Effectiveness of rectal MRI and endorectal ultrasound predicting the complete response of rectal cancer after neoadjuvant chemoradiotherapy / 中国实用外科杂志

OBJECTIVE: To offer some important insights into clinical decision-making by evaluating endorectal ultrasound and rectal MRI when they were used to predict pathological complete response for rectal cancer patients who were performed neoadjuvant therapy. METHODS: The study was a prospective cohort study which was conducted at a single tertiary care center. Patients diagnosed with mid-low rectal cancer between May 2014 and June 2018 in Peking Union Medical College Hospital were collected in the study. Both of their endorectal ultrasound and rectal MRI were performed to evaluate the tumor stage before their preoperative chemoradiation and were reevaluated at the 6 to 7 th weeks after their preoperative radiation treatment. The pathological preoperative tumor staging achieved by endorectal ultrasound and rectal MRI was compared with postoperative staging by pathologic examination. Sensitivity,specificity,accuracy and Youden index of each evaluation method and their combination were calculated. The ROC curve was administered likewise. RESULTS: A total of 247 patients were enrolled in the study. The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Youden index for ypT0 N0 separate evaluation of for whom was qualified as compete endorectal ultrasound(163 patients) and of rectal MRI(212 patients) was15.9% and 23.1%,94.0% and 94.9%,77.8% and 83.4%,0.1 and 0.2. Combined two methods,the data were recorded as 13.6%,98.1%,83.6% and 0.1.Area under curve ROC for ultrasound and MRI when using specifically for ypT0 N0 measurement was 0.656 and 0.742.The two modalities showed 0.517 and 0.667 in terms of AUC when comparing with each other. CONCLUSION: The sensitivity of MRI and ERUS as terms of diagnosing complete response is rather unsatisfactory,although they all bear a relatively good specificity. For the patients not diagnosed with clinical response by one of the two methods,radical operations were strongly recommended. For the patients confirmed as complete response by both modalities,there still exists possibilities that residual tumor persists,“watch and wait”approach can be taken cautiously and the patient must be followed up intensely.

Monoenergetic Reconstructions Using Detector-based Spectral CT for Imaging of Small Lesions in the Rabbit VX2 Liver Cancer Models / 中国医学科学院学报

Objective To evaluate the value of virtual monoenergetic(monoE)using dual-layer detector spectrum CT in detecting small lesions in rabbit VX2 liver cancer models.Methods Hepatic VX2 double tumor models were established in 24 New Zealand white rabbits by CT-guided puncture. All the rabbits underwent CT scans by using dual-layer detector CT to generate conventional 120-keV polychromatic images and monoE images with energy levels ranging from 40 to 100 keV during the arterial phase. The quantity of the lesion and measurement of the lesion length as well as the objective evaluations[signal noise ratio(SNR)and contrast noise ratio(CNR)] and the subjective evaluations(overall image quality score)of the image quality were independently measured by two radiologists. The results were compared with pathological findings.Results Pathology confirmed that 30 lesions were successfully established,with an average size of(3.99±0.91)mm. Eighteen(47.40%)and 30(100%)lesions were detected by conventional images and monoE images with energy levels from 40 to 65 keV,respectively. The correlation between the length diameter of fresh pathological specimens and the measurements of lesion length diameter on 40(r=0.948,P=0.000),45(r=0.958,P=0.000),50(r=0.972,P=0.000),55(r=0.952,P=0.000),60(r=0.921,P=0.000),65 keV(r=0.917,P=0.000)monoE images was better than that on conventional images(r=0.206,P=0.270). The subjective evaluation scores of the quality of the 40,45,50,and 55 keV monoE images were 4.50(4.00,4.50)(P=0.000),5.00(5.00,5.00)(P=0.000),5.00(4.50,5.00)(P=0.000),and 4.00(4.00,4.50)(P=0.002),respectively,which were significantly higher than the conventional mixed energy images[3.00(2.50,3.00)]. The objective evaluation of image quality showed that the SNR and CNR of monoE images decreased with the increase of the energy level of the monoE image. The CNR of monoE images with 40(P=0.000),45(P=0.002),and 50 keV(P=0.011)were higher than that of the conventional image. The CNR of monoE images with 40(P=0.000),45(P=0.000),50(P=0.000),and 55 keV(P=0.002)were higher than that of the conventional images.Conclusion Dual-layer detector spectrum CT monoE image in the low-energy state of 45-50 keV can improve the detection rate of small lesions in rabbit hepatic VX2 tumor models with better noise control and provide better image quality compared with conventional polychromatic images.

Performance of computer-assisted imaging system in detection of squamous intraepithelial lesion of uterine cervix / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the performance of computer-assisted imaging system in the detection of cervical squamous intraepithelial lesion and quality-assurance.</p><p><b>METHODS</b>Manual PAP screening (n = 140 580) and image-assisted screening (n = 32 885) were compared for the detection rates of squamous cell abnormalities, the atypical squamous cells (ASC) to squamous intraepithelial lesion (SIL) ratio, the positive rates of high risk human papillomavirus (HR-HPV) test in the case of atypical squamous cells of undetermined significance (ASC-US), and the correlation between cytopathology and histopathology.</p><p><b>RESULTS</b>Compared with manual screening, computer-assisted imaging system showed increased overall positive detection by 0.32%, decreased detection of ASC by 0.21%, increased detection of low-grade squamous intraepithelial lesion (LSIL) by 0.22%, increased detection of high-grade squamous intraepithelial lesion or worse (HSIL) by 0.31%, and decreased ASC to SIL ratio from 2.59 to 1.60. Computer-assisted imaging system did not change the HR-HPV positive rate of the patients who were ASC-US, or the coincidence rate between cytopathology and histopathology. Moreover, the productivity of the laboratory operation increased 58.33%.</p><p><b>CONCLUSION</b>Computer-assisted imaging system significantly increases the overall positive detection rate of cervical SIL, improves accuracy and work efficiency of screening, decreases the ASC/SIL rate, and strengths the quality-assurance of laboratory testing.</p>

Expression and significance of p-AKT, p-GSK3β and β-catenin in epithelial carcinoma of ovary / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the expressions of phosphorylated protein kinase B (p-AKT), phosphorylated glycogen synthase kinase 3β (p-GSK3β) and β-catenin proteins and to evaluate their relationship with the clinical pathological characteristics in epithelial tumors of the ovary.</p><p><b>METHODS</b>The expression of p-AKT, p-GSK3β, and β-catenin was detected with immunohistochemical staining (EnVision method) in 10 cases of benign epithelial neoplasia, 10 cases of borderline epithelial neoplasia and 70 cases of ovarian carcinoma. The relationship of the expression of p-AKT, p-GSK3β and β-catenin with the clinical pathological features was analyzed.</p><p><b>RESULTS</b>The positive expression rates of p-AKT, p-GSK3β and β-catenin in epithelial ovarian carcinoma were 67.1% (47/70), 60.0% (42/70) and 71.4% (50/70), respectively. Compared to the results of benign and borderline epithelial neoplasia, the expression of the three proteins in carcinoma of the ovary was significantly different (all P < 0.05).Positive correlation was found between p-AKT and p-GSK3β, p-GSK3β and β-catenin, and p-AKT and β-catenin in epithelial ovarian carcinoma (r = 0.546, 0.581, 0.500, respectively; all P < 0.05). Compared to the results of benign and borderline epithelial neoplasia, the expression of p-AKT protein in epithelial ovarian carcinoma was significantly different (all P < 0.05). The expression of p-AKT was correlated with the differentiation of epithelial ovarian carcinoma (P < 0.05), but no relationship was found between its expression and histological classification and FIGO staging (P > 0.05). The expression of p-GSK3β and β-catenin in epithelial ovarian carcinoma were both higher than that in benign and borderline epithelial neoplasia (P < 0.05), and correlated with tumor differentiation and FIGO staging (P < 0.05), but no relationship were found between their expression with histological classification (P > 0.05).</p><p><b>CONCLUSIONS</b>Positive correlations are found between p-AKT, p-GSK3β and β-catenin in epithelial ovarian carcinoma. The activation of β-catenin is possibly correlated with inactivation of p-GSK3β that binds to p-AKT.</p>

Optimized Expression of Snake Fibrinolytic Enzyme Alfimeprase in Pichia pastoris and Its Activity Identification / 中国生物工程杂志

Alfimeprase(ALF)is a recombinantly modified variant of non-hemorrhagic zinc metalloproteinase fibrolase.The target gene alf was obtained from the clone vector p43-alf and cloned into the Pichia pastoris expression vector pPICZ? A.Through high efficiency transformation and Zeocin selection,the recombinant strains of pPICZ?A-alf /GS115 were isolated.In order to achieve a high level expression of recombinant Alfimeprase(rALF),optimization of pH value,methanol daily addition concentration,cell density and methanol induction time points were carried out,and the production of rALF reached up to 425 mg/L.By His?Bind chromatography,the purity of secreted rALF was as high as 95 %.SDS-PAGE and Western blot analysis show that rALF has a molecular weight of about 24 kDa and is bound specifically to anti-His?tag monoclonal antibody.Activity identification results of the modified fibrin plate method demonstrate that the secreted rALF has high fibrinolytic activity.Thus sets up an optimized expression system for ALF,which will play an important role in its further studies and industrial production.