Coronary artery disease diagnosis with 64-slice spiral CT coronary artery angiography in China and abroad: a meta analysis / 中华心血管病杂志

<p><b>OBJECTIVE</b>This meta-analysis evaluated the accuracy of diagnosing coronary artery disease using 64-section spiral computed tomography, and compared the difference between Chinese studies and abroad studies.</p><p><b>METHODS</b>Relevant English and Chinese articles published from 1998 to 2009 were searched in Cochrane library, Medline, Embase database, OVID database and CNKI. Heterogeneity was tested, pooled weighted sensitivity and specificity and the corresponding 95%CI were calculated. Summary receiver operating characteristic (SROC) curve was drawn and the area under the curve was calculated, differences between studies from China and abroad were compared.</p><p><b>RESULTS</b>A total of 433 articles were searched and 108 articles were included (46 English articles and 62 Chinese articles) after excluding articles of research purposes or design does not match. Because of no gold standard, no blind, can not be calculated literature data, 7 and 20 (P > 0.05), 44 and 6 (P < 0.05), 3 and 1 (P < 0.05) Chinese studies and English articles respectively were excluded. Twenty-seven articles fulfilled all inclusion criteria (8 Chinese and 19 foreign studies) In 8 Chinese studies the pooled weighted sensitivity and specificity and area under SROC curve was 0.892 (95%CI: 0.868 - 0.913), 0.972 (95%CI: 0.966 - 0.977) and 0.983 (95%CI: 0.966 - 1.000) at segment-based analysis. In 19 foreign studies, the pooled weighted sensitivity and specificity and area under SROC curve was 0.971(95%CI: 0.957 - 0.982), 0.878 (95%CI: 0.852 - 0.902) and 0.973 (95%CI: 0.958 - 0.989) at patient-based analysis, 0.917 (95%CI: 0.895 - 0.936), 0.919 (95%CI: 0.909 - 0.928) and 0.974 (95%CI: 0.964 - 0.984) at vessel-based analysis, 0.882 (95%CI: 0.868 - 0.895), 0.959 (95%CI: 0.956 - 0.962) and 0.985 (95%CI: 0.978 - 0.992) at segment-based analysis. Pooled weighted pecificity of 64-section spiral CT angiography at segment-based analysis has significant different between home and abroad (P < 0.05).</p><p><b>CONCLUSIONS</b>Meta-analysis showed that noninvasive 64-section spiral computed tomography could correctly diagnose coronary artery disease with high sensitivity and specificity. Quality of related studies performed in abroad is significantly higher than those performed in China.</p>

Predicting value of various clinical probability scores for diagnosis of lower limb deep venous thrombosis in Chinese patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the predicting value of Wells, Kahn, St. André and Constans scores for the diagnosis of deep venous thrombosis in Chinese patients.</p><p><b>METHODS</b>A total of 274 patients suspected with deep venous thrombosis was prospectively blinded evaluated with the four clinical-score systems. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores according sonography results.</p><p><b>RESULTS</b>Sonography evidenced deep venous thrombosis in 88 out of 274 patients. The sensitivity, specificity, positive predictive value and negative predictive value was 77.3%, 65.6%, 51.5% and 85.9%, respectively, for Wells score; 58%, 55.9%, 38.3% and 73.8%, respectively, for Kahn score; 64.8%, 55.4%, 40.7% and 76.9%, respectively, for St. André score and 86.4%, 37.6%, 39.6% and 85.4%, respectively, for Constans score. ROC was 0.761 for Wells score, which was similar as that of Constans score (0.759), then followed by St. André score (0.627) and Kahn score (0.591).</p><p><b>CONCLUSION</b>Our results showed that Wells score and Constans score are superior to Kahn score or St. André score for diagnosing patients with suspected deep venous thrombosis in terms of sensitivity, negative prediction value and ROC values.</p>

SKOV-3 cell imaging by paramagnetic particles labeled with hairpin cell-penetrating peptides / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The hairpin cell-penetrating peptides (hCPPs) demonstrate an interesting characteristic of conditioned activation by molecules. We hypothesized that hCPPs have the potential to selectively deliver a paramagnetic gadolinium probe into the matrix metalloproteinase 2 (MMP-2) positive human ovary adenocarcinoma cell lines, SKOV-3.</p><p><b>METHODS</b>hCPPs were synthesized and labeled with 1,4,7,10-tetraazacyclododecane-N,N',N'',N''' tetraacetic acid gadolinium (III) (Gd-DOTA) and fluorescein isothiocyanate (FITC) by f-moc strategy using a standard solid phase peptide synthesis protocol. MMP-2 expression and activity were demonstrated by reverse transcriptase polymerase chain reaction (RT-PCR) and zymography. Internalization and location of hCPPs in SKOV-3 cells were observed by fluorescein imaging and flow cytometery. Selective delivery of Gd-DOTA in SKOV-3 cells was observed by magnetic resonance imaging (MRI) and transmission electron microscopy (TEM).</p><p><b>RESULTS</b>The uptake of hCPPs by SKOV-3 cells depended on the activity of MMP-2. T1WI signals of SKOV-3 cells treated with Gd-DOTA-hCPPs suggested the uptake of Gd-DOTA-hCPPs increased in a time- (r = 0.990, P < 0.01) and concentration-dependent manner (r = 0.964, P < 0.001), but was inhibited by a MMP-2 inhibitor. Electron-dense particles observed in the cytoplasm and nucleus by transmission electron microscopy proved the intracellular penetration of gadolinium.</p><p><b>CONCLUSIONS</b>hCPPs can be used as an effective vector for an MRI molecular probe to assess the activity of MMP-2.</p>