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Purpose Meta-analysis of diagnostic value of prostate cancer (PCa) based on multi-parameter magnetic resonance imaging (mp-MRI). Materials and Methods Computer-based search of PubMed, Ebsco, Embase, Ovid, CBM, VPCS, Wanfang, and CNKI databases for related literatures on PCa diagnosed via mp-MRI from January 1, 2013 to September 31, 2017. Two researchers independently screened out literatures, extracted data based on inclusion and exclusion criteria, applied QUADAS-2 to evaluate the quality of methodologies included for the study, calculated combined sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and diagnostic odds ratio (DOR), drew Summerized receiver operating characteristic (SROC) curve and calculated the area under the curve (AUC). Results Eventually 20 articles of literatures were included, totally 3334 lesions. Meta-analysis results showed that Senmergeof PCa diagnosed via mp-MRI was 0.89(95% CI 0.87-0.92),Spemerge0.76(95% CI 0.67-0.84),+LRmerge3.8(95% CI 2.7-5.4),-LRmerge=0.14(95% CI 0.11-0.17),DORmerge=27(95% CI 17-44),AUCmerge=0.92(95% CI 0.89-0.94).Conclusion mp-MRI has a high diagnostic value for PCa and can be used as an important method for PCa diagnosis.
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Purpose To synthetically evaluate MR diffusion kurtosis imaging (DKI) using Meta-analysis to differentiate diagnostic value of benign and malignant breast lesions and quantitatively analyze mean kurtosis (MK) values of benign and malignant breast lesions in an attempt to provide evidence-based facts for clinical decision making. Materials and Methods Computer-based retrieval of Chinese and English literatures concerning differential diagnosis of benign and malignant breast lesions with application of DKI publicly published at home and abroad in PubMed, Ebsco, Embase, CNKI, Cochrane Library, CBM, VIP Data database from January. 1, 2006 to September. 30, 2017. Two valuators independently screened and extracted data according to inclusion and exclusion criteria, and drew on QUADAS for quality assessment, Stata 12.0 and Meta-Disc 1.4 software for Meta analysis and extraction of relevant parameters. Results Totally 8 up-to-standard literatures were included, including 3 in English and 5 in Chinese. The total number of focus was 689. Corresponding effect model analysis revealed that MK value in malignant breast lesion group was higher than that in benign lesion group, the difference of which was statistically significant. The optimal diagnostic threshold was determined by the maximum Youden index, which was approximately 0.71 in size,with combined sensitivity of 0.907(95% CI 0.860-0.939),specificity of 0.910(95% CI 0.856-0.945),positive likelihood ratio of 10.053(95% CI 6.293-16.059),negative likelihood ratio of 0.102(95% CI 0.068-0.154),and diagnostic test odds ratio of 98.203(95% CI 55.014-175.296).The area under receiver operating characteristic curve was 0.96.MK value suggested 94% posterior malignant rate of malignant breast lesions, and 13% malignant rate of benign breast lesions. Conclusion MK value has high diagnostic value for benign and malignant breast lesions with good sensitivity and specificity.
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Percutaneous imaging-guided cryoablation (PICA) is a recently developed technique,which applies extreme hypothermia to destroy tumors guided with CT,MRI or ultrasound images.Compared with other oncologic cryoablation therapies,PICA has some advantages,such as treating under local anesthesia,superior monitoring capability on multimodal imaging,less intraoperative and postoperative pain and preservation of tissue collagenous architecture.In recent years,PICA has been used in treatment of tumors in lung,liver,kidney,breast,prostate and so on.In this article,the principle of cryoablation and the application progresses of PICA in oncotherapy were reviewed.
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Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.
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Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in diagnosing benign and malignant solitary pulmonary nodule (SPN)with Meta-analysis.Methods The databases including PubMed,EBSCO,Cochrane Library,Ovid, CBM,VIP,Wan Fang Database and CNKI were searched to select the literatures about the diagnosis of SPN with DCE-MRI.Inclusion criteria were established,according to the validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests .Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS-2)instrument.Meta-analysis was performed by Stata 12.0 and Meta-Disc 1.4.According to the results of heterogeneity of the included articles,proper effect model was selected to calculate the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio.Summary receiver operating characteristic (SROC)curve was drawed and the area under the curve (AUC)was calculated.Results A total of 17 studies involving 1255 lesions were included.The results of Meta-analysis showed the pooled sensitivity,specificity,positive likelihood ration,negative likelihood ration,and diagnostic odds ratio were 0.95,0.81,4.9,0.06 and 85,respectively.The AUC of SROC was 0.97.Conclusion DCE-MRI has relatively high sensitivity and specificity in the differential diagnosis of benign and malignant SPN.
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BACKGROUND: It has been recently found that endothelial progenitor cells (EPCs) can promote injured endothelial healing. There is a supposition that in-stent restenosis possibly correlates with the number and/or activity of EPCs.OBJECTIVE: To comparatively observe the number and activity of circulating EPCs in patients with and without coronary in-stent restenosis, and to verify the above-mentioned supposition.DESIGN, TIME AND SETTING: This study, a comparative observation, was performed at the Department of Internal Medicine, Beijing Shijitan Hospital, Department of Internal Medicine, First Hospital, Peking University, and Department of Physiology and Pathophysiology, Peking University Health Science Center between March 2005 and May 2007.PARTICIPANTS: According to the coronary angiography, 15 patients were recruited into the restenosis group and 17patients with patent stents were selected into the control group.METHODS: Total peripheral mononuclear cells were isolated from blood of patients with restenosis or control subjects by Ficoll density-gradient centrifugation. These cells were plated on dishes coated with human fibronection. After 7 days in culture, the nature of adherent cells was confirmed by direct fluorescent staining with the use of 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanide percholate-labelled acetylated low-dencity lipoprotein and fluorescein isothiocyanate-labeled ulex europaeus agglutinin-Ⅰ under a laser scanning confocal microscope. Cells demonstrating double-positive fluorescence were identified as differentiating EPCs.MAIN OUTCOME MEASURES: After 7 days of culture, EPCs were counted under an inverted microscope. Proliferation of EPCs was determined using the MTT colorimetric assay. Migration of EPCs was assayed using the scratch assay qualitatively. EPCs adhesion was performed by replating cells on fibronectin-coated dishes and then counting the adherent cells.RESULTS: The number of EPCs was significantly reduced in patients with in-stent restenosis compared with that in the control group (P = 0.001). The proliferative activities were impaired in the in-stent restenosis group than in the control group(P < 0.05). In addition, the migrative activities were also impaired in the in-stent restenosis group, but no significant difference in adherent activities existed between the two groups (P > 0.05).CONCLUSION: The number and functional activities of proliferation and migration of EPCs were decreased in patients with in-stent restenosis, which may be related to the number and/or activities of EPCs.
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Objective To evaluate the effect and safety of use of tirofiban in percutaneous coronary interventional therapy (PCI) in elder patients with acute ST segment elevation myocardial infarction (STEMI). Methods Sixty-five patients with acute STEMI were divided into two groups: 31 patients in the elderly group (≥70 years) and 34 patients in the younger group (0.05). Conclusion It is safe and effective to administer tirofiban to elderly patients with acute STEMI undergoing PCI.