Application of Contrast-enhanced Ultrasound and Bosniak Classification to the Diagnosis of Cystic Renal Masses.

BACKGROUND: The Bosniak classification system based on contrast-enhanced computed tomography (CECT) is commonly used for the differential diagnosis of cystic renal masses. Contrastenhanced ultrasound (CEUS) is a relatively novel technique, which has gradually played an important role in the diagnosis of cystic renal cell carcinoma (CRCC) due to its safety and lowest price. OBJECTIVE: The aim of the study is to investigate the application value of CEUS and Bosniak classification into the diagnosis of cystic renal masses. METHODS: 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional ultrasound (US), CEUS and CECT from subjects confirmed by surgical pathology were retrospectively analyzed. The Bosniak classification system of cystic renal masses was implemented using CEUS and CECT, and the diagnostic ability was compared. RESULTS: For the 32 cystic masses, postoperative pathology confirmed 11 cases of multilocular CRCC, 15 cases of clear cell carcinoma with hemorrhage, necrosis and cystic degeneration, 5 cases of renal cysts, and 1 case of renal tuberculosis. The Bosniak classification based on CEUS was higher than that based on CECT, and the difference was statistically significant (P = .024). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS were comparable to CECT. There was no significant difference observed in the diagnosis of CRCC (P >.05). CONCLUSION: CEUS combined with Bosniak classification greatly improves the diagnosis of CRCC. CEUS shows a comparable diagnostic ability to CECT. In daily clinical routine, patients who require multiple examinations and present contraindications for CECT can particularly benefit from CEUS.

Bioactivity-guided isolation of the active compounds from Rosa nutkana and quantitative analysis of ascorbic acid by HPLC.

Rosa nutkana Presl. (Rosaceae) is distributed abundantly throughout central and southern areas of British Columbia, Canada. Aboriginal people in the Pacific Northwest have traditionally used R. nutkana as a food, medicine, and source of cultural material. The methanolic extract of the fruits of R. nutkana was previously found to have inhibitory activity against methicillin-resistant Staphylococcus aureus (MRSA). In our study, bioactivity-guided fractionation of the methanol extract from R. nutkana led to the isolation of the following 10 compounds: (i) tormentic acid, (ii) euscaphic acid, (iii) ursolic acid, (iv) maslinic acid, (v) quercetin, (vi) catechin gallate, (vii) quercetin-3-O-glucoside, (viii) 1,2,3,4,6-penta-O-galloyl-beta-D-glucoside, (ix) L-ascorbic acid (vitamin C), and (x) 1,6-digalloyl-beta-D-glucoside. Structures were elucidated by ultraviolet, infrared, mass spectrometry, and nuclear magnetic resonance data, as well as by comparison with those of the literature. The compounds quercetin, catechin gallate, quercetin-3-O-glucoside, 1,2,3,4,6-penta-O-galloyl-beta-D-glucoside, and 1,6-digalloyl-beta-D-glucoside exhibited weak antibacterial activity against MRSA. Our research demonstrates the value of traditional knowledge held by Aboriginal people in the Pacific Northwest with respect to uses of R. nutkana. Some described uses in the ethnobotanical literature correspond to activities observed under laboratory conditions. Further work on British Columbia Rosa spp. may contribute to identifying other potential therapeutic uses.