Objectives: Neoadjuvant chemotherapy (NAC) is an important method for breast cancer treatment. By monitoring its pathological response, the selection of clinical treatment strategies can be guided. In this study, the meta-analysis was used to compare the accuracy of contrast-enhanced MRI (CE-MRI) and contrast-enhanced spectral mammography (CESM) in detecting the pathological response of NAC. Methods: Literatures associated to CE-MRI and CESM in the evaluation of pathological response of NAC were searched from PubMed, Cochrane Library, web of science, and EMBASE databases. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the quality of studies. Pooled sensitivity, specificity, and the area under the SROC curve were calculated to evaluate the diagnostic accuracy of CE-MRI and CESM in monitoring the pathological response of NAC. Results: There were 24 studies involved, 18 of which only underwent CE-MRI examination, three of which only underwent CESM examination, and three of which underwent both CE-MRI and CESM examination. The pooled sensitivity and specificity of CE-MRI were 0.77 (95%CI, 0.67–0.84) and 0.82 (95%CI, 0.73–0.89), respectively. The pooled sensitivity and specificity of CESM were 0.83 (95%CI, 0.66–0.93) and 0.82 (95%CI, 0.68–0.91), respectively. The AUCs of SROC curve for CE-MRI and CESM were 0.86 and 0.89, respectively. Conclusions: Compared to CE-MRI, CESM has equal specificity, greater sensitivity and excellent performance, which may have a brighter prospect in evaluating the pathological response of breast cancer to NAC. Advances in knowledge: CESM showed equal specificity, greater sensitivity, and excellent performance than CE-MRI.

Polysaccharide is widely distributed in natural resources, and currently attracts scientists' attention for their various bio‐functions including immunomodulatory activity, hypoglycemic activity, hypolipidemic activity, antitumor activity, promoting effects on gastrointestinal function, and so on. The purity and structure characteristics of different polysaccharides greatly restrict the in‐depth study of their bioactivity mechanism. Therefore, this guideline will display the extraction, isolation, purification, and structural characterization of polysaccharides from natural resources. The extraction methods of acid‐soluble polysaccharides, water‐soluble polysaccharides, and alkaline soluble polysaccharides are included. Common purification methods like membrane filtration, alcohol precipitation, and column chromatographic separation are explained in detail. A comprehensive procedure for polysaccharide structural characterization is given from molecular weight and monosaccharide composition study to Fourier transform infrared and nuclear magnetic resonance analysis. Examples are added where necessary to help you better understand this guideline.

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Kidney injury molecule-1 (KIM-1) has an important role in chronic kidney disease development. The present study aimed to retrospectively analyze patients with idiopathic membranous nephrology (IMN) with different therapeutic outcomes to investigate the association between KIM-1 levels and therapeutic outcomes. A total of 51 patients with IMN and 20 healthy controls were included. Patients were classified into three groups: Spontaneous remission, remission with immunosuppressive therapy (IST) and nonremission with IST. Clinical and biochemical variables were collected. Urinary KIM-1 levels were measured by ELISA and renal KIM-1 expression was evaluated by immunohistochemistry. Patients with IMN were characterized as having elevated urinary and renal KIM-1 levels compared with those in the controls. Significantly increased urinary and renal KIM-1 levels were observed in the nonremission with IST group compared with those in the spontaneous remission group, and the same trend was observed for the plasma anti-podocyte antigen phospholipase A2 receptor antibody levels. Patients with more severe tubular injury (T2 index) presented with significantly higher urinary and renal KIM-1 levels than those with the T0 index. Urinary and renal KIM-1 levels were positively correlated with blood urea nitrogen, serum creatinine, serum cystatin-C, urinary albumin/creatinine ratio, urinary β2-microglobulin and the renal interstitial fibrosis index, and they were negatively correlated with serum albumin. Furthermore, urinary KIM-1 levels were positively correlated with the renal KIM-1 levels. In conclusion, the measurement of urinary and renal KIM-1 levels may be helpful in guiding medication selection and predicting therapeutic outcomes for patients with IMN.

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