methanol-water binary solvent, the impact of methanol-water mixture on three-dimensional fluorescence spectra of carbaryl is discussed. The results show that the characteristic excitation-emission spectra of carbaryl is single peak, the range of the excitation wavelength and emission wavelength are: 244~304 and 300~350 nm respectively, the maximum excitation/emission peak located at 280 and 335 nm. With increasing the content of methanol in methanol-water binary solvent mixture, there is no obviously spectra shift of three dimensional fluorescence spectra of carbaryl. However, the intensity of fluorescence is nonlinear dependent on the content of methanol, mainly due to the specific properties of binary mixed solvent.
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Laser-induced breakdown spectroscopy (LIBS) was used to calibrate the concentration of Cr in soils combined with Support Vector Machine. The Nd:YAG pulse laser with the wavelength of 1 064 nm was used as the excitation source. The grating spectrometer and the charge couple device were used as spectral separation device and the spectral detection device. The multiple linear regression and support vector machine were adopted to make quantitative analysis on Cr in soils respectively. The result indicate that the multiple linear regression can get more accurate informination of the spectral lines: the correlation coefficient is increased from 0.689 to 0.980 compared with conventional quantitative method. Thereofre, the the accuracy of quantitative analysis is increased. The slope about calibration curve with support vector machine of test set is nearly about 1 and the correlation coefficient is 0.998, the relative errors for the test set all are lower than 2.57%, the quantitative analysis results about support vector machine are better than the results combined with the conventional quantitative method and the multiple linear regression. The support vector machine can correct the matrix effect and improve the accuracy of prediction on the concentration of Cr in soil.
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Doença Celíaca/diagnóstico , Enteropatias/diagnóstico , Intestino Delgado/imunologia , Transtornos Linfoproliferativos/diagnóstico , Linfócitos T/imunologia , Biópsia , Doença Celíaca/dietoterapia , Doença Celíaca/imunologia , Doença Celíaca/patologia , Erros de Diagnóstico , Dieta Livre de Glúten , Duodenoscopia , Glucocorticoides/uso terapêutico , Humanos , Imuno-Histoquímica , Enteropatias/tratamento farmacológico , Enteropatias/imunologia , Enteropatias/patologia , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/patologia , Transtornos Linfoproliferativos/tratamento farmacológico , Transtornos Linfoproliferativos/imunologia , Transtornos Linfoproliferativos/patologia , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Linfócitos T/efeitos dos fármacos , Linfócitos T/patologia , Resultado do TratamentoRESUMO
There are many influence factors in the precision and accuracy of the quantitative analysis with LIBS technology. According to approximately the same characteristics trend of background spectrum and characteristic spectrum along with the change of temperature through in-depth analysis, signal-to-background ratio (S/B) measurement and regression analysis could compensate the spectral line intensity changes caused by system parameters such as laser power, spectral efficiency of receiving. Because the measurement dates were limited and nonlinear, we used support vector machine (SVM) for regression algorithm. The experimental results showed that the method could improve the stability and the accuracy of quantitative analysis of LIBS, and the relative standard deviation and average relative error of test set respectively were 4.7% and 9.5%. Data fitting method based on signal-to-background ratio(S/B) is Less susceptible to matrix elements and background spectrum etc, and provides data processing reference for real-time online LIBS quantitative analysis technology.
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The standard addition method with laser induced breakdown spectroscopy was used to analyze an unknown sample taken from a lead battery factory. the matrix influence on the results was effectively avoided when the external or internal standard method was used, and the pretreatment of samples was simple and quick. The Nd ' YAG pulse laser with wavelength 1 064 nm was used as the excitation source. The echelle spectroscopy with high resolution and wide spectral range was used as the spectral separation device, and the intensified charge coupled device (ICCD) as the spectral detection device in the experiment. The characteristic line at 405. 78 nrn was chosen as the analysis line to measure Pb concentration. Fe I : 404. 58 line was chosen as the internal standard. Pre-experiment was carried out to confirm the appropriate condition. Under the laser energy of 128. 5 mJ, the delay time of 2. 5 tps, and the gate width of 3 ps, it was determined that with the addition of Pb to the sample in the range of 0 and 25 000 mg . kg-1, there wasn't self-absorption. There was a good linear relationship between the intensity of the spectral line of 405. 78 nm and the addition of Pb. The appropriate concentration of Pb added into the sample for analysis was determined by this series of samples. On this basis, four samples were prepared with three parallel samples for each sample in order to verify the repeatability and reliability of the method, i. e. 5 000, 10 000, 15 000, 20 000 mg . kg-1 Pb was added into the original sample. The results were compared with the result of ICP-MS. The twelve samples' relative errors were between -24. 6% and 17. 6%. The average result was 43 069 mg . kg-1 with the relative error -2. 44%.
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The one of the advantages about Laser Induced Breakdown Spectroscopy (LIBS) is multielement detection at the same time. In order to obtain the optimum signal in the multi-element measurements of water with LIBS, the present paper firstly models the numerical relationship between the signal-to-background ratio of characteristic spectral lines and the delay time and gate width time with BP neural network, using DM design experiment data as the checking sample to ensure the generalization ability of the BP neural network model. Based on the above model, genetic algorithm is used to optimize measurement parameters and the fitness function phi is defined. When the optimum delay time and gate width time is (15.5 micros, 21.5 micros), the minimum value of psi is 0.102 4. The optimization results of genetic algorithm are further confirmed with experimental results. So the method of parameters optimization overall improves S/B of multi-element measurements in water with LBS, and provides the reference for parameter optimization of other experiments.
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By means of field sampling and laboratory analysis, the content distribution characteristics of Cd, Cr, Cu, Ni, Pb and Zn in agricultural region soils of Huaihe basin in Anhui province were analyzed. Assessment of heavy metal pollutions was conducted using enrichment factor, geoaccumulation index and potential ecological risk index. The results showed that the average mass fraction of Cd and Cu was 0.113 5 and 22.09 mg x kg(-1) respectively in the study area soil, which were above the background values 0.097 and 20.4 mg x kg(-1) in Anhui Province. The average mass fraction of other four heavy metals did not exceed the average values of Anhui Province. The results of the evaluations from geoaccumulation index and ecological risk assessment discovered that Cd is the strongest pollution metal among six heavy metals in the study area soil. For some samples of the study soil, Cd was slight risk for the ecosystem. The ecosystem risks caused by the other five heavy metals were not obviously for the sampling points. The entire study area soils were mid integrated potential ecological risk.
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Monitoramento Ambiental , Metais Pesados/análise , Poluentes do Solo/análise , Solo/química , Agricultura , China , Ecossistema , Medição de RiscoRESUMO
According to the phytoplankton fluorescence induction characteristics under different light conditions, chlorophyll fluorescence as a probe for analysis of phytoplankton photosynthesis was studied. The present paper proposed a in-situ measurement method based on the chlorophyll fluorescence values Ft and Fm to get phytoplankton photosynthesis activity, Chlorella vulgaris, microcystis aeruginosa and Cyclotella meneghiniana Kiits were selected as experimental subjects, a comparison test was done between self-developed in-situ measurement system and Water PAM in lab, and the results showed that coefficients between the two methods were 0.9778, 0.8786 and 0.7953. This work provides a rapid and in-situ measurement method for phytoplankton photosynthesis activity.
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Fluorescência , Fotossíntese , Fitoplâncton/fisiologia , Clorofila/análise , LuzRESUMO
Objective: This qualitative study aimed to understand the clinical safety, efficacy, and receptiveness of using the female condom (FC) during anal intercourse among men who have sex with men (MSM). Methods: Subjects for this study were recruited from a two-group crossover trial among MSM in Shanghai. The trial consisted of two phases, each including the use of condoms (FC vs. male condom), questionnaires, and in-depth one-on-one interviews. The two phases were separated by a washout period of 4 weeks. The minimum sample size for this study was determined in accordance with the principle of "information saturation." The qualitative data were organized and analyzed using ATLAS.ti version 7. Results: A total of 26 participants from the MSM population were recruited for this study, with 10 assuming the insertive role (i.e., "1"), 8 assuming the receptive role (i.e., "0"), and 8 being versatile (i.e., "0.5"). Each participant completed the crossover trial comprising two phases. The cumulative usage of FCs and male condoms (MCs) amounted to 115 and 127 times, respectively. During the reported sexual encounters, no participants reported incidents of condom rupture, slippage, or other malfunctions. A few participants reported experiencing slight chafing pain, primarily put forward by "0" participants. Apart from those reports, no instances of bleeding, swelling, or allergic reactions were reported. The efficiency of FC in disease prevention, the sexual partner's willingness to use FC, the freshness of FC, and positive sexual experiences were the main reasons for the consistent use of FC for anal sex. Discomfort and pain during sexual activity, the loose design and thick material of FCs, and difficulties in placing FCs were the major obstacles to FC use among MSM. The elements referring to the forehead exhibited varied in importance among "1,", "0," and "0.5" participants. Regarding the willingness to use the FC in the future anal intercourse, 61.54% of participants expressed a positive inclination, 23.08% were uncertain, and 15.38% stated that they would not. "A better sense of security during anal sex" was the main factor affecting willingness among "0" participants and "the sexual pleasure that the FC brought" among "1" participants. Improving the design and technology of FCs and increasing the frequency of use and practice might improve the use skills, which will favor the willingness to use FCs among the MSM population. Conclusion: FCs received positive user feedback from study participants, but distinctions were found in individuals in different sexual roles. Large-scale quantitative studies are needed to evaluate the clinical safety of the FC and its effectiveness in preventing the transmission of STDs during anal intercourse.
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Preservativos Femininos , Minorias Sexuais e de Gênero , Feminino , Humanos , Masculino , China , Homossexualidade Masculina , Dor , Comportamento Sexual , Pesquisa QualitativaRESUMO
The spectroscopy emission characteristics and the detection limit of trace heavy metal nickel in water was studied based on laser induced breakdown spectroscopy technique, with a 1,064 nm wavelength Nd : YAG laser as excitation source, and the echelle spectrometer and ICCD detector were used for spectral separation and high sensitive detection with high resolution and wide spectral range. A round flat solid state graphite as matrix was used for element enrichment for reducing water splashing, extending the plasma lifetime and improving the detection sensitivity, and the experimental sample was prepared by titrating a fixed volume of nickel nitrate solution of different concentrations on a fixed area of the graphite matrix. The results show that the better detection delay time is about 700 ns, the spectrum intensity raises with the concentration increase, a good linear relationship is presented at low concentration with a correlation coefficient 0.996 1, and the lower limit of detection of nickel in water with 0.28 mg x L(-1) was retrieved. A measurement method for further study of trace heavy metals in water is provided with laser induced breakdown spectroscopy technique.
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Objective: The diagnostic efficiency of the quantitative fecal immunochemical test (qFIT) has large variations in colorectal cancer (CRC) screening. We aimed to explore whether the practical sample collection operant training could improve the diagnostic accuracy of the qFIT in CRC screening. Methods: Moderate-/high-risk individuals aged 50-75 years old were invited to participate in a prospective observational study between July 2020 and March 2021. Participants took a qFIT sample without fecal sample collection operant training in advance and then completed another qFIT sample after the operant training. The primary outcome was the sensitivity and specificity of the qFITs for CRC and advanced colorectal neoplasia (ACRN). The secondary outcome was the difference in the area under the curves (AUCs) and the concentrations of the fecal hemoglobin (Hb) between the qFIT without and after the operant training. Results: Out of 913 patients, 81 (8.9%) patients had ACRN, including 25 (2.7%) patients with CRC. For CRC, the sensitivities of the qFIT without and after the operant training at 10 µg/g were 80.4 and 100.0%, respectively, and the specificities were 90.1 and 88.4%, respectively. For ACRN, the sensitivities were 49.4 and 69.1% and the specificities were 91.7 and 91.3%, respectively. The AUC of the qFIT after the operant training was significantly higher than that without the operant training for CRC (p = 0.027) and ACRN (p = 0.001). After the operant training, the concentration of the fecal Hb was significantly higher than that without the operant training (p = 0.009) for ACRN, but there was no significant difference for CRC (p = 0.367). Conclusion: Practical sample collection operant training improves the diagnostic accuracy of the qFIT, which increases the detection of the low concentrations of fecal Hb. Improving the quality of the sample collection could contribute to the diagnostic efficiency of the qFIT in CRC screening.
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BACKGROUND: As the second most common female malignant tumor, cervical cancer is also one of the most preventable and avoidable cancers. The World Health Organization has launched a global plan to accelerate the elimination of cervical cancer. Therefore, in the era of postvaccine, the role of HPV subtypes in cervical precancerous lesions and cervical cancer that are not covered by vaccine should be further discussed. The purpose of this study was to explore the role of HPV subtypes not covered by the nine-valent vaccine in high-grade cervical precancerous lesions and cervical cancer. MATERIALS AND METHODS: A retrospective analysis was performed on the clinical data of 5220 patients with an HPV infection who were diagnosed and treated in the Department of Gynecology of Shanghai General Hospital between October 2016 and February 2020. In addition, the clinical characteristics of the biopsy results of 470 cases of cervical intraepithelial neoplasia (CIN) 2-3 and 205 cases of cervical squamous cell carcinoma were analyzed. RESULTS: Among patients with HPV subtype infection not covered by the nine-valent vaccine, univariate analysis showed that compared with patients with CIN 2-3, age ≥ 50, not using condom and TCT reported as ASC-H were risk factors for cervical squamous cell carcinoma (P < 0.05). The detection rates of HPV subtype not covered by the nine-valent vaccine in CIN 2-3 and cervical squamous cell carcinoma patients were 7.23% and 6.34%, respectively. CONCLUSION: In patients with CIN 2-3 and cervical squamous cell carcinoma, the infection rates of HPV subtype not covered by the nine-valent vaccine were 7.23% and 6.34%, respectively. With the increasing popularity of the vaccine, the infection rates of the corresponding HPV subtype decreased; however, HPV subtype infection not covered by the nine-valent vaccine should not be ignored.
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Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/virologia , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/virologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Adolescente , Adulto , Carcinoma de Células Escamosas/patologia , China/epidemiologia , Anticoncepção/métodos , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Papillomaviridae , Infecções por Papillomavirus/complicações , Vacinas contra Papillomavirus/genética , Estudos Retrospectivos , Fatores de Risco , Neoplasias do Colo do Útero/patologia , Adulto Jovem , Displasia do Colo do Útero/patologiaRESUMO
INTRODUCTION: Conventional gastrointestinal (GI) endoscopy reports written by physicians are time consuming and might have obvious heterogeneity or omissions, impairing the efficiency and multicenter consultation potential. We aimed to develop and validate an image recognition-based structured report generation system (ISRGS) through a multicenter database and to assess its diagnostic performance. METHODS: First, we developed and evaluated an ISRGS combining real-time video capture, site identification, lesion detection, subcharacteristics analysis, and structured report generation. White light and chromoendoscopy images from patients with GI lesions were eligible for study inclusion. A total of 46,987 images from 9 tertiary hospitals were used to train, validate, and multicenter test (6:2:2). Moreover, 5,699 images were prospectively enrolled from Qilu Hospital of Shandong University to further assess the system in a prospective test set. The primary outcome was the diagnosis performance of GI lesions in multicenter and prospective tests. RESULTS: The overall accuracy in identifying early esophageal cancer, early gastric cancer, early colorectal cancer, esophageal varices, reflux esophagitis, Barrett's esophagus, chronic atrophic gastritis, gastric ulcer, colorectal polyp, and ulcerative colitis was 0.8841 (95% confidence interval, 0.8775-0.8904) and 0.8965 (0.8883-0.9041) in multicenter and prospective tests, respectively. The accuracy of cecum and upper GI site identification were 0.9978 (0.9969-0.9984) and 0.8513 (0.8399-0.8620), respectively. The accuracy of staining discrimination was 0.9489 (0.9396-0.9568). The relative error of size measurement was 4.04% (range 0.75%-7.39%). DISCUSSION: ISRGS is a reliable computer-aided endoscopic report generation system that might assist endoscopists working at various hospital levels to generate standardized and accurate endoscopy reports (http://links.lww.com/CTG/A485).