[Detection of clinically significant prostate cancer in lesions of PI-RADS score 3 in different histological zones of the prostate and MRI/TRUS fusion prostate biopsy].

Objective: To investigate the detection rate of clinically significant PCa (CSPCa) in lesions of prostate imaging-reporting and data system (version 2) (PI-RADS v2) score 3 in different histological zones of the prostate, the value range of clinical parameters, and the possibility of improving the detection rate by MRI/TRUS fusion prostate biopsy. METHODS: This retrospective study included 297 patients with prostatic lesions of PI-RADS v2 score 3 undergoing transperineal prostate biopsy in Nanjing Drum Tower Hospital from January to December 2019. We analyzed their clinical data, the detection rate of CSPCa in the four histological zones of the prostate and the value range of the clinical parameters. RESULTS: The detection rates of CSPCa in the peripheral zone, transitional zone, central zone and anterior fibromuscular stroma were 23.8%, 11.2%, 40.0% and 50.0%, respectively. In comparison with conventional biopsy, additional MRI/TRUS image fusion biopsy improved the detection rate of CSPCa in the four zones, though with no statistically significant difference. The patients with CSPCa, compared with those in the non-CSPCa group, showed a lower value of free PSA/total PSA (fPSA/tPSA) (0.12 ± 0.05 vs 0.18 ± 0.07) but a higher tPSA level (ï¼»13.06 ± 10.07ï¼½ vs ï¼»8.61 ± 5.86ï¼½ µg/L) and PSA density (PSAD) (ï¼»0.35 ± 0.34ï¼½ vs ï¼»0.16 ± 0.11ï¼½ µg/L2). CONCLUSIONS: In prostate lesions of PI-RADS v2 score 3, the detection rate of CSPCa was higher in the peripheral zone, even higher in the central zone and anterior fibromuscular stroma, than in the transitional zone. Prostatic biopsy is strongly recommended for patients with fPSA/tPSA < 0.12 or PSAD > 0.35 µg/L2, and additional MRI/TRUS image fusion biopsy is preferable for the lesions in the transitional or central zone.

Some characteristics and purification of anti-(human ovarian carcinoma)xanti-(human CD3) single-chain bispecific antibody.

To obtain high-quality AhOC x AhCD3 [anti-(human ovarian carcinoma)xanti-(human CD3)] with high biological activity economically and easily, some characteristics and purification of AhOC x AhCD3, a single chain bispecific antibody, were investigated. During the present study, some important properties of AhOC x AhCD3, such as molecular mass, pI, solubility, stability, hydrophobic ability, molecular status and bioactivity were primarily studied. The molecular mass of AhOC x AhCD3 was determined to be approx. 58.0 kDa by SDS/PAGE (theoretical molecular mass: 56972.5 Da, calculated on the basis of the primary structure) and the pI was approx. 7.5+/-0.4 by IEF (isoelectric focusing; theoretical pI: 8.5, predicted by the ProtParam software tool) respectively. Experiments showed that the solubility of AhOC x AhCD3 increased with the pH increase and that the AhOC x AhCD3 was easily degraded into several fragments during the storage time of samples and the mixtures of both fragment B and fragment C retained normal bioactivity. Particularly, the soluble aggregate/polymer status of AhOC x AhCD3 with bioactivity was verified by non-reducing SDS/PAGE. After optimization of purification process, AhOC x AhCD3 with electrophoretic homogeneity was successfully obtained and the yield was approx. 20%. Some important properties of AhOC x AhCD3 were first observed and a procedure for soluble AhOC x AhCD3 purification in scale-up was first established. Some characteristics of AhOC x AhCD3, especially the stability of AhOC x AhCD3, are critical for the development of this protein pharmaceutical and useful for reference to other proteins.

Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for video-assisted thoracoscopic lobectomy.

BACKGROUND: It is controversial as to which ventilation mode is better during one-lung ventilation (OLV). This study was designed to figure out whether there was any difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on oxygenation and postoperative complications under the condition of protective ventilation (PV). METHODS: Sixty-five patients undergoing video-assisted thoracoscopic lobectomy were randomized into two groups. Patients in group V received VCV mode during OLV while patients in group P received PCV. The tidal volume (VT) in both groups was 6 mL per predicted body weight (PBW). Positive end-expiratory pressure (PEEP) was set at the level of 5 cmH2O in both groups. Arterial gas analysis were performed preoperatively with room air (T0), at 15 mins (T1) and 1 h (T2) after OLV, at the end of OLV (T3), 30 min after PACU admission (T4), 24 h after surgery (post-operative day 1, POD1) and 48 h after surgery (post-operative day 2, POD2). Peak inspiratory airway pressure (Ppeak) and plateau airway pressure (Pplat) were recorded at T1, T2 and T3. The perioperative complications were also recorded. RESULT: Sixty-four patients completed this study. Ppeak in group V was significantly higher than that in group P (T1 22.3±2.9 vs. 18.7±2.1 cmH2O; T2 22.2±2.8 vs. 18.7±2.6 cmH2O). There were no differences with Pplat and intraoperative oxygenation index (T1 203.3±109.7 vs. 198.1±93.4; T2 216.8±79.1 vs. 232.1±101.4). The postoperative oxygenation index (T4 525.0±160.9 vs. 520.7±127.1, post-operative day 1 (POD1) 452.1±161.3 vs. 446.1±109.1; post-operative day 2 (POD2) 403.8±93.4 vs. 396.7±92.8) and postoperative complications were also comparable between these two groups. CONCLUSIONS: When they were utilized during OLV, PCV and VCV had the same performance on the intraoperative oxygenation and postoperative complications under the condition of PV.