Sub-differentiation of PI-RADS 3 lesions in TZ by advanced diffusion-weighted imaging to aid the biopsy decision process.

Background: Performing biopsy for intermediate lesions with PI-RADS 3 has always been controversial. Moreover, it is difficult to differentiate prostate cancer (PCa) and benign prostatic hyperplasia (BPH) nodules in PI-RADS 3 lesions by conventional scans, especially for transition zone (TZ) lesions. The purpose of this study is sub-differentiation of transition zone (TZ) PI-RADS 3 lesions using intravoxel incoherent motion (IVIM), stretched exponential model, and diffusion kurtosis imaging (DKI) to aid the biopsy decision process. Methods: A total of 198 TZ PI-RADS 3 lesions were included. 149 lesions were BPH, while 49 lesions were PCa, including 37 non-clinical significant PCa (non-csPCa) lesions and 12 clinical significant PCa (csPCa) lesions. Binary logistic regression analysis was used to examine which parameters could predict PCa in TZ PI-RADS 3 lesions. The ROC curve was used to test diagnostic efficiency in distinguishing PCa from TZ PI-RADS 3 lesions, while one-way ANOVA analysis was used to examine which parameters were statistically significant among BPH, non-csPCa and csPCa. Results: The logistic model was statistically significant (χ2 = 181.410, p<0.001) and could correctly classify 89.39% of the subjects. Parameters of fractional anisotropy (FA) (p=0.004), mean diffusion (MD) (p=0.005), mean kurtosis (MK) (p=0.015), diffusion coefficient (D) (p=0.001), and distribute diffusion coefficient (DDC) (p=0.038) were statistically significant in the model. ROC analysis showed that AUC was 0.9197 (CI 95%: 0.8736-0.9659). Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 80.4%, 93.9% and 75.5%, respectively. FA and MK of csPCa were higher than those of non-csPCa (all p<0.05), while MD, ADC, D, and DDC of csPCa were lower than those of non-csPCa (all p<0.05). Conclusion: FA, MD, MK, D, and DDC can predict PCa in TZ PI-RADS 3 lesions and inform the decision-making process of whether or not to perform a biopsy. Moreover, FA, MD, MK, D, DDC, and ADC may have ability to identify csPCa and non-csPCa in TZ PI-RADS 3 lesions.

Protective Effects of Rocuronium Bromide on Ischemia-Reperfusion Injury in Skeletal Muscle Induced by Tourniquet in Patients Undergoing Elective Unilateral Total Knee Arthroplasty: A Prospective, Double Blind, Randomized, Controlled Study.

PURPOSE: To investigate the effects of different doses of rocuronium on ischemia-reperfusion injury in skeletal muscle induced by tourniquet in patients undergoing elective unilateral total knee arthroplasty. PATIENTS AND METHODS: A total of 90 patients undergoing elective unilateral knee arthroplasty under general anesthesia combined with femoral nerve block were randomly divided into 3 groups: normal saline group (group S), rocuronium 0.6 mg/kg group (group L), and rocuronium 1.2 mg/kg group (group H). The primary outcome was the expression of dystrophin in skeletal muscle at 60 min after ischemia. Secondary outcomes included the concentration of malondialdehyde (MDA) and neuronal nitric oxide synthase (nNOS) in blood at 5 min and 30 min after reperfusion. In addition, thigh girth at 24 h and 48 h after operation, the leaving bed time, the incidence of tourniquet-related hypertension and short-term (3 days after operation) complications (nausea and vomiting, swelling, blister, wound infection) and long-term (3 months after operation) complications (joint instability, stiffness, nerve paralysis, pain) were recorded. MAIN RESULTS: The expression of dystrophin in the rocuronium group was higher than that in group S after ischemia (P <0.05). The concentration of MDA in the rocuronium 1.2 mg/kg group was lower at 30 min after reperfusion (P < 0.05). There was no significant difference in nNOS among groups at each time point (P > 0.05). The change of thigh girth was the smallest in the rocuronium 1.2 mg/kg group after operation (P<0.05). The leaving bed time was significantly earlier after operation in the rocuronium group than that in group S (P <0.05). CONCLUSION: Rocuronium can protect skeletal muscle from ischemia-reperfusion injury induced by tourniquet. The mechanism may be related to the fact that rocuronium can reduce the loss of dystrophin in skeletal muscle and have the effects of anti-oxidation and anti-stress. TRIAL REGISTRATION: The study was registered at http://www.chictr.org.cn (ChiCTR1800019221, registered on 2018-10-31).

[Multi Spectral Detection of Ethanol Content in Gasoline Based on SiPLS Feature Extraction and Information Fusion].

The ethanol content in ethanol gasoline was detected with ultraviolet/visible(UV/vis) and near-infrared (NIR) spectroscopy while information fusion technology and synergy interval PLS(SiPLS) algorithm were used as the feature extraction method with the establishment of partial least squares(PLS) regression model. Using the information fusion theory, UV/vis and NIR spectra were used for data fusion, the data level fusion (Low level data fusion, LLDF) and feature level fusion(Mid-level data fusion, MLDF) model were established. The results were compared with the single source modelwith low level data fusion before vector normalization(LLDF-VN1) selected for the optimal model. Finally, the optimal model was tested using the spectral data collected from the samples of high ethanol content and commercial gasoline. The results showed that both UV/vis and NIR can be used to detect and provide good prediction results, whereas direct fusion of the UV/vis and NIR spectral data provided the best results in the regression model based on the calibration set, with the highest correlation coefficient rc, the smallest Biasc and RMSECV values, as 0.999 9, 0.125 8 and 0.000 6, respectively. And the prediction effect of the model of LLDF-VN1(low level data fusion before vector normalization) was the best, r(p)=0.999 1，Bias(p)=0.352 7，RMSEP=-0.073 8. In the verification of the optimal model (LLDF-VN1) by the self distribution solution, rp=0.999 7, Bias(p)=0.102 2, RMSEP=0.329 1; and that for gasoline sold on market, r(p)=0.990 1, RMSEP=0.675 1, Bias(p)=0.892 7, respectively. It showed that the data level fusion based on UV/vis and NIR spectral information could be used to detect the content of ethanol in ethanol-gasoline quickly and accurately, achieving a wide range of ethanol concentration detection, which laid a foundation for further realization of the rapid detection of substances in the blended fuel oil.

[Comparison of early clinical outcomes between mobile-bearing and fixed-bearing total knee arthroplasty for the valgus knee].

OBJECTIVE: To compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis. METHODS: From January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis. RESULTS: All the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening. CONCLUSION: The early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.

Characterization of MSCs from human placental decidua basalis in hypoxia and serum deprivation.

Recently, we reported that human PDB (placental decidua basalis) is an excellent source of MSCs (mesenchymal stem cells), meanwhile, PDB-MSCs could survive under hypoxia and serum deprivation. Herein, we investigated the proliferation, clonogentic efficiency, phenotypes, metabolic activity and cytokines secretion of PDB-MSCs in hypoxia and serum deprivation. PDB-MSCs were cultured in four groups: normoxia (20% O2) and complete medium [10% FBS (foetal bovine serum)+DMEM-HG (Dulbecco's modified Eagle's medium-high glucose)], hypoxia and complete medium, normoxia and serum deprivation (0% FBS), and hypoxia and serum deprivation. After 96 h of culture in the above groups, PDB-MSCs maintain the phenotypes stably. Interestingly, hypoxia notably enhanced the proliferation, colony-forming potential and lactate/glucose ratio in complete medium, but suppressed the secretion of BMP-2 (bone morphogenetic protein-2) and bFGF (basic fibroblast growth factor), while it did not change the quantity of VEGF (vascular endothelial growth factor) and bFGF in serum deprivation. Although PDB-MSCs grew slowly and seldom formed a colony unit in hypoxia and serum deprivation, they possessed a moderate metabolism. In conclusion, our results indicate that PDB-MSCs appear to be promising seed cells for ischaemia-related tissue engineering.

Repair of infarcted myocardium using mesenchymal stem cell seeded small intestinal submucosa in rabbits.

Myocardial infarction (MI) remains a common and deadly disease. Using tissue-engineered cardiac grafts to repair infarcted myocrdium is considered to be a therapeutic approach. This study tested the feasibility of using MSCs-seeded SIS to repair chronic myocardial infarction in a rabbit model. MI in rabbits was created by ligation of the left anterior descending artery. BrdU-labeled mesenchymal stem cells (MSCs) were seeded on the small intestinal submucosa and cultured for 5-7 days prior to implantation. Four weeks after myocardial infarction, cardiac grafts were implanted onto the epicardial surface of infarcted myocardium. Four weeks after implantation of the membranes, a serial of tests including echocardiography, hemodynamics, histology and immunohistochemistry were undertaken to evaluate the effect of the implanted grafts on recovery of the infarcted myocardium. It was shown that left ventricular contractile function and dimension, the capillary density of the infarcted region, and myocardial pathological changes were significantly improved in rabbits implanted either SIS or MSCs-seeded SIS. But the MSCs-seeded SIS was more effective. Immunofluorescence staining demonstrated the migration of Brdu-labeled MSCs from the membrane into the infarcted area and their differentiation to cardiomyocytes and smooth muscle cells. Taken together, these results suggest that MSCs-seeded SIS can be used to repair chronic myocardial infarction, which enhances myocardial regeneration.