Head-to-head comparisons of enhanced CT, 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT in identifying adverse pathology of clear-cell renal cell carcinoma: a prospective study

ABSTRACT Objectives: Accurate preoperative prediction of adverse pathology is crucial for treatment planning of renal cell carcinoma (RCC). Previous studies have emphasized the potential of prostate-specific membrane antigen positron emission tomography / computed tomography (PSMA PET/CT) in differentiating between benign and malignant localized renal tumors. However, there is a scarcity of case reports elucidating the identification of aggressive pathological features using PET/CT. Our study was designed to prospectively compare the diagnostic value of enhanced CT, 68Ga-PSMA-11 and 18F-fluorodeoxyglucose (18F-FDG) PET/CT in clear-cell renal cell carcinoma (ccRCC) with necrosis or sarcomatoid or rhabdoid differentiation. Materials and Methods: A prospective case series of patients with a newly diagnosed renal mass who underwent enhanced CT, 68Ga-PSMA-11 and 18F-FDG PET/CT within 30 days prior to nephrectomy was included. Complete preoperative and postoperative clinicopathological data were recorded. Patients who received neoadjuvant targeted therapy, declined enhanced CT or PET/CT scanning, refused surgical treatment or had non-ccRCC pathological indications were excluded. Radiological parameters were compared within subgroups of pathological characteristics. Bonferroni corrections were used to adjust for multiple testing and statistical significance was set at a p-value less than 0.017. Results: Seventy-two patients were available for the final analysis. Enhanced CT demonstrated poor performance in identifying necrosis, sarcomatoid or rhabdoid differentiation and adverse pathology (all P > 0.05). The maximum standardized uptake value (SUVmax) of 68Ga-PSMA-11 PET/CT was more effective than 18F-FDG PET/CT in identifying tumor necrosis and adverse pathology, with an area under the curve (AUC) of 0.85 (cutoff value=25.26, p<0.001; Delong test z=2.709, p=0.007) for tumor necrosis and AUC of 0.90 (cutoff value=25.26, p<0.001; Delong test z=3.433, p<0.001) for adverse pathology. However, no significant statistical difference was found between 68Ga-PSMA-11 and 18F-FDG PET/CT in predicting sarcomatoid or rhabdoid feature (AUC of 0.91 vs.0.75, Delong test z=1.998, p=0.046). Subgroup analyses based on age, sex, tumor location, maximal diameter, stage and WHO/ISUP grade demonstrated that 68Ga-PSMA-11 PET/CT SUVmax had a significant predictive value for adverse pathology. Enhanced CT value and SUVmax demonstrated strong reliability [intraclass correlation coefficient (ICC) > 0.80], indicating a robust correlation. Conclusions: 68Ga-PSMA-11 PET/CT demonstrates distinct advantages in identifying aggressive pathological features of primary ccRCC when compared to enhanced CT and 18F-FDG PET/CT. Further research and assessment are warranted to fully establish the clinical utility of 68Ga-PSMA-11 PET/CT in ccRCC.

Identification of types of GABAA receptors in neurons in brain tissues at target of anesthetic action of isoflurane in mice / 中华麻醉学杂志

Objective To identify the types of γ?aminobutyric acid type A ( GABAA ) receptors in neurons in brain tissues at the target of anesthetic action of isoflurane in mice. Methods Two mouse strains were developed that were either sensitive or resistant to isoflurane. One hundred isoflurane?sensitive ICR∕CD?1 mice ( 50 males, 50 females) and 100 isoflurane?resistant ICR∕CD?1 mice ( 50 males, 50 fe?males) , aged 65-70 days, were used in this study. Brain tissues were obtained, and total RNA was ex?tracted and then reverse transcribed to cDNA using AMV reverse transcriptase. Polymerase chain reaction was used to detect the cDNA sequences. Chi?square analysis was used to compare the cDNA sequence of each GABAA receptor subunit between two strains. Results The cDNA sequence of GABAA receptor sub?units α1?6 , β2,3 andγ1?3 in isoflurane?sensitive strain was completely consistent with that in isoflurane?resist?ant strain. A single nucleotide polymorphism at the nucleotide position 462 ( C∕G) in the β1 sequence was found. The allele C frequencies were 11.0% and 87.0% in isoflurane?sensitive strain and isoflurane?resistant strain, respectively. Compared with isoflurane?sensitive strain, the allele C frequency in cDNA sequences of β1 subunit was significantly increased in isoflurane?resistant strain ( P<0.01) . Conclusion β1 subunit?containing GABAA receptor in neurons in brain tissues is the target of anesthetic action of isoflurane in mice.

Effect of hyperbaric oxygen treatment on mitochondrial free radicals after transient focal cerebral ischemia in rats / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of hyperbaric oxygen(HBO)therapy on mitochondrial free radicals after transient focal cerebral ischemia in rats.</p><p><b>METHODS</b>The male SD rats were randomly assigned into two groups, control and HBO groups. All animals were subjected to 90 min intra-luminal middle cerebral artery occlusion (MCAO) with the regional cerebral blood flow monitored in vivo by laser Doppler flowmetry. HBO treatment was performed in a pressure chamber with 100% O(2)(3 ATM 1 h) 3 h after ischemia. Twenty-four hours after ischemia, mitochondria in the ischemic core and penumbra were isolated and the contents of H(2)O(2), O(2)(*-), MDA, SOD, GSH-PX and GSH in mitochondria were measured respectively.</p><p><b>RESULT</b>After cerebral ischemia-reperfusion, contents of mitochondrial H(2)O(2), O(2)(*-), MDA increased, while the SOD, GSH-PX and GSH in the mitochondria decreased significantly both in the ischemic core and the ischemic penumbra, compared with those in the normal controls(P<0.05). In the ischemic penumbra, HBO therapy increased significantly the content of O(2)(*-)(P<0.05), enhanced the activity of SOD, and decreased the level of MDA (P<0.05). However, HBO therapy did not change the level of MDA, though it also increased the content of O(2)(*-) and the activity of SOD in the ischemic core. HBO therapy had no significant effect on the contents of H(2)O(2), GSH-PX and GSH in the ischemic mitochondria.</p><p><b>CONCLUSION</b>HBO therapy initiated early after acute transient cerebral ischemia in rats can increase the mitochondrial free radicals level, but also increase the activity of the anti-radical enzymes. HBO treatment inhibits the lipid peroxidation damage of mitochondria in the ischemic penumbra, but not in the ischemic core, which indicates that the mitochondrial function plays a role in the reaction of the free radical in the ischemic area after HBO therapy.</p>

Effects of osmotic stress on antioxidant enzymes activities in leaf discs of PSAG12-IPT modified Gerbera / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Leaf senescence is often caused by water deficit and the chimeric gene P(SAG12)-IPT is an auto-regulated gene delaying leaf senescence. Using in vitro leaf discs culture system, the changes of contents of chlorophylls, carotenoids, soluble protein and thiobarbituric acid reactive substance (TBARS) and antioxidant enzymes activities were investigated during leaf senescence of P(SAGl2)-IPT modified gerbera induced by osmotic stress compared with the control plant (wild type). Leaf discs were incubated in 20%, 40% (w/v) polyethylene glycol (PEG) 6000 nutrient solution for 20 h under continuous light [130 micromol/(m(2) x s)]. The results showed that the contents of chlorophylls, carotenoids and soluble protein were decreased by osmotic stress with the decrease being more pronounced at 40% PEG, but that, at the same PEG concentration the decrease in the transgenic plants was significantly lower than that in the control plant. The activities of superoxide dismutase (SOD), catalases (CAT), ascorbate peroxidase (APX), guaiacol peroxidase (GPX) and dehydroascorbate reductase (DHAR) were stimulated by PEG treatment. However, the increases were higher in P(SAG12)-IPT transgenic plants than in the control plants, particularly at 40% PEG treatment. Lipid peroxidation (TBARS content) was increased by PEG treatment with the increase being much lower in transgenic plant than in the control plant. It could be concluded that the increases in the activities of antioxidant enzymes including SOD, CAT, APX, GPX and DHAR were responsible for the delay of leaf senescence induced by osmotic stress.

Prognostic value of ventricular longitudinal systolic velocities and maximal oxygen consumption in patients with dilated cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the prognostic value of regional longitudinal ventricular systolic velocities with that of maximal oxygen consumption (VO(2max)) in patients with dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>VO(2max) derived from cardiopulmonary exercise tests and regional longitudinal ventricular systolic velocities obtained from tissue Doppler imaging were compared in 18 DCM patients with cardiac events (death, cardiac transplantation, hospitalization, group A) and 24 patients without cardiac events (group B). Peak velocities during isovolumic contraction (is) and ejection (ez) were interrogated at the mitral or tricuspid annulus (site 1), at the mid parts of the walls (site 3, at the level of papillary muscle), and at the midpoints (site 2) between sites 1 and 3 of interventricular septum (S), lateral wall of LV (L) and of RV (R) in apical 4 chambers view.</p><p><b>RESULTS</b>R1is, R2is, R2ez, R3is, S1is, S1ez, S2ez, L1is, L1ez and L2ez of group A were significantly lower than those in group B (all P < 0.05). Independent of VO(2max), high sensitivity and specificity were shown for R3ez, S1ez, L1ez, L1is, L2is and L3is in predicting cardiac events of DCM patients.</p><p><b>CONCLUSION</b>LV and RV systolic velocities could independently predict cardiac events in DCM patients.</p>

Noninvasive assessment of left anterior descending and right coronary artery flow reserve by transthoracic Doppler echocardiography in patients with coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the feasibility of evaluation of CFR for LAD and right coronary artery (RCA) as well as diagnostic accuracy for patency of each vessel by transthoracic Doppler echocardiography (TTDE).</p><p><b>METHODS</b>65 consecutive patients (age 58 +/- 14, ejection fraction 49% +/- 8%, 48 men and 17 women) were studied for CFR by TTDE with adenosine infusion (140 microg.kg(-1).min(-1)). LAD flow was interrogated nearby the apex in modified 2-ch apical view. RCA flow was interrogated at mid posterior wall on distal part of the posterior descending branch (PDA) in modified 2-ch apical view for PDA.</p><p><b>RESULTS</b>Flow for LAD was detected in all patients (4 with use of contrast agent) and for RCA in 55 patients (5 with contrast agent). Two patients had an occluded RCA. Feasibility of RCA flow detection was 55/63 (87%). In all patients maximal flow of each branch was detected in less than 2 min of adenosine infusion (140 mg.kg(-1).min(-1)). Total time for both CFR estimation was 7.3 +/- 1.6 min. Selecting 2.0 or 1.8 as CFR cut-off value for diagnosis of coronary stenosis (> or = 50% in diameter) or severe stenosis (> or = 70%) was found fitted for both LAD and RCA with similar diagnostic performance (sensitivity 89%/93%, specificity 86%/84%, area under curve 0.89/0.92 respectively, in stenosis diagnosis and sensitivity 88%/89%, specificity 90%/83%, area under curve 0.94/0.95 respectively in severe stenosis diagnosis).</p><p><b>CONCLUSIONS</b>CFR evaluation of both distal LAD and PDA is of high feasibility and can provide high diagnostic yield for relevant vessel patency.</p>

Significance of Serum Cystatin C in Early Diagnosis of Henoch-Schonlein Purpura Nephritis / 实用儿科临床杂志

Objective To explore the change and clinical significance of serum Cystain-C in children with Henoch-Schonlein purpura(HSP).Methods Thirty-three children diagnosed HSP according to the domestic criteria hospitalized in department of pediatrics were enrolled in patient group and 31 children outpatients during the corresponding time period as controls.Venous blood of each child in 2 groups was collected in the day of admission,serum Cystain-C was determined by enzyme-linked immunosorbent assay,plasma D-dimer was measured by gold standard double antibody sandwich method,and blood urea nitrogen(BUN) and serum creatinine(Scr) were detected by automatic biochemistry analyzer.At the same time each child undertook routine urine examination.Data was analyzed by Stata 8.0 software.Results 1.BUN and Scr of 2 groups were both normal.2.Proteinuria or hematuria was found in 15 of all 33 patients through routine urianlysis,and the detection rate was 45%.3.The pre-and post-therapy level of serum cystain-C[(3.83?0.83) mg/L,(3.76?1.02) mg/L] and plasma D-dimer [(1.93?2.05) mg/L,(0.77?0.79) mg/L] in HSP group were higher than that in controls [(1.21?0.43) mg/L,(0.13?0.07) mg/L] significantly (P0.05).5.In HSP group,the level of plasma D-dimer pretherapy was significantly higher than that of post-therapy(P0.05).Conclusion The level of serum Cystain-C can act as the significant indicator of early diagnosis and continuous observation of HSP nephritis.