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IntroductionCold polypectomy has the advantages of simple operation, less time-consuming and fewer complications. Guidelines have recommended cold snare polypectomy (CSP) to resect small polyps sized ≤5 mm and sessile polyps sized 6–9 mm. However, evidence is scarce regarding cold resection for non-pedunculated polyps sized ≥10 mm. Cold snare endoscopic mucosal resection (CS-EMR) combining CSP and submucosal injection was designed to improve the complete resection rate and reduce adverse events. We hypothesise that CS-EMR is non-inferior to conventional hot snare endoscopic mucosal resection (HS-EMR) in the resection of 10–19 mm non-pedunculated colorectal polyps.Methods and analysisThis study is a prospective, randomised, open-label, non-inferiority, single-centre trial. Outpatients scheduled to undergo a colonoscopy and present eligible polyps will be randomised to receive either CS-EMR or HS-EMR. The primary endpoint is the complete resection. Considering that HS-EMR of 10–19 mm colorectal polyps will yield a complete resection rate of at least 92% and a non-inferiority margin of −10%, a total of 232 polyps will be included (one-sided α, 2.5%; β, 20%). The analyses are intended to evaluate first non-inferiority (lower limit 95% CI greater than −10% for group difference) and then superiority (lower limit 95% CI>0%) if non-inferiority is achieved. Secondary endpoints include en-bloc resection, the occurrence of adverse events, the use of endoscopic clips, resection time and cost.Ethics and disseminationThe study has been approved by the institutional review board of the Peking Union Medical College Hospital (No. K2203). All participants in the trial will provide written informed consent. The results of this trial will be published in an open-access way.Trial registration numberNCT05545787.

IntroductionChronic gastritis is a common disease worldwide. Studies have consistently shown that chronic gastritis is usually associated with gastric microbial dysbiosis, especially the infection ofHelicobacter pylori. However, the interaction betweenH. pyloriand non-H. pyloribacteria in patients with chronic gastritis has not been clearly identified yet. Consequently, we designed a protocol for a systematic review and meta-analysis, which focused on identifying the changes in gastrointestinal microbiota composition between patients withH. pylori-infective and non-infective chronic gastritis.Method and analysisWe will search PubMed, EMBASE and Cochrane Library databases to retrieve observational studies on humans. The eligible studies must include data about the relative abundance of the gastrointestinal microbiome in patients withH. pylori-infective or non-infective chronic gastritis. Only the data of adults aged over 18 years will be analysed. Two researchers will extract the data independently, and Newcastle–Ottawa Scale will be used to assess the risk of bias. Random-effects model will be performed in quantitative analyses. Correlation analysis, bioinformatics analysis and function analysis will be performed.DiscussionCurrently, numerous studies have revealed the role ofH. pyloriin chronic gastritis. However, the alterations of non-H. pyloribacteria in patients with chronic gastritis remain an open question. The results of our study might provide new insights into future diagnosis and treatments.Ethics and disseminationThis study is based on published documents, unrelated to personal data, so ethical approval is not in need. The results of this study are expected to be published in journals or conference proceedings.PROSPERO registration numberCRD42020205260; Pre-results.

BackgroundAerosol-generating procedures such as oesophagogastroduodenoscopy (OGD) result in infectious particles being exhaled by patients. This substantially increases the medical staff’s risk of occupational exposure to pathogenic particles via airway inhalation and facial mucosal deposition. Infectious particles are regarded as a key route of transmission of SARS-CoV-2 and, thus, represents a major risk factor for medical staff during the ongoing COVID-19 pandemic. There is a need for quantitative evidence on medical staff’s risk of multiroute exposure to infectious particles exhaled by patients during OGD to enable the development of practical, feasible and economical methods of risk-reduction for use in OGD and related procedures. This randomised controlled trial (RCT)—Personal protective EquiPment intervention TrIal for oesophagogastroDuodEnoscopy (PEPTIDE)—aims to establish a state-of-the-art protocol for quantifying the multiroute exposure of medical staff to infectious particles exhaled by patients during real OGD procedures.Method and analysisPEPTIDE will be a prospective, two-arm, RCT using quantitative methods and will be conducted at a tertiary hospital in China. It will enrol 130 participants (65 per group) aged over 18. The intervention will be an anthropomorphic model with realistic respiratory-related morphology and respiratory function that simulates a medical staff member. This model will be used either without or with a surgical mask, depending on the group allocation of a participant, and will be placed beside the participants as they undergo an OGD procedure. The primary outcome will be the anthropomorphic model’s airway dosage of the participants’ exhaled infectious particles with or without a surgical mask, and the secondary outcome will be the anthropomorphic model’s non-surgical mask-covered facial mucosa dosage of the participants’ exhaled infectious particles. Analyses will be performed in accordance with the type of data collected (categorical or quantitative data) using SPSS (V.26.0) and RStudio (V.1.3.959).Ethics and disseminationEthical approval for this RCT was obtained from the Ethics Committee of Peking Union Medical College Hospital (ZS-3377). All of the potential participants who agree to participate will provide their written informed consent before they are enrolled. The results will be disseminated through presentations at national and international conferences and publications in peer-reviewed journals.Trial registration numberNCT05321056.

IntroductionColonoscopy is the reference method in screening and diagnosis of colorectal neoplasm, but its efficacy is closely related to the quality of bowel preparation. Poor patient compliance is a major risk factor for inadequate bowel preparation likely due to poor patient education. Such an education is usually provided via either oral or written instructions by clinicians. However, multiple education methods, such as smartphone applications, have been proved useful in aiding patients through bowel preparation. Also, it was reported that a large proportion of patients feel anxious before colonoscopy. Virtual reality (VR) is a novel method to educate patients and provides them with an immersive experience. Theoretically, it can make patients better prepared for bowel preparation and colonoscopy. However, no prospective studies have assessed the role of this novel technology in patient education before colonoscopy. We hypothesise that VR videos can improve bowel preparation quality and reduce pre-procedure anxiety.Methods/designThe trial is a prospective, randomised, single-blinded, single-centre trial. Outpatients who are scheduled to undergo colonoscopy for screening or diagnostic purposes for the first time will be randomised to receive either the conventional patient education or the conventional methods plus VR videos, and 322 patients will be enrolled from the Peking Union Medical College Hospital. The primary endpoint is the quality of bowel preparation, measured by the Boston bowel preparation score. Secondary endpoints include polyp detection rate, adenoma detection rate, cecal intubation rate, patient compliance to complete bowel cleansing, withdrawal time, pre-procedure anxiety, overall satisfaction and willingness for the next colonoscopy.Ethics and disseminationThe study has been approved by the institutional review board of the Peking Union Medical College Hospital (No. ZS-1647). The results of this trial will be published in an open-access way and disseminated among gastrointestinal physicians and endoscopists.Trial registration numberNCT03667911