Intraoperative Diagnosis of Serosal Invasion in Gastric Cancer by Magnifying Endoscopy with Narrow-Band Imaging for Intraoperative Measurement Decision.

Purpose: To establish a precise diagnostic method for serosal invasion in gastric cancer (GC) during surgery using therapeutic measures, and facilitate quick decision-making. Methods: A total of 19 GC patients treated in the department of gastrointestinal surgery of Fujian Provincial Hospital between April 2019 and December 2020 were enrolled. An electronic gastroscopy with a magnifying endoscope with narrow-band imaging was used to photograph the serosal surface of the GC lesion site and the normal gastric wall around the lesion during surgery. The endoscopic diagnosis was confirmed on the basis of the microvascular phenotype of the serosal surface and validated by comparison with the pathological diagnosis. Results: Under the specific endoscopy, serosal invasion, including subserosal tissue invasion and serosal layer invasion, was diagnosed by observing the capillary morphology change, and capillary diameter and density increase. According to the pathological diagnosis, the accuracy of serosal invasion diagnosis was 94.7%, the sensitivity was 100%, the specificity was 75%, the positive predictive value was 93.8%, and the negative predictive value was 100%. To further distinguish the subserosal tissue invasion and serosal layer invasion, the magnifying endoscope with narrow-band imaging possessed a 78.9% accuracy by distinguishing irregular changes in microvessels. Conclusions: Magnifying endoscope with narrow-band imaging is less time-consuming than pathological diagnosis. Intraoperative diagnosis using microvascular observation can accurately detect serosal invasion. It is of value for the intraoperative diagnosis in GC patients.

[Depression before and after operation in patients undergoing coronary artery bypass grafting and the effect thereof on quality of life].

OBJECTIVE: To investigate the presence and severity of depression before and after operation in patients undergoing coronary artery bypass grafting (CABG) and the effect thereof on the quality of life. METHODS: A validated Chinese version of Beck Depression Inventory (BDI) was used in 138 CABG patients that were divided into 2 groups according the fact if depression was present. 1 week before and 1, 3, and 6 months after operation, and SF-36 scale was used to evaluate the quality of life (QOL) one week before operation and 1 and 6 months after operation. RESULTS: Depressive disorders occurred in 42.7% of the patients preoperatively and in 23.1% of the patients 6 months after the operation. There were no significant differences in all the dimensions of the SF-36 scale before operation between the depression and non-depression groups. All the scores of the 36-F dimensions were improved 1 and 6 months after the operation. However, the SF-36 social functioning (SF), mental health (MH), role emotional (RE), and bodily pain (BP) subscale scores 6 months after operation of the depression group were all lower than those in the non-depressive groups (all P < 0.05). CONCLUSION: Depression symptoms at different degrees exist before CABG and can be improved post-operatively. The improvement of QOL of the depressive patients after operation is not so marked compared to the non-depressive patients, especially in SF, MH, RE, and BP dimensions.