Search

Artificial intelligence (AI), especially deep learning, is gaining extensive attention for its excellent performance in medical image analysis. It can automatically make a quantitative assessment of complex medical images and help doctors to make more accurate diagnoses. In recent years, AI based on ultrasound has been shown to be very helpful in diffuse liver diseases and focal liver lesions, such as analyzing the severity of nonalcoholic fatty liver and the stage of liver fibrosis, identifying benign and malignant liver lesions, predicting the microvascular invasion of hepatocellular carcinoma, curative transarterial chemoembolization effect, and prognoses after thermal ablation. Moreover, AI based on endoscopic ultrasonography has been applied in some gastrointestinal diseases, such as distinguishing gastric mesenchymal tumors, detection of pancreatic cancer and intraductal papillary mucinous neoplasms, and predicting the preoperative tumor deposits in rectal cancer. This review focused on the basic technical knowledge about AI and the clinical application of AI in ultrasound of liver and gastroenterology diseases. Lastly, we discuss the challenges and future perspectives of AI.

Background Ultrafast ultrasound imaging has been demonstrated to be an effective method to evaluate carotid stiffness through carotid pulse wave velocity (PWV) with high reproducibility, but lack of reference values has precluded its widespread use in clinical practice. This study aimed to establish reference values of PWV for ultrafast ultrasound imaging in a prospective, multicenter, population-based cohort study and to investigate the main determinants of carotid PWV. Methods A total of 1,544 healthy Han Chinese volunteers (581 [38%] men; age, 18–95 years) were enrolled from 32 collaborating laboratories in China. The participants were categorized by age, blood pressure (BP), and body mass index (BMI). The basic clinical parameters and the carotid PWV at the beginning of systole (BS) and end of systole (ES) were measured via ultrafast ultrasound imaging techniques. Results The PWV at both BS and ES was significantly higher in the left carotid artery than in the right carotid artery. The PWV at BS was significantly higher in men than in women; however, no significant difference was noted in the PWV at ES between men and women. Multiple linear regression analyses revealed that age, BP, and BMI were independently correlated with the PWV at both BS and ES. The PWV at BS and ES progressively increased with increase in age, BP, and BMI. Further, the age- and sex-specific reference values of carotid PWV for ultrafast ultrasound imaging were established. Conclusions Reference values of carotid PWV for ultrafast ultrasound imaging, stratified by sex and age, were determined for the first time. Age, BP, and BMI were the dominant determinants of carotid PWV for ultrafast ultrasound imaging, which should be considered in clinical practice for assessing arterial stiffness.

To observe the synergistic effect of Qilan Capsules in the treatment of the patient with Qi-deficiency blood-stasis type of prostate cancer receiving androgen-deprivation therapy after castration.This randomized controlled double-blind study included 246 cases of Qi-deficiency blood-stasis type of prostate cancer after castration, which were randomly divided into an experiment and a control group of equal number to be treated with Qilan Capsules + androgen-deprivation and placebo + androgen-deprivation, respectively. After 6 months of treatment, we compared the International Prostate Symptoms Scores (IPSS), TCM Symptoms Scores (TCMSS), maximal urine flow rate (Qmax), and the level of serum prostate-specific antigen (PSA) between the two groups of patients.Statistically significant differences were observed between the experiment and control groups in the syndrome classification-based efficacy (87.7% vs 67.9%, P0.05) and total effectiveness rate (86.0% vs 71.6%, P0.05). Compared with the baseline, the experiment group showed remarkable improvement after treatment in TCMSS (17.1±5.1 vs 8.3±4.0, P0.05), IPSS (17.7±7.5 vs 11.4±4.6, P0.05), and Qmax (［10.9±4.3］ ml/s vs ［14.7±3.7］ ml/s, P0.05), and so did the control group (16.8±5.2 vs 11.5±5.2, 17.8±6.7 vs 14.6±5.8, and ［11.0±4.3］ ml/s vs ［12.0±4.1］ ml/s, P0.05). The above three parameters were even more markedly improved in the former than in the latter group (P0.05). However, there was no statistically significant difference between the two groups in the improvement of the PSA level after treatment (P0.05).Qilan Capsules can significantly enhance the effect of androgen-deprivation therapy in the treatment of Qi-deficiency blood-stasis type of prostate cancer after castration though cannot obviously improve the PSA level.目的: 观察中药芪蓝胶囊对去势后行内分泌治疗的前列腺癌患者（气虚血瘀型）的临床增效作用。方法: 采用随机、对照、双盲的方法，分别从成都中医药大学附属医院、四川大学华西医院和四川省人民医院3家医疗中心各取82例去势后前列腺癌患者（气虚血瘀型），共246例。随机分为试验组（芪蓝胶囊联合去势及雄激素拮抗剂）和对照组（安慰剂联合去势及雄激素拮抗剂）各123例。芪蓝胶囊每日3次，每次4粒，去势治疗为手术去势或戈舍瑞林3.6 mg，每4周1次，皮下注射，雄激素拮抗剂比卡鲁胺50 mg，每日1次，口服。安慰剂为外观和芪蓝胶囊一致的淀粉制剂。观察比较两组患者治疗前以及治疗6个月后国际前列腺症状评分（IPSS）、中医症侯评分、最大尿流率（Qmax）及血清PSA水平。结果: 试验组和对照组治疗后在分级证候疗效(87.7% vs 67.9%， P0.05)、总有效率上(86.0% vs 71.6%，P0.05)比较，两组间差异有统计学意义。试验组在中医症侯评分［治疗前(17.1±5.1)分，治疗后(8.3±4.0）分］、IPSS［（治疗前(17.7±7.5)分，治疗后(11.4±4.6）分］及Qmax［治疗前(10.9±4.3)ml/s，治疗后(14．7±3.7） ml/s］等方面疗效优于对照组［治疗前(16.8±5.2)分，治疗后(11.5±5.2)分；治疗前(17.8±6.7)分，治疗后(14.6±5.8)分；治疗前(11.0±4.3) ml/s，治疗后(12.0±4.1）ml/s］，差异有统计学意义（P0.05）；试验组在PSA改善例数上与对照组相比不具有统计学意义（P0.05）。结论: 芪蓝胶囊对去势术后气虚血瘀型前列腺癌患者治疗安全有效，对去势后抗雄激素治疗有增效作用，但对血清PSA值的干预作用不明显。.