urea

尿素
  • 文章类型: Journal Article
    梗阻性肥厚型心肌病治疗进展的一个关键领域是围绕心肌肌球蛋白抑制剂的出现,其中mavacanten和aficanten代表第一和第二分子。我们总结了关键的研究证据,包括研究这些分子的各种临床试验之间的许多相似性和潜在差异。
    A key area of therapeutic progress in obstructive hypertrophic cardiomyopathy revolves around the emergence of cardiac myosin inhibitors, of which mavacamten and aficamten represent the first and second molecules. We summarize the key research evidence, including many similarities and potential differences between various clinical trials studying these molecules.
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  • 文章类型: Journal Article
    抑制可溶性环氧化物水解酶(sEH)可以降低二羟基二十碳三烯酸(DHET)的水平,有效维持内源性环氧二十碳三烯酸(EET)的水平,导致炎症和疼痛的改善。因此,20多年来,sEH抑制剂的开发一直是一个突出的研究领域。在本研究中,我们合成并评估了磺酰脲衍生物抑制sEH的潜力。这些化合物进行了广泛的体外研究,揭示了它们对人类和小鼠的功效,4f显示最有希望的sEH抑制潜力。当受到脂多糖(LPS)诱导的急性肺损伤(ALI)在小鼠的研究中,化合物4f表现出有希望的抗炎功效。我们研究了sEH抑制剂4f在甩尾反射的小鼠疼痛模型中的镇痛效果。这些结果验证了sEH抑制在炎性疾病中的作用,并为基于磺酰脲模板的sEH抑制剂的合理设计和优化铺平道路。
    The inhibition of soluble epoxide hydrolase (sEH) can reduce the level of dihydroxyeicosatrienoic acids (DHETs) effectively maintaining endogenous epoxyeicosatrienoic acids (EETs) levels, resulting in the amelioration of inflammation and pain. Consequently, the development of sEH inhibitors has been a prominent research area for over two decades. In the present study, we synthesized and evaluated sulfonyl urea derivatives for their potential to inhibit sEH. These compounds underwent extensive in vitro investigation, revealing their potency against human and mouse sEH, with 4f showing the most promising sEH inhibitory potential. When subjected to lipopolysaccharide (LPS)-induced acute lung injury (ALI) in studies in mice, compound 4f manifested promising anti-inflammatory efficacy. We investigated the analgesic efficacy of sEH inhibitor 4f in a murine pain model of tail-flick reflex. These results validate the role of sEH inhibition in inflammatory diseases and pave the way for the rational design and optimization of sEH inhibitors based on a sulfonyl urea template.
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  • 文章类型: Journal Article
    这项研究探索了一系列PZM21类似物用于疼痛治疗的潜力。具体来说,PZM21的羟苯环被萘环取代,噻吩环被苯环或呋喃环取代,并且保留了必需的二甲胺和脲基团。这些化合物旨在提高安全性并最小化与阿片类药物相关的副作用。研究结果表明,化合物6a在低纳摩尔浓度下不诱导β-抑制蛋白募集,但在已建立的小鼠模型中表现出明显的镇痛作用。和吗啡相比,图6a示出了在减轻呼吸抑制和最小化物理依赖性方面的优点。分子对接研究强调了D147氨基酸残基在6a镇痛机制中的关键作用。因此,6a是开发更安全的阿片类镇痛药的令人信服的候选药物,值得进一步关注。
    This study explored the potential of a series of PZM21 analogues for pain treatment. Specifically, the hydroxyphenyl ring of PZM21 was replaced with a naphthyl ring, the thienyl ring was substituted with either a phenyl ring or furan rings, and the essential dimethylamine and urea groups were retained. These compounds aimed to enhance safety and minimize the adverse effects associated with opioid drugs. The research findings suggest that compound 6a does not induce β-arrestin recruitment at low-nanomolar concentrations but exhibits significant analgesic effects in established mouse models. Compared to morphine, 6a shows advantages in alleviating respiratory depression and minimizing physical dependence. Molecular docking studies underscore the pivotal role of the D147 amino acid residue in the analgesic mechanism of 6a. Consequently, 6a is a compelling candidate for the development of safer opioid analgesics and warrants further attention.
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  • 文章类型: Journal Article
    目的:探讨重症监护病房(ICU)入院后7d内床旁超声检查脓毒症患者膈肌和肢体骨骼肌的动态变化及其与血尿素/肌酐比值(UCR)的相关性。
    方法:进行前瞻性观察性研究。选取2022年6月至2023年2月宁夏医科大学总医院ICU收治的55例脓毒症患者作为研究对象。一般信息,实验室指标[尿素,血清肌酐(SCr),和UCR]在ICU入院的第1、4和7天,并观察预后指标。床旁超声用于评估膈肌形态的动态变化[包括膈肌偏移(DE),吸气末隔膜厚度(DTei),和呼气末隔膜厚度(DTee)]在ICU入院的第1、4和7天,以及肢体骨骼肌(股四头肌)形态[包括股直肌层厚度(RF-MLT),中间肌-肌层厚度(VI-MLT),和股直肌横截面积(RF-CSA)]。计算膈肌增厚分数(DTF)和RF-CSA萎缩率,记录膈肌和肢体骨骼肌功能障碍的发生率。采用Pearson相关性分析ICU入住后7天各时间点膈肌、股四头肌超声形态学参数与UCR的相关性。
    结果:共纳入55例脓毒症患者,其中29例发生感染性休克。随着ICU住院时间的增加,脓毒症患者膈肌功能障碍的发生率先升高后降低(63.6%,69.6%,入住ICU的第1天、第4天和第7天的58.6%,分别),而肢体骨骼肌功能障碍的发生率呈上升趋势(入住ICU第4天和第7天分别为54.3%和62.1%,分别),在入住ICU的第4天和第7天同时发生的概率分别为32.6%和34.5%,分别。入住ICU第7天的UCR明显高于第1天[121.77(95.46,164.55)vs.97.00(70.26,130.50)],第7天的RF-CSA萎缩率明显高于第4天[%:-39.7(-52.4,-22.1)vs.-26.5(-40.2,-16.4)]。与第1天相比,第7天的RF-CSA显着降低[cm2:1.3(1.0,2.5)与2.1(1.7,2.9)],差异均有统计学意义(均P<0.05)。Pearson相关分析显示,ICU入住第7天的RF-CSA与当天的UCR呈负相关(r=-0.407,P=0.029)。
    结论:脓毒症患者膈肌功能障碍发生早,可得到改善。四肢骨骼肌功能障碍发生得相对较晚,进展缓慢。ICU入院第7天的RF-CSA可能是脓毒症患者肢体骨骼肌功能障碍的可靠指标。可作为ICU获得性肌无力(ICU-AW)早期识别和诊断的指标。脓毒症患者肌肉质量的持续丢失主要与持续的机体分解代谢有关,并在ICU中一周左右发生重大变化。
    OBJECTIVE: To investigate the dynamic changes of diaphragm and limb skeletal muscle in patients with sepsis by bedside ultrasound and their correlation with the ratio of blood urea/creatinine ratio (UCR) in 7 days after intensive care unit (ICU) admission.
    METHODS: A prospective observational study was conducted. A total of 55 patients with sepsis admitted to ICU of General Hospital of Ningxia Medical University from June 2022 to February 2023 were selected as the research objects. General information, laboratory indicators [urea, serum creatinine (SCr), and UCR] on days 1, 4, and 7 of ICU admission, and prognostic indicators were observed. Bedside ultrasound was used to assess the dynamic changes of diaphragm morphology [including diaphragmatic excursion (DE), end-inspiratory diaphragm thickness (DTei), and end-expiratory diaphragm thickness (DTee)] on days 1, 4, and 7 of ICU admission, as well as limb skeletal muscle (quadriceps femoris) morphology [including rectus femoris-muscle layer thickness (RF-MLT), vastus intermedius-muscle layer thickness (VI-MLT), and rectus femoris-cross sectional area (RF-CSA)]. Diaphragm thickening fraction (DTF) and RF-CSA atrophy rate were calculated, and the incidence of diaphragm and limb skeletal muscle dysfunction was recorded. The correlation between ultrasound morphological parameters of diaphragm and quadriceps and UCR at each time points in 7 days after ICU admission was analyzed by Pearson correlation.
    RESULTS: A total of 55 patients with sepsis were included, of which 29 were in septic shock. As the duration of ICU admission increased, the incidence of diaphragm dysfunction in patients with sepsis increased first and then decreased (63.6%, 69.6%, and 58.6% on days 1, 4, and 7 of ICU admission, respectively), while the incidence of limb skeletal muscle dysfunction showed an increasing trend (54.3% and 62.1% on days 4 and 7 of ICU admission, respectively), with a probability of simultaneous occurrence on days 4 and 7 of ICU admission were 32.6% and 34.5%, respectively. The UCR on day 7 of ICU admission was significantly higher than that on day 1 [121.77 (95.46, 164.55) vs. 97.00 (70.26, 130.50)], and RF-CSA atrophy rate on day 7 was significantly higher than that on day 4 [%: -39.7 (-52.4, -22.1) vs. -26.5 (-40.2, -16.4)]. RF-CSA was significantly lower on day 7 compared to day 1 [cm2: 1.3 (1.0, 2.5) vs. 2.1 (1.7, 2.9)], with all differences being statistically significant (all P < 0.05). Pearson correlation analysis showed that RF-CSA on day 7 of ICU admission was negatively associated with the UCR on the same day (r = -0.407, P = 0.029).
    CONCLUSIONS: Diaphragmatic dysfunction in patients with sepsis occurred early and can be improved. Limb skeletal muscle dysfunction occurred relatively later and progresses progressively. The RF-CSA on day 7 of ICU admission may be a reliable measure of limb skeletal muscle dysfunction in patients with sepsis, can be an indicator of early identification and diagnosis of ICU-acquired weakness (ICU-AW). Continuous loss of muscle mass occurring in septic patients is mainly associated with persistent organismal catabolism, and undergoes significant changes around a week in ICU.
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  • 文章类型: Journal Article
    近年来,氢作为替代化石燃料的潜在解决方案已经引起了人们的关注,从而减少温室气体排放。由于担心这种气体泄漏和潜在爆炸的固有风险,不断改进的氢传感器的开发是一个不断研究的主题。在这项工作中,一个新的,长期的,开发了稳定的基于磷烯的氢检测传感器。使用尿素对磷烯进行简单的官能化,以合成空气稳定的材料,随后用于制备气体传感应用的薄膜,通过滴注法。该材料通过不同的技术进行了深入的表征(扫描电子显微镜,X射线衍射,X射线光电子,和拉曼光谱),并评价了材料在非惰性气氛中的稳定性。基于磷烯的传感器在室温下表现出高灵敏度(高达700ppm)和对氢的选择性,以及在环境条件下五个月的长期稳定性。为了进一步了解表面上的气体传感机制,我们用了一个专用的仪器,即operando漫反射红外傅里叶变换,通过在干燥空气条件下将化学电阻传感器暴露于氢气。
    In recent years, hydrogen has gained attention as a potential solution to replace fossil fuels, thus reducing greenhouse gas emissions. The development of ever improving hydrogen sensors is a topic that is constantly under study due to concerns about the inherent risk of leaks of this gas and potential explosions. In this work, a new, long-term, stable phosphorene-based sensor was developed for hydrogen detection. A simple functionalization of phosphorene using urea was employed to synthesize an air-stable material, subsequently used to prepare films for gas sensing applications, via the drop casting method. The material was deeply characterized by different techniques (scanning electron microscopy, X-ray diffraction, X-ray photoelectron, and Raman spectroscopy), and the stability of the material in a noninert atmosphere was evaluated. The phosphorene-based sensor exhibited high sensitivity (up to 700 ppm) and selectivity toward hydrogen at room temperature, as well as long-term stability over five months under ambient conditions. To gain further insight into the gas sensing mechanism over the surface, we employed a dedicated apparatus, namely operando diffuse reflectance infrared Fourier transform, by exposing the chemoresistive sensor to hydrogen gas under dry air conditions.
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  • 文章类型: Journal Article
    在大肠杆菌中,二糖海藻糖可以作为碳源代谢或在渗透胁迫下作为渗透保护剂积累。在高渗环境中,大肠杆菌通过由胞质酶OtsA和OtsB介导的葡萄糖合成在细胞中积累海藻糖。周质海藻糖酶TreA可以将周质中的海藻糖水解为葡萄糖。我们先前已经表明,肠外大肠杆菌菌株BEN2908的treA突变体显示出0.6M尿素对渗透胁迫的抗性增加,减少了1型菌毛的产量,减少禽成纤维细胞的侵袭,在小鼠尿路感染模型中膀胱定植减少。由于TreA的丢失可能导致更高的周质海藻糖浓度,我们想知道是否缺失了otsA和otsB基因,这将导致内部海藻糖浓度降低,会降低0.6M尿素对胁迫的抵抗力,并促进1型菌毛的产生。BEN2908ΔotsBA突变体对尿素的渗透胁迫敏感,但是显示出1型菌毛的产量更明显的减少,从而减少禽类成纤维细胞的粘附/侵袭,并减少小鼠泌尿道中的膀胱定植。BEN2908ΔtreAotsBA突变体还显示出1型菌毛的产量减少,但是与ΔotsBA突变体相反,在尿素存在下的抗性比野生型更好。我们假设,在BEN2908中,尿素对应激的抗性将取决于周质海藻糖的水平,但是1型菌毛的产生会受到胞浆海藻糖水平的影响。
    In Escherichia coli, the disaccharide trehalose can be metabolized as a carbon source or be accumulated as an osmoprotectant under osmotic stress. In hypertonic environments, E. coli accumulates trehalose in the cell by synthesis from glucose mediated by the cytosolic enzymes OtsA and OtsB. Trehalose in the periplasm can be hydrolyzed into glucose by the periplasmic trehalase TreA. We have previously shown that a treA mutant of extraintestinal E. coli strain BEN2908 displayed increased resistance to osmotic stress by 0.6 M urea, and reduced production of type 1 fimbriae, reduced invasion of avian fibroblasts, and decreased bladder colonization in a murine model of urinary tract infection. Since loss of TreA likely results in higher periplasmic trehalose concentrations, we wondered if deletion of otsA and otsB genes, which would lead to decreased internal trehalose concentrations, would reduce resistance to stress by 0.6 M urea and promote type 1 fimbriae production. The BEN2908ΔotsBA mutant was sensitive to osmotic stress by urea, but displayed an even more pronounced reduction in production of type 1 fimbriae, with the consequent reduction in adhesion/invasion of avian fibroblasts and reduced bladder colonization in the murine urinary tract. The BEN2908ΔtreAotsBA mutant also showed a reduction in production of type 1 fimbriae, but in contrast to the ΔotsBA mutant, resisted better than the wild type in the presence of urea. We hypothesize that, in BEN2908, resistance to stress by urea would depend on the levels of periplasmic trehalose, but type 1 fimbriae production would be influenced by the levels of cytosolic trehalose.
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  • 文章类型: Journal Article
    UNASSIGNED: The prognostic performance of urea-to-albumin ratio (UAR) has been assessed in various pulmonary and nonpulmonary conditions, but never in thoracic empyema. Therefore, our aim was to determine whether this marker has the ability to predict outcome in such patients.
    UNASSIGNED: A single-center retrospective study was conducted in a Clinic of Thoracic Surgery at a University Hospital between January 2021 and October 2023. A total of 84 patients who underwent emergency surgery due to thoracic empyema were involved. Serum levels of urea and albumin at admission were used to calculate UAR. We analyzed area under receiver operating characteristics (AUROC) curves of UAR, systemic inflammatory response syndrome (SIRS) and quick-sequential organ failure assessment (qSOFA), and compared their prognostic performance.
    UNASSIGNED: The identified in-hospital mortality was 10.7%. The UAR showed the best ability to prognosticate mortality compared to qSOFA (AUROC = 0.828 vs 0.747) and SIRS (AUROC = 0.828 vs 0.676). We established a sensitivity of 87.5% and specificity of 74.2% at optimal cut-off value UAR > 51.1 for prediction of adverse outcome.
    UNASSIGNED: In patients with thoracic empyema urea-to-albumin ratio showed significant prognostic performance and a potential for clinical application as a low cost and widely available predictor of death.
    UNASSIGNED: Karbamido ir albumino santykio (UAR) prognozė buvo vertinama įvairių plaučių ir ne plaučių ligų atveju, tačiau niekada nebuvo vertinta esant krūtinės ląstos empiemai. Todėl mūsų tikslas buvo nustatyti, ar šis žymuo gali prognozuoti tokių pacientų ligos baigtį.
    UNASSIGNED: Nuo 2021 m. sausio mėn. iki 2023 m. spalio mėn.Vilniaus universiteto ligoninės Krūtinės chirurgijos klinikoje buvo atliktas vieno centro prospektyvusis tyrimas. Iš viso tyrime dalyvavo 84 pacientai, kuriems buvo atlikta skubi operacija dėl krūtinės ląstos empiemos. UAR apskaičiuoti buvo naudojamas karbamido ir albumino kiekis kraujo serume, buvęs priėmimo į centrą metu. Analizavome UAR, sisteminio uždegiminio atsako sindromo (SIRS) ir greito organų nepakankamumo vertinimo (qSOFA) ploto pagal imtuvo operacines charakteristikas (AUROC) kreives ir palyginome jų prognostinius rodiklius.
    UNASSIGNED: Nustatytas hospitalinis mirtingumas buvo 10,7 %. UAR parodė geriausią mirtingumo prognozavimo gebėjimą, palyginti su qSOFA (AUROC = 0,828 vs. 0,747) ir SIRS (AUROC = 0,828 vs. 0,676). Nustatėme 87,5 % jautrumą ir 74,2 % specifiškumą, esant optimaliai ribinei vertei UAR > 51,1 nepalankiai baigčiai prognozuoti.
    UNASSIGNED: Krūtinės ląstos empiema sergantiems pacientams urėjos ir albumino santykis pasižymėjo reikšmingu prognostiniu efektyvumu ir klinikinio pritaikymo galimybėmis kaip pigus ir plačiai prieinamas ligos baigties prognozavimo rodiklis.
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  • 文章类型: Journal Article
    用于施肥和饲料补充的尿素,以及制造塑料和药物的原材料。尿素最通常通过使二氧化碳与氨在高温下反应来生产。光催化作为进行尿素的可持续途径已经受到关注。这项工作的重点是设计基于铈有机骨架(Ce-BTC)掺杂有金属氧化物纳米颗粒(高锰酸钼,Mo(MnO4)5)用于通过氨与二氧化碳的偶联生产尿素。使用不同的光谱分析对制备的材料进行表征,并使用微观数据分析形态。研究了催化剂负载量对尿素生产率的影响,得到的结果表明,在低温下尿素生产速度快,产率高。可回收性测试证实了所制备的光固化剂(Mo(MnO4)5@Ce-BTC)的可持续性,这支持了尿素生产中光催化过程的益处。
    Urea used in fertilization and feed supplement, as well as a starting material for the manufacture of plastics and drugs. Urea is most commonly produced by reacting carbon dioxide with ammonia at high temperature. Photocatalysis has gained attention as a sustainable pathway for performing urea. This work focus on designing very active photocatalysts based on cerium organic framework (Ce-BTC) doped with metal oxide nanoparticles (molybdenum permanganate, Mo(MnO4)5) for production of urea from coupling of ammonia with carbon dioxide. The prepared materials were characterized using different spectral analysis and the morphology was analysed using microscopic data. The effect of catalyst loading on the production rate of urea was investigated and the obtained results showed speed rate of urea production with high production yield at low temperature. The recyclability tests confirmed the sustainability of the prepared photocatlysts (Mo(MnO4)5@Ce-BTC) which supported the beneficial of the photocatalysis process in urea production.
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  • 文章类型: Journal Article
    目的:本研究评估了15%和20%过氧化脲(CP)对颜色的影响,表面粗糙度,计算机辅助设计/计算机辅助制造(CAD/CAM)牙科陶瓷的硬度。
    方法:这项体外研究是在120VitaMarkII上进行的,CeltraDuo,和SuprinityCAD/CAM陶瓷试样。每组(n=40)的陶瓷试样被随机分配到两个亚组(n=20)进行抛光和上釉,和它们的基线颜色,表面粗糙度(Ra),和硬度进行了评估。在每个子组中,一半的标本暴露于15%的CP,而另一半暴露于20%CP。它们的颜色变化(ΔE),表面粗糙度,然后再次测量硬度。表面粗糙度,硬度,用轮廓仪依次分析颜色,维氏硬度计,和分光光度计,分别。数据通过重复测量方差分析,单向方差分析,和事后Bonferroni检验(α=0.05)。
    结果:漂白处理后,所有组的表面粗糙度均显着增加(p<0.05)。漂白处理后各组表面硬度均有所下降,但这种减少仅在VitaMarkII亚组中显著(釉面,打磨,15%,和20%CP)。在任何组中,ΔE均无法在临床和视觉上感知。
    结论:目前的结果表明,CP的浓度和表面处理类型会影响CAD/CAM陶瓷的表面性能。表面处理类型仅影响VitaMarkII陶瓷的表面硬度(p<0.05)。CP的浓度仅对抛光的VitaMarkII有显著影响。
    OBJECTIVE: This study assessed the effects of 15% and 20% carbamide peroxide (CP) on color, surface roughness, and hardness of computer-aided design/computer-aided manufacturing (CAD/CAM) dental ceramics.
    METHODS: This in vitro study was conducted on 120 Vita Mark II, Celtra Duo, and Suprinity CAD/CAM ceramic specimens. The ceramic specimens in each group (n = 40) were randomly assigned to two subgroups (n = 20) for polishing and glazing, and their baseline color, surface roughness (Ra), and hardness were assessed. In each subgroup, half of the specimens were exposed to 15% CP, while the other half were exposed to 20% CP. Their color change (ΔE), surface roughness, and hardness were then measured again. Surface roughness, hardness, and color were analyzed sequentially by profilometer, Vickers hardness tester, and spectrophotometer, respectively. Data were analyzed by repeated measures ANOVA, one-way ANOVA, and post hoc Bonferroni test (α = 0.05).
    RESULTS: The surface roughness of all groups significantly increased after bleaching treatment (p < 0.05). Surface hardness of all groups decreased after bleaching treatment, but this reduction was only significant in Vita Mark II subgroups (glazed, polished, 15%, and 20% CP). The ΔE was not clinically and visually perceivable in any group.
    CONCLUSIONS: The present results revealed that concentration of CP and type of surface treatment affected the surface properties of CAD/CAM ceramics. Type of surface treatment only affected the surface hardness of Vita Mark II ceramics (p < 0.05). Concentration of CP had a significant effect only on polished Vita Mark II.
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  • 文章类型: Journal Article
    对于在磁共振成像(MRI)检查中出现前列腺成像报告和数据系统(PI-RADS)3/4发现的患者,标准建议通常包括进行活检以进行病理评估,以确定病变的性质。这一行动方针,尽管对于准确诊断至关重要,总是会放大患者所经历的心理困扰,并引入许多与活检程序相关的潜在并发症。然而,[18F]DCFPyLPET/CT成像成为一种有前途的替代方案,在辨别良性前列腺病变和恶性前列腺病变方面表现出相当大的诊断功效。本研究旨在探讨[18F]DCFPyLPET/CT显像对前列腺癌患者PI-RADS3/4病灶的诊断价值,协助临床决策,以避免不必要的活检。30例通过mpMRI诊断为PI-RADS3/4病变的患者接受[18F]DCFPyLPET/CT成像,以最终活检病理结果作为“参考标准”。通过受试者工作特性(ROC)分析评估诊断性能,在[18F]DCFPyLPET/CT成像中评估分子影像学PSMA(miPSMA)视觉分析和半定量分析的诊断效能。根据前列腺癌分子影像学标准化评估标准对病变进行miPSMA评分。在30名患者中,13例经病理证实为前列腺癌。敏感性,特异性,正预测值,负预测值,视觉分析[18F]DCFPyLPET/CT显像诊断PI-RADS3/4病灶的准确率为61.5%,88.2%,80.0%,75.0%,76.5%,分别。使用SUVmax4.17作为最佳阈值,灵敏度,特异性,正预测值,负预测值,诊断准确率为92.3%,88.2%,85.7%,93.8%,90.0%,分别。半定量分析的ROC曲线下面积(AUC)为0.94,明显高于视觉分析的0.80。[18F]DCFPyLPET/CT显像在15例(50%)PI-RADS3/4患者中准确诊断良性病变。对于PI-RADS4病变的患者,[18F]DCFPyLPET/CT显像的阳性预测值达到100%。[18F]DCFPyLPET/CT成像提供了对mpMRIPI-RADS3/4患者的病变性质的潜在术前预测,这可能有助于治疗决策和减少不必要的活检。
    For patients presenting with prostate imaging reporting and data system (PI-RADS) 3/4 findings on magnetic resonance imaging (MRI) examinations, the standard recommendation typically involves undergoing a biopsy for pathological assessment to ascertain the nature of the lesion. This course of action, though essential for accurate diagnosis, invariably amplifies the psychological distress experienced by patients and introduces a host of potential complications associated with the biopsy procedure. However, [18F]DCFPyL PET/CT imaging emerges as a promising alternative, demonstrating considerable diagnostic efficacy in discerning benign prostate lesions from malignant ones. This study aims to explore the diagnostic value of [18F]DCFPyL PET/CT imaging for prostate cancer in patients with PI-RADS 3/4 lesions, assisting in clinical decision-making to avoid unnecessary biopsies. 30 patients diagnosed with PI-RADS 3/4 lesions through mpMRI underwent [18F]DCFPyL PET/CT imaging, with final biopsy pathology results as the \"reference standard\". Diagnostic performance was assessed through receiver operating characteristic (ROC) analysis, evaluating the diagnostic efficacy of molecular imaging PSMA (miPSMA) visual analysis and semi-quantitative analysis in [18F]DCFPyL PET/CT imaging. Lesions were assigned miPSMA scores according to the prostate cancer molecular imaging standardized evaluation criteria. Among the 30 patients, 13 were pathologically confirmed to have prostate cancer. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of visual analysis in [18F]DCFPyL PET/CT imaging for diagnosing PI-RADS 3/4 lesions were 61.5%, 88.2%, 80.0%, 75.0%, and 76.5%, respectively. Using SUVmax 4.17 as the optimal threshold, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosis were 92.3%, 88.2%, 85.7%, 93.8%, and 90.0%, respectively. The area under the ROC curve (AUC) for semi-quantitative analysis was 0.94, significantly higher than visual analysis at 0.80. [18F]DCFPyL PET/CT imaging accurately diagnosed benign lesions in 15 (50%) of the PI-RADS 3/4 patients. For patients with PI-RADS 4 lesions, the positive predictive value of [18F]DCFPyL PET/CT imaging reached 100%. [18F]DCFPyL PET/CT imaging provides potential preoperative prediction of lesion nature in mpMRI PI-RADS 3/4 patients, which may aid in treatment decision-making and reducing unnecessary biopsies.
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