FAPI PET Missed Widespread Bone Marrow Metastases From Follicular Thyroid Cancer That Were Detected by FDG PET.

ABSTRACT: A 62-year-old woman with follicular thyroid cancer who had received total thyroidectomy and multiple rounds of radioactive iodine therapy underwent both 18 F-FDG and 18 F-FAPI PET/CT. 18 F-FAPI PET failed to reveal widespread bone marrow metastases that were clear visualized on 18 F-FDG PET. This case highlights that FAPI PET may not be used to describe bone metastases in detail in follicular thyroid cancer patients, as it is not a sensitive method to detect bone marrow metastases.

Complete Absence of FAPI Uptake in a Patient With Aggressive Diffuse Large B-Cell Lymphoma Involving Multiple Nodal and Extranodal Sites.

ABSTRACT: A 73-year-old man with histopathologically confirmed diffuse large B-cell lymphoma underwent both 18 F-FDG and 18 F-FAPI PET/CT. Although 18 F-FDG PET showed abnormally increased tracer uptake in multiple nodal sites and organs, indicating the aggressiveness of the disease status, 18 F-FAPI PET showed no obvious FAPI uptake in any of the FDG-avid lesions. Our case suggests that low expression of FAP in diffuse large B-cell lymphoma, as indicated by FAPI PET, might help determine a subgroup of patients with poorer outcome.

Head-to-head comparison of contrast-enhanced mammography and contrast-enhanced MRI for assessing pathological complete response to neoadjuvant therapy in patients with breast cancer: a meta-analysis.

OBJECTIVE: Breast cancer patients receiving neoadjuvant therapy (NAT) are in need of a more patient-friendly imaging modality such as contrast-enhanced mammography (CEM) for monitoring therapy response. The purpose of this study was to conduct a meta-analysis to compare the diagnostic performances of CEM and contrast-enhanced magnetic resonance imaging (CE-MRI) for assessing pathological complete response (pCR) in these patients. METHODS: The PubMed, Embase, and Cochrane Library databases were searched through March 2023 to identify studies reporting a head-to-head comparison of CEM and CE-MRI in detecting pCR in breast cancer patients receiving NAT. Pooled diagnostic performance was calculated using a bivariate random-effects model, and an AUC was derived for each test from hierarchic summary ROC analysis. RESULTS: Six studies with 328 patients were included. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were 93% (95% CI 84-97%), 68% (95% CI 60-76%), and 29.29 (95% CI 11.41-75.18) for CEM versus 84% (95% CI 62-95%), 80% (95% CI 71-87%), and 21.39 (95% CI 5.94-77.13) for CE-MRI. The AUC was 0.85 (95% CI 0.82-0.88) for CEM and 0.85 (95% CI 0.82-0.88) for CE-MRI. CONCLUSION: This meta-analysis of head-to-head comparison studies showed that CEM provides an equivalent diagnostic accuracy to CE-MRI in identification of pCR in breast cancer patients receiving NAT. The results support the increasing use of CEM in this setting and would encourage future studies to validate CEM as a suitable replacement for MRI.

Head-To-Head Comparison of 68Ga-FAPI PET/CT and FDG PET/CT for the Detection of Peritoneal Metastases: Systematic Review and Meta-Analysis.

BACKGROUND. FDG PET/CT has limited diagnostic performance in the detection of peritoneal metastasis (PM). Gallium-68-labeled fibroblast activation protein inhibitor (FAPI) targets tumor stroma, leading to high accumulation across cancer types. OBJECTIVE. The purpose of this study was to conduct a meta-analysis to compare the diagnostic performances of 68Ga-FAPI PET/CT and FDG PET/CT in detecting PM on the basis of studies providing head-to-head comparisons between the two tests. EVIDENCE ACQUISITION. PubMed, Embase, and Cochrane Library databases were searched through July 2022 to identify studies reporting head-to-head comparison of 68Ga-FAPI PET/CT and FDG PET/CT for detection of PM. The reference standard was classified as histopathology for all patients or as a combination of histopathologic, clinical, imaging, laboratory, and follow-up information (multidisciplinary reference standard). A random-effects statistical model was applied to conduct a meta-analysis of the diagnostic performances of the tests in patient-based and lesion-based analyses. The QUADAS-2 and QUADAS Comparative tools were used to assess study quality. EVIDENCE SYNTHESIS. Eleven studies were included. Patient-based analysis was reported in nine studies including 340 patients, and lesion-based analysis was reported in four studies including 222 lesions. The pooled sensitivity of 68Ga-FAPI PET/CT was significantly higher than that of FDG PET/CT in patient-based analysis (98.2% [95% CI, 96.1-100.0%] vs 55.9% [95% CI, 33.9-77.9%]) and lesion-based analysis (99.9% [95% CI, 99.5-100.0%] vs 27.3% [95% CI, 11.2-43.4%]). Eight studies were rated at high risk of bias in the reference standard domain because the multidisciplinary reference standard was not sufficiently explained and may have included one of the two index tests, which would have artificially increased sensitivity. In three studies specificity was reported as 100.0% for both tests; these studies were considered at uncertain risk of bias in the patient selection domain because patients with benign peritoneal conditions may have been excluded, resulting in underestimation of potential false-positive results. CONCLUSION. The current evidence suggests excellent sensitivity of 68Ga-FAPI PET/CT for the detection of PM in comparison with poorer sensitivity of FDG PET/CT. However, most included studies had high risk of bias. Further studies are needed to more convincingly characterize true- and false-positive results. CLINICAL IMPACT. The sensitivity of 68Ga-FAPI PET/CT may be substantially greater than that of FDG PET/CT for the evaluation of PM, facilitating surgical planning and candidate selection.

Efficacy of Ginkgo biloba Extract Combined with Hormones in the Treatment of Sudden Deafness and Its Effect on the Reactivity of Peripheral Blood T Cell Subsets.

This work was aimed at exploring the efficacy of Ginkgo biloba extract combined with hormones in the treatment of sudden deafness and the influence on the reactivity of peripheral blood T cell subsets (PBTCSs). In this work, 64 patients with sudden deafness who were treated in The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from August 2019 to August 2022 were selected as the research objects. The patients were randomly divided into a hormone group (treatment with prednisone acetate, n = 34) and a combination group (treatment with Ginkgo-Damole combined with prednisone acetate, n = 30). After the two groups of patients were treated in different ways, their efficacy, symptom improvement, changes in blood rheology, and PBTCSs were compared. The total effective rates (TERs) of the hormone group and the combination group were 76.32% and 95.73%, respectively (P < 0.05). The fibrinogen contents of the patients in the combination group were obviously lower than those in the hormone group after 5 d, 7 d, and 10 d of treatment (P < 0.05). The high blood viscosity (HBV) values of patients in the combination group at 5 d, 7 d, and 10 d after treatment were greatly lower than those in the hormone group (P < 0.05). The low blood viscosity (LBV) values after 3 d, 7 d, and 10 d of treatment in the combined group were much lower in contrast to those in the hormone group (P < 0.05). The CD3+, CD4+, and CD4+/CD8+ in peripheral blood in the combination group were sharply higher while the CD8+ in the combined group was lower in contrast to the hormone group (P < 0.05). There was no visible difference in the incidence of adverse reactions between the two groups of patients after treatment (P > 0.05). In conclusion, the combined application of Ginkgo biloba extract and hormones could effectively improve the abnormal hemorheological indexes of patients with sudden deafness and effectively relieve the imbalance of PBTCSs, which was safe.

Application of decision tree model in predicting the risk of hypothermia after cardiopulmonary bypass in children with congenital heart disease / 中华实用儿科临床杂志

Objective:To analyze the influential factors of hypothermia in congenital heart disease (CHD) after cardiopulmonary bypass (CPB) rewarming using the decision tree model, thus providing theoretical basis for medical staff.Methods:A total of 711 CHD children who underwent surgery in the Shanghai Children′s Medical Center from January 1, 2019 to April 30, 2019 were retrospectively analyzed.A decision tree model was established to predict the risk factors for hypothermia in CHD children following CPB.Results:The decision tree model showed that CPB program, preoperative nutrition score and body surface area were the high-risk factors for hypothermia in CHD children after CPB rewarming.The accuracy, sensitivity, specificity of the decision tree model were 86.45%, 77.14% and 90.97%, respectively, and the area under the receiver operating characteristic curve was 0.851(95% CI: 0.798-0.904). Conclusions:Decision tree model has a high application value in predicting hypothermia in CHD children following CPB.It contributes to identify the influential factors of hypothermia, and provides references for performing preventive treatment and nursing measures to control the risk of hypothermia.

Surveillance of drug resistance of clinically isolated fungi strains from 46 hospitals in Shandong Province / 中华临床感染病杂志

Objective:To analyze the distribution of clinically isolated fungal strains and their resistance to common antifungal drugs in Shandong province.Methods:Through the Shandong Children’s Bacterial & Fungal Drug Resistance Surveillance and Research Collaborative Network, a total of 1 030 fungi were collected in 46 hospitals of Shandong province from January 1 to December 31, 2018. The source and type of strains were analyzed, and antifungal drug sensitivity tests were performed by using the micro-dilution method. Whonet 5.6 and SPSS 22.0 were applied to analyze the data.Results:The overall main strains were Candida albicans (38.74%, 399/1 030), Candida tropicalis (16.99%, 175/1 030) and Candida parapsilosis (16.41%, 169/1 030); the main fungi strains in child patients were C. albicans (52.50%, 63/120), C. parapsilosis (12.50%, 15/120) and C. tropicalis (9.17%, 11/120); the main fungi strains in adult patients were C. albicans (36.37%, 331/910), C. tropicalis (17.03%, 155/910) and C. parapsilosis (15.27%, 139/910). The isolation rate of main Candida strains from January to March and August to December was much higher than that of other months. The drug resistance rates of C. albicans to fluconazole and voriconazole were 7.14% and 7.43%, respectively, and the drug resistance rates to itraconazole were 50.44%. The resistance rates of C. tropicalis to fluconazole, voriconazole and itraconazole were 29.05%, 23.29% and 48.65%, respectively. The sensitivity rates of C. parapsilosi to fluconazole, voriconazole and itraconazole were 93.06%, 93.75% and 94.44%, respectively. Candida glabrata showed a dose-dependent sensitivity rate of 2.33% to fluconazole. Analysis of 244 blood fungi strains showed that non-candida albicans bacteremia accounted for 70.08%. In the pathogen spectrum covering 92.22%, fluconazole was sensitive to 64.65% of the pathogens, voriconazole was 68.88%, and amphotericin B was 88.75%. After quantification, the effective rates of fluconazole, voriconazole and amphotericin B in the clinical treatment of fungal bacteremia were 70.10%, 74.69% and 96.23%, respectively. Among them, the sensitivity rate of voriconazole to C. tropicalis was lower than that of fluconazole. Conclusions:Candida is the main clinical fungus isolates in hospitals of Shandong province. The resistance rate of C. tropicalis to azole antifungal drugs is on the rise, and the sensitivity of other Candida species to clinically used antifungal drugs is basically stable.

Preoperative Use of Intravenous Contrast Media Is Associated With Decreased Excellent Response Rates in Intermediate-Risk DTC Patients Who Subsequently Receive Total Thyroidectomy and Low-Dose RAI Therapy.

Purpose: To evaluate the impact of preoperative use of intravenous contrast media (ICM) on the excellent response (ER) rates in a cohort of intermediate-risk differentiated thyroid cancer (DTC) patients who received total thyroidectomy (TT) and low-dose radioactive iodine (RAI) therapy. Methods: A total of 683 consecutive patients were retrospectively reviewed in a single center between August 2016 and August 2018. Patients were divided into ICM group (n = 532) and non-ICM group (n = 151). Intravenous contrast media patients were 1:1 propensity matched to non-ICM patients based on T stage, N stage, and urinary iodine. Risk-adjusted logistic regression models were constructed to assess the association between the use of ICM and ER rates. Results: Intravenous contrast media patients had significantly higher T stage (P < 0.001), N stage (P < 0.001), urinary iodine (P < 0.001), and ps-Tg (P = 0.042) than non-ICM patients. Preoperative use of ICM was found to be significantly associated with decreased ER rates in both the primary cohort [odds ratio (OR) = 0.47, 95% confidence interval (CI) = 0.32-0.71; P < 0.001] and the matched cohort (OR = 0.48, 95% CI = 0.25-0.94; P = 0.031). Subgroup analysis on RAI delay time in the primary cohort revealed that ER rates in ICM patients were significantly lower than that of non-ICM patients for 1-2 months (P = 0.0245) and >2-3 months (P = 0.0221) subgroups, but not for >3-4 months, >4-5 months, and >5-6 months subgroups (all P > 0.05). A delay time of >3-4 months exhibited the highest ER rate (63.08%) within the ICM group. Conclusions: Preoperative use of ICM is associated with decreased ER rates in intermediate-risk DTC patients who subsequently receive TT and low-dose RAI therapy. For such patients, if ICM has already been received, an RAI delay time of >3-4 months would seem to be more appropriate to achieve better ER rates.

Comparison of 18F-FDG-PET and 18F-FDG-PET/CT for the diagnostic performance in thyroid nodules with indeterminate cytology: A meta-analysis.

BACKGROUNDS: We performed a meta-analysis to compare F-FDG-PET and F-FDG-PET/CT for the diagnostic performance in thyroid nodules with indeterminate cytology by Bethesda classification. METHODS: PubMed and Embase databases were searched for eligible studies from the earliest available date of indexing through September 2019. Only studies with clearly stated histopathology confirmation were included. Publication bias was assessed by Deeks funnel plot. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and diagnostic odds ratio was determined by random-effect analysis, respectively. All diagnostic estimate indexes were determined separately for PET alone and PET/CT and were compared pair-wisely using Z-test. RESULTS: We included 214 patients from five PET alone studies and 420 patients from 8 PET/CT studies in this meta-analysis. The range of the prevalence of malignancy was 11% to 27% for PET alone studies (Median, 20%) and 4% to 50% for PET/CT studies (Median, 24%). The sensitivity (0.95 vs 0.73, P < .01), negative likelihood ratio (0.20 vs 0.53, P = .04) and negative predictive value (0.99 vs 0.91, P < .01) of PET alone are significantly better than those of PET/CT. For PET/CT, Fagan nomogram indicated that when the pre-test probability was set at 24%, the negative post-test probability could decrease to 12%. CONCLUSION: This meta-analysis reveals that in evaluating thyroid nodules with indeterminate cytology by Bethesda classification, the rule-out performance of F-FDG-PET is significantly better than F-FDG-PET/CT, although the latter represents a more objective and accurate technique. We hypothesize that the lack of precise localization of suspicious FDG uptake in the neck region may have contributed to this overvaluation for PET alone studies, and advocate that future studies be performed with PET/CT rather than PET alone to avoid misinterpretation and overvaluation in this scenario.

Comparison of pulmonary availability and anti-inflammatory effect of dehydroandrographolide succinate via intratracheal and intravenous administration.

Dehydroandrographolide succinate (DAS) injection, which was approved in China for the treatment of viral pneumonia and upper respiratory tract infections, is often off-label used for nebulization therapy to avoid the adverse drug reactions associated with the injection. However, the aerodynamic properties and pulmonary fate of nebulized DAS was largely uninvestigated. In this study, the main objectives were to evaluate the in vitro aerodynamic deposition profiles of nebulizer generated aerosols and comparatively investigate the local drug availability and anti-inflammatory efficacy of DAS between intratracheal and intravenous dosing. The in vitro evaluation of aerodynamic characteristics and droplet size distribution showed more than 50% aerosol particles with size being <5 µm, allowing the aerosols to reach the lower respiratory tract. Following intratracheal administration, the drug underwent pulmonary absorption into the bloodstream, rendering an absolute bioavailability of 47.3%. Compared to the intravenous delivery, the intratracheal administration dramatically increased the drug availability in the lung tissue in rats by more than 80-fold, leading to an improved and prolonged local anti-inflammatory efficacy in a lipopolysaccharide induced lung injury model in mice. The present results demonstrated that inhalation delivery of DAS is a convenient and effective alternative to intravenous injections.

Joint optic disc and cup segmentation based on residual multi-scale fully convolutional neural network / 生物医学工程学杂志

Glaucoma is the leading cause of irreversible blindness, but its early symptoms are not obvious and are easily overlooked, so early screening for glaucoma is particularly important. The cup to disc ratio is an important indicator for clinical glaucoma screening, and accurate segmentation of the optic cup and disc is the key to calculating the cup to disc ratio. In this paper, a full convolutional neural network with residual multi-scale convolution module was proposed for the optic cup and disc segmentation. First, the fundus image was contrast enhanced and polar transformation was introduced. Subsequently, W-Net was used as the backbone network, which replaced the standard convolution unit with the residual multi-scale full convolution module, the input port was added to the image pyramid to construct the multi-scale input, and the side output layer was used as the early classifier to generate the local prediction output. Finally, a new multi-tag loss function was proposed to guide network segmentation. The mean intersection over union of the optic cup and disc segmentation in the REFUGE dataset was 0.904 0 and 0.955 3 respectively, and the overlapping error was 0.178 0 and 0.066 5 respectively. The results show that this method not only realizes the joint segmentation of cup and disc, but also improves the segmentation accuracy effectively, which could be helpful for the promotion of large-scale early glaucoma screening.

Diagnostic performance of 18F-FDG-PET/CT in DTC patients with thyroglobulin elevation and negative iodine scintigraphy: a meta-analysis.

PURPOSE: To evaluate the accuracy of 18F-FDG-PET/CT for the detection of recurrent and/or metastatic diseases in differentiated thyroid cancer (DTC) patients with thyroglobulin elevation and negative iodine scintigraphy. Whether PET/CT with TSH stimulation (sPET/CT) had better diagnostic performance than PET/CT without TSH stimulation (nsPET/CT) in this scenario was also evaluated. METHODS: PubMed and Embase databases were searched for eligible studies from January 2001 to December 2018. Only studies with clearly stated reference standard (histopathology confirmation and/or clinical/imaging follow-up) were included. Publication bias was assessed by Deeks funnel plot. The pooled sensitivity, specificity, diagnostic odds ratio (DOR) and the area under the summary receiver-operating characteristics curve (AUC) for PET/CT was determined by random-effect analysis, respectively. sPET/CT and nsPET/CT were compared pairwise for all diagnostic estimate indexes using Z-test. RESULTS: We included 17 studies with 1195 patients in this meta-analysis. The pooled sensitivity, specificity, DOR and AUC for PET/CT on patient-based data were 0.86 (95% CI: 0.79-0.91), 0.84 (95% CI: 0.72-0.91), 31.00 (95% CI: 12.00-80.00) and 0.91 (95% CI: 0.88-0.93), respectively. There was high heterogeneity (I 2 = 80% for sensitivity, I 2 = 82% for specificity) and possible publication bias (P = 0.01). Z test did not detect statistically significant difference between sPET/CT and nsPET/CT for all the diagnostic estimate indexes (all P > 0.05). CONCLUSIONS: On patient-based analysis, 18F-FDG-PET/CT has high diagnostic accuracy for the detection of recurrent and/or metastatic diseases in DTC patients with thyroglobulin elevation and negative iodine scintigraphy, but existing studies were limited by high heterogeneity and possible publication bias. The diagnostic performance of sPET/CT may be not superior to nsPET/CT.

Negative remnant 99mTc-pertechnetate uptake predicts excellent response to radioactive iodine therapy in low- to intermediate-risk differentiated thyroid cancer patients who have undergone total thyroidectomy.

OBJECTIVE: Negative 99mTc-pertechnetate uptake of the thyroid bed indicates the absence or a small volume of remnant thyroid tissue (RTT) after total thyroidectomy (TT). The aim of this study is to evaluate the predictive value of negative 99mTc-pertechnetate scintigraphy for excellent response (ER) to radioactive iodine therapy (RIT) in low- to intermediate-risk differentiated thyroid cancer (DTC) patients. PATIENTS: One-hundred and eighty-nine low- to intermediate-risk DTC patients who underwent TT, RIT with a single dose of 30 mCi and suppressive therapy with thyroid-stimulating hormone (TSH) from July 2015 to February 2016 in our hospital were retrospectively evaluated. 99mTc-pertechnetate thyroid scintigraphy was performed just before RIT and images were reported dichotomously as negative or positive. The response of patients was assessed for 23.2 ± 3.8 months after RIT and dichotomized as excellent response (ER) or non-excellent response (NER). 99mTc-pertechnetate uptake, age at diagnosis, gender, multifocality, T stage, N stage, preablative stimulated thyroglobulin (ps-Tg), and TSH were explored as potential predictors for ER. RESULTS: 80.68% (71/88) of patients with negative 99mTc-pertechnetate uptake achieved ER. When patients were evaluated according to different ps-Tg levels, we found that 94.83% (55/58) of patients with ps-Tg < 1 ng/ml and negative 99mTc-pertechnetate uptake achieved ER. Multivariate Cox regression analysis revealed that ps-Tg (P = 0.0001) and 99mTc-pertechnetate uptake (P = 0.0473) were independent predictors for ER. CONCLUSIONS: In addition to ps-Tg, negative 99mTc-pertechnetate uptake is also a significant independent predictor for an excellent response in low- to intermediate-risk patients. It may be possible to omit RIT in patients with ps-Tg < 1 ng/ml and concurrent negative 99mTc-pertechnetate uptake.

Preparation of disulfiram naonosuspensions and their anti-tumor efficacy in vitro and in vivo / 药学学报

Disulfiram (DSF) is a traditional anti-alcohol drug, but it was recently found that DSF has strong inhibitory effect on the growth of a variety of cancer cells. However, its clinical application is greatly limited due to its poor solubility, instability in gastrointestinal tract and short plasma half-life. In this study, DSF is fabricated into nanosuspensions with the aim of trying to solve these problems. DSF nanosuspensions (DSF-NSps) were prepared by the anti-solvent precipitation method under ultrasonication, and the suitable stabilizer was screened according to the size, polydispersity index (PDI), and zeta potential of the resultant nanosuspensions, along with their particle size change during the storage at room temperature. The particle size, PDI, and zeta potential of DSF-NSps were determined using dynamic light scattering method, while the morphology of DSF-NSps was observed by transmission electronic microscope (TEM). The stability of DSF-NSps in media was examined according to their particle size change in different physiological media. The concentration of DSF was measured by HPLC assay. The in vitro drug release was evaluated on basis of dialysis. MTT assay was employed to evaluate the in vitro cytotoxicity of DSF-NSps against cancer cell lines. The 4T1 tumor-bearing mouse model was used to evaluate the in vivo therapeutic efficacy of DSF-NSps. All the animal experiments were acquired according to the Regulations for Animal Experiments and Guidelines for Ethical as defined by Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College. As a result, the combinational use of soyabean lecithin (SPC) and D-alpha tocopherol acid polyethyene glycol succinate (TPGS) was determined to best stabilize DSF-NSps when the ratio of DSF-SPC-TPGS was 24∶20∶4 (weight ratio), with small particle size and good storage stability. The resultant DSF-NSps showed a regular spherical morphology and drug loading content of (45.36 ± 2.09) %, with average particle size of 175.00 ± 0.75 nm, PDI of 0.24 ± 0.07 and zeta potential of -14.3 mV. DSF-NSps displayed good particle size stability in a variety of biological media including phosphate buffer saline, normal saline, 5% glucose, artificial gastric fluid, artificial intestinal fluid and plasma, which would meet the demand of both intravenous and oral administration. The in vitro study demonstrated that nano-encapsulation greatly increased the stability of DSF in aqueous media, DSF-NSps exhibited sustained release of the encapsulated drug and significantly inhibited 4T1 cells compared to free DSF (IC50, 1.07 vs 5.53 μg·mL-1, P<0.01). DSF-NSps showed a good dose-response relationship on the 4T1 tumor-bearing mice with the tumor inhibition rates at the three doses being 80.22%, 75.14% and 66.10%, all higher than that of paclitaxel injections (55.01%, P<0.05). The in vivo biodistribution study displayed that DSF-NSps were mainly distributed into liver, spleen and tumor. In sum, disulfiram nanoparticles could be expected to provide an effective anti-cancer drug for the treatment of breast cancer.

Protective effect of raspberry extract on ConA-induced acute liver injuryin mice / 中国中药杂志

In this experiment,the antioxidant capacity of raspberry extract and the protective effect on liver injury induced by ConA in mice were investigated. Balb/C male mice were randomly divided into six groups: normal group,model group,bicyclol control group( 200 mg·kg~(-1)),low-dose raspberry extract group( 200 mg·kg~(-1)),middle-dose raspberry extract group( 400 mg·kg~(-1)),and highdose raspberry extract group( 800 mg·kg~(-1)). Each group was intragastrically administered with drugs according to the body weight once a day. Seven days later,all of the groups except for the normal group were treated with ConA( 20 mg·kg~(-1)) through tail vein injection to establish the acute liver injury model. The mice were put to death 8 hours later. The organ indexes were calculated. These rum levels of ALT,AST and LDH and the activities of SOD,CAT,GSH and MDA in liver tissue were detected. HE staining was used to observe the pathological changes of liver tissue in mice. Western blot was used to detect the expressions of Bax,Bcl-2,Nrf2 and Keap-1. The antioxidant capacity of raspberry extract was measured by CAA assay. The results showed that,raspberry extract had a strong antioxidant capacity. Simultaneously,compared with the model group,raspberry extract can significantly improve the pathological conditions of liver,and significantly reduce ALT,AST and LDH activities in serum of liver injury mice( P<0. 01). The activities of SOD,CAT in liver homogenate supernatant were significantly increased in the high-dose group,the content of GSH increased,while the content of MDA was sharply declined in the high-dose group( P<0. 01). Meanwhile,raspberry extract down-regulated the expressions of Bax and Keap-1 and up-regulated the expressions of Bcl-2 and Nrf2. CAA showed that the compound raspberry extract had a strong antioxidant capacity. Therefore,raspberry extract has an obvious protective effect on acute liver injury induced by ConA in mice.

Efficacy and safety between brachytherapy combined with external beam radiation therapy and external beam radiation therapy alone for prostate cancer: a meta-analysis / 中华放射肿瘤学杂志

Objective To systematically evaluate the efficacy and safety of brachytherapy (BT) combined with external beam radiation therapy (EBRT) and EBRT alone for prostate cancer.Methods Databases including PubMed,Web of Science,Cochrane Library,CNKI,WanFang Data and VIP were searched from the inception to July 2018 to collect the clinical trials which comparatively analyzed the efficacy and safety between EBRT plus BT and EBRT alone for prostate cancer.According to the inclusion and exclusion criteria,data of the included studies were extracted and the methodological quality was evaluated.Then,a meta-analysis was performed using RevMan 5.3.Results Ten studies of 23 393 patients were included,in which 6 were randomized controlled trials (RCTs) and the other 4 were non-RCTs.The 3-year biochemical progression-free survival (b-PFS)[OR=2.03(95％CI:1.11 to 3.73),P=0.02] and the 5-year b-PFS of intermediate-risk patients[OR=2.27(95％CI:1.49 to 3.45),P＜0.01] in the EBRT+BT group were significantly higher compared with those in the EBRT group.The 3-and 5-year b-PFS,5-year overall survival and 5-year metastasis-free survival did not differ between two groups.in the incidence of ≥ grade 2 acute[OR=1.44(95％CI:1.11 to 1.38),P＜0.01] and chronic genitourinary adverse reactions [OR=3.06(95％CI:1.37 to 6.80),P＜0.01],≥ grade 3 acute[OR=1.75 (95％CI:1.14 to 2.69),P=0.01] and chronic genitourinary adverse reactions[OR=3.41(95％CI:2.42 to 4.82),P＜0.01] in the EBRT group were significantly lower than those in the EBRT+BT group.The incidence of gastrointestinal adverse reactions did not significantly differ between two groups.Conclusion Compared with EBRT alone,EBRT combined with BT can effectively improve the 3-and 5-year b-PFS,whereas increase the incidence of genitourinary adverse reactions for patients with intermediate-risk prostate cancer.

Protective effect of scutellarin on myocardial ischemia/reperfusion injury and its mechanism / 中国药理学通报

Aim To study the protective effect of scutellarin (Scu) on ischemia/reperfusion (I/R) injury in isolated rat hearts and its mechanism. Methods Acute myocardial I/R injury was induced by Lange-ndorff perfusion in isolated rat hearts. SD rats were randomly divided into five groups; blank group, model group, low, medium and high dose group of Scu (0.3, 3, 30 mg • kg-1). The drug experimental group was perfused with K-H solution containing Scu (0. 3, 3, 30 mg • L-1) in vitro perfusion. Myocardial contractile function was recorded; AST, CK and LDH activities in rat myocardium were detected by kit; ICAM-1, IL-ip, IL-6, IL-18 and TNF-α were detected by ELISA; the morphological changes of myocardium were observed by HE staining; and the expressions of IL-1 p, NLRP3 and NF-kB were detected by Western blot. Results Compared with blank group, the contractile function of isolated rat heart in model group significantly decreased, the activities of AST, CK and LDH in myocardium significantly increased, and the contents of inflammatory factors such as ICAM-1, IL-lp, IL-6, IL-18 and TNF-a significantly increased. The expression of IL-1 (3 and NLRP3 and the nuclear translocation of NF-kB significantly increased. Scu significantly improved the above pathological changes. Conclusion The protective effect of Scu on myocardial I/R injury may be related to the inhibition of NF-KB/NLRP3/IL-1 p pathway.

Indeterminate solitary vertebral lesions on planar scintigraphy.

OBJECTIVE: This study aims to evaluate the added value of hybrid SPECT-CT in differential diagnosis of indeterminate solitary vertebral lesion (SVL) on planar scintigraphy in patients with non-small cell lung cancer (NSCLC). METHODS: Sixty-three NSCLC patients with indeterminate "hot spot" SVL on planar scintigraphy were retrospectively included in this study. Pathological confirmation and followup by whole body scintigraphy and SPECT-CT were used as golden standard for the evaluation of diagnostic performance of planar scintigraphy, SPECT, and SPECT-CT. Receiver operating characteristic (ROC) analyses were performed and compared among the three imaging modalities. For subgroup analysis, the performance of each imaging modality in different NSCLC subgroups including age, gender, histology of primary tumor and nature, site and location of SVL were analyzed, respectively. The impact of SPECT-CT on the management of NSCLC patient with SVL was also analyzed. RESULTS: The sensitivity and specificity of planar scintigraphy, SPECT, and SPECT-CT in differentiating SVL were 41.9 % and 81.2 %, 83.9 % and 71.9 %, and 90.3 % and 90.6 %, respectively. SPECT-CT performed significantly better than both planar scintigraphy (P < 0.0001) and SPECT (P = 0.0027). The sensitivity for planar scintigraphy in nonlytic SVL was significantly higher than in lytic SVL (88.5 % vs. 50.0 %, P = 0.0008). The sensitivity for the planar scintigraphy and SPECT-CT in dorsal SVL was significantly higher than in non-dorsal SVL (55.0 % vs. 18.2 %, P = 0.0029 and 100 % vs. 85.7 %, P = 0.0236, respectively). SPECT-CT had an impact on the clinical management of 52.6 % (20/38) of patients compared to planar scintigraphy and 23.6 % (9/38) of patients compared to SPECT. CONCLUSION: Compared to planar scintigraphy and SPECT, hybrid SPECT-CT shows excellent performance in differentiating indeterminate SVL in NSCLC patients, the application of which will significantly impact patient management. ZIEL: : Ziel dieser Studie ist es, den Mehrwert der hybriden SPECT-CT in der Differenzialdiagnose der unbestimmten solitären Knochenläsionen der Wirbelsäule (SVL) auf der planaren Szintigraphie bei Patienten mit nichtkleinzelligem Lungenkarzinom (NSCLC) zu untersuchen. METHODE: Retrospektiv wurden 63 NSCLC-Patienten mit unbestimmten solitären "hot spot" Knochenläsionen der Wirbelsäule unter planarer Szintigraphie eingeschlossen. Pathologische Bestätigung und Follow-up durch Ganzkörper-Szintigraphie und SPECTCT wurden als Goldstandard für die Bewertung der diagnostischen Leistung der Planar- Szintigraphie, SPECT und SPECT-CT verwendet. ROC-Analysen (Receiver Operating Characteristic, Beobachterkennlinie) wurden erstellt und zwischen den drei Bildgebungsmodalitäten verglichen. Für die Subgruppenanalyse wurde die Leistung jeder Bildgebungsmodalität in verschiedenen NSCLC-Untergruppen einschließlich Alter, Geschlecht, Histologie des Primärtumors und der Art, Lage und Ort der SVL analysiert. Der Einfluss von SPECT-CT auf das Management von NSCLC-Patienten mit SVL wurde ebenfalls analysiert. ERGEBNISSE: Die Sensitivität und Spezifität der planaren Szintigraphie, SPECT und SPECT-CT bei der Differenzierung von SVL waren 41,9 % und 81,2 %, 83,9 % und 71,9 % bzw. 90,3 % und 90,6 %. Die SPECT-CT zeigte eine signifikant bessere Leistung als die planare Szintigraphie (P < 0,0001) und die SPECT (P = 0,0027). Die Sensitivität für die planare Szintigraphie bei nicht-lytischer SVL war signifikant höher als bei der lytischen SVL (88,5 % vs. 50,0 %, p = 0,0008). Die Sensitivität für die planare Szintigraphie und SPECT-CT in der dorsalen SVL war signifikant höher als in nicht-dorsalen SVL (55,0 % gegenüber 18,2 %, P = 0,0029 und 100 % gegenüber 85,7 %, P = 0,0236). SPECT-CT beeinflusste das klinische Management von 52,6 % (20/38) der Patienten im Vergleich zur planaren Szintigraphie und 23,6 % (9/38) der Patienten im Vergleich zur SPECT. SCHLUSSFOLGERUNG: Im Vergleich zur Planar-Szintigraphie und SPECT zeigt die hybride SPECT-CT eine hervorragende Leistung bei der Differenzierung unbestimmter SVL bei NSCLC-Patienten, deren Anwendung das Patientenmanagement signifikant beeinflussen wird.

Psicosis aguda similar a la esquizofrenia como principal presentación clínica de la enfermedad de Graves tratada con éxito con radioyodo en combinación con antipsicóticos: caso clínico / Acute schizophrenia-like psychosis as major clinical presentation of Graves' disease successfully treated by radioiodine in combination with antipsychotics: a case report

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