ENPROSTIL AND RANITIDINE: COMPARATIVE EFFICACY AND SAFETY IN PATIENTS WITH DUODENAL ULCER

Abstract This randomised, double-blind, double-dummy, multiclinic study of duodenal ulcer healing compared the efficacy and safety of enprostil with ranitidine. The six week trial admitted 164 patients with endoscopically demonstrated duodenal ulcer. Ratings of symptoms and adverse events were collated from patients' daily diaries, and endoscopy was repeated to verify healing after four weeks and, if appropriate, after six weeks. Medication used was enprostil (35 μg capsule) or ranitidine hydrochloride (150 mg tablet) with matching placebos twice daily. After six weeks, 81 % of patients treated with enprostil and 95% of those treated with ranitidine had healed ulcers, a statistically significant difference (p = 0.007). There were no differences between treatment groups for the number of days until the daytime ulcer pain completely ceased. Night-time ulcer pain ceased significantly earlier in the group receiving ranitidine (p = 0.019) and was less severe during the week before the last visit (p = 0.001); daytime pain for ranitidine users was also less severe (p = 0.020) during this week. Mild to moderate adverse experiences were reported by 44% of enprostil and 35% of ranitidine patients. There were no severe adverse events. In conclusion, both enprostil and ranitidine were found to be safe and effective in the treatment of duodenal ulcer. However, the ranitidine regimen used in this trial produced better results than the enprostil regimen.     

Synthetic cathinones: an evolving class of new psychoactive substances

Abstract

Synthetic cathinones (SCat) are amphetamine-like psychostimulants that emerged onto drug markets as “legal” alternatives to illicit drugs such as ecstasy, cocaine, and amphetamines. Usually they are sold as “bath salts,” “plant food,” or “research chemicals,” and rapidly gained popularity amongst drugs users due to their potency, low cost, and availability. In addition, internet drug sales have been replacing the old way of supplying drugs of abuse, contributing to their rapid spread. Despite the legislative efforts to control SCat, new derivatives continue to emerge on the recreational drugs market and their abuse still represents a serious public health issue. To date, about 150 SCat have been identified on the clandestine drugs market, which are one of the largest groups of new psychoactive substances (NPS) monitored by the United Nations Office on Drugs and Crime and the European Monitoring Center for Drugs and Drug Addiction. Similar to the classical stimulants, SCat affect the levels of catecholamines in the central nervous system, which results in their psychological, behavioral and toxic effects. Generally, the effects of SCat greatly differ from drug to drug and relatively little information is available about their pharmacology. The present work provides a review on the development of SCat as substances of abuse, current patterns of abuse and their legal status, chemical classification, known mechanisms of action, and their toxicological effects.     

Synthetic control of mammalian-cell motility by engineering chemotaxis to an orthogonal bioinert chemical signal

Directed migration of diverse cell types plays a critical role in biological processes ranging from development and morphogenesis to immune response, wound healing, and regeneration. However, techniques to direct, manipulate, and study cell migration in vitro and in vivo in a specific and facile manner are currently limited. We conceived of a strategy to achieve direct control over cell migration to arbitrary user-defined locations, independent of native chemotaxis receptors. Here, we show that genetic modification of cells with an engineered G protein-coupled receptor allows us to redirect their migration to a bioinert drug-like small molecule, clozapine-N-oxide (CNO). The engineered receptor and small-molecule ligand form an orthogonal pair: The receptor does not respond to native ligands, and the inert drug does not bind to native cells. CNO-responsive migration can be engineered into a variety of cell types, including neutrophils, T lymphocytes, keratinocytes, and endothelial cells. The engineered cells migrate up a gradient of the drug CNO and transmigrate through endothelial monolayers. Finally, we demonstrate that T lymphocytes modified with the engineered receptor can specifically migrate in vivo to CNO-releasing beads implanted in a live mouse. This technology provides a generalizable genetic tool to systematically perturb and control cell migration both in vitro and in vivo. In the future, this type of migration control could be a valuable module for engineering therapeutic cellular devices.The ability of many cell types to migrate long distances within the body and specifically localize to target sites of action is critical for their proper function. For example, immune cells rapidly home to sites of infection, concentrating their powerful cytotoxic and proinflammatory activities for maximum efficacy while limiting damage to healthy tissue. In morphogenesis, cells undergo a complex stereotyped process involving migration as well as proliferation, differentiation, and programmed cell death to produce fully developed multicellular structures. In wound healing and regenerative processes, stem and progenitor cells home to injured tissues from nearby sites—as well as from distant locations including the bone marrow—to provide a stream of new cells to replenish and provide trophic support to old and damaged cells.Cell migration is also an important factor to consider in the use of cells as therapeutic agents. The use of cells for the treatment of a growing array of diseases including cancer, autoimmunity, and chronic wounds is currently being explored (1–6). The appropriate and efficient localization of therapeutic cells to sites of disease has been identified as an important factor for successful cell-based therapy (7–17). However, preclinical studies and clinical trials to date have shown that the homing to sites of disease of many cell types commonly used as therapeutics is frequently impaired or limited, especially after ex vivo expansion of cells in culture (7, 12, 18, 19).The ability to redirect the migration of cells to any user-specified location in the body would be a powerful enabling technology for basic research as well as for future applications, but there are currently few easily generalizable strategies to accomplish this goal. We conceived of an approach to direct cellular homing to small molecules by expressing, in motile cells, engineered G protein-coupled receptors (GPCRs) called receptors activated solely by a synthetic ligand (RASSLs) (20, 21).RASSLs are engineered to be unresponsive to endogenous ligands but can be activated by pharmacologically inert orthogonal small molecules (Fig. 1A). Versions of these receptors exist for the three major GPCR signaling pathways (Gαs-, Gαi-, and Gαq-coupled receptors), and the design of a new arrestin-biased variant has recently been reported (21, 22). Because GPCRs control many important physiological functions, including cell migration, we hypothesized that, by expressing these engineered receptors in motile cells, we could develop a general strategy for establishing user control over cell homing (Fig. 1B). Here, we use a family of second-generation RASSLs, known as designer receptors exclusively activated by a designer drug (DREADDs), that are activated only by the small molecule clozapine-N-oxide (CNO), an inert metabolite of the FDA-approved antipsychotic drug clozapine (Fig. S1) (20). CNO is highly bioavailable in rodents and humans, lacks affinity for any known receptors, channels, and transporters, and does not cause any appreciable physiological effects when systemically administered in normal mice (20, 23, 24).Open in a separate windowFig. 1.Engineered Gαi-coupled GPCRs Di3 and Di mediate cytoskeletal changes and chemotaxis of HL-60 neutrophils in response to CNO. (A) RASSLs are engineered GPCRs that interact orthogonally with a bioinert small-molecule drug. Natural ligands do not interact with the engineered receptors, and the bioinert drug that activates the engineered receptors does not interact with native receptors. (B) We tested whether certain second-generation RASSLs known as DREADDs could mediate cell motility. (C) Changes in electrical impedance that result from cell spreading in response to drug or ligand are detected by an electrode array. HL-60 neutrophils transiently transfected to express engineered GPCRs were plated on fibronectin-coated impedance assay plates and stimulated with vehicle control, 100 nM fMLP (positive control chemoattractant) or 100 nM CNO. All cells responded to fMLP whereas only Di3- or Di-expressing cells responded to CNO. Mean ± SEM for n = 3 replicates is shown. (D) Cell migration of HL-60 neutrophils transiently transfected with engineered GPCRs was quantitated in a porous transwell Boyden-chamber assay. All cells migrated in response to fMLP whereas only Di3- or Di-expressing cells migrated in response to CNO. Drug concentrations used: 100 nM CNO, 100 nM fMLP. Mean ± SEM for n = 3 replicates is shown. (E) Polarization and cell migration in neutrophils involves Rac and PI3K activation. Di-expressing HL-60 neutrophils were treated with 100 nM fMLP or 100 nM CNO before immunoblotting for phosphorylated Akt and phosphorylated PAK as readouts for PI3K and Rac activity, respectively. Peak levels of phospho-Akt and phospho-PAK are shown for each condition. Both were increased by CNO stimulation in Di cells but not in control cells (P < 0.01 by Student t test). Stimulation with fMLP increased phospho-Akt and phospho-PAK levels in both Di and control cells (P < 0.01 by Student t test), but Di cells showed higher peak levels of phospho-Akt than did control cells (P < 0.01 by Student t test). Three (for CNO) or four (for fMLP) independent experiments were performed and mean ± SEM are shown.     

Polyspecific pyrrolysyl-tRNA synthetases from directed evolution

Pyrrolysyl-tRNA synthetase (PylRS) and its cognate tRNA^Pyl have emerged as ideal translation components for genetic code innovation. Variants of the enzyme facilitate the incorporation >100 noncanonical amino acids (ncAAs) into proteins. PylRS variants were previously selected to acylate N^ε-acetyl-Lys (AcK) onto tRNA^Pyl. Here, we examine an N^ε-acetyl-lysyl-tRNA synthetase (AcKRS), which is polyspecific (i.e., active with a broad range of ncAAs) and 30-fold more efficient with Phe derivatives than it is with AcK. Structural and biochemical data reveal the molecular basis of polyspecificity in AcKRS and in a PylRS variant [iodo-phenylalanyl-tRNA synthetase (IFRS)] that displays both enhanced activity and substrate promiscuity over a chemical library of 313 ncAAs. IFRS, a product of directed evolution, has distinct binding modes for different ncAAs. These data indicate that in vivo selections do not produce optimally specific tRNA synthetases and suggest that translation fidelity will become an increasingly dominant factor in expanding the genetic code far beyond 20 amino acids.The standard genetic code table relates the 64 nucleotide triplets to three stop signals and 20 canonical amino acids. Some organisms, including humans, naturally evolved expanded genetic codes that accommodate 21 amino acids (1), or possibly 22 amino acids in rare cases (2). Engineering translation system components, including tRNAs (3, 4), aminoacyl-tRNA synthetases (AARSs) (5, 6), elongation factors (7), and the ribosome itself (8), have produced organisms with artificially expanded genetic codes. Products of genetic code engineering include bacterial, yeast, and mammalian cells and animals that are able to synthesize proteins with site-specifically inserted noncanonical amino acids (ncAAs) (9).Genetic code expansion systems rely on an orthogonal AARS/tRNA pair (o-AARS, o-tRNA) (5, 6). The o-AARS should be specific in ligating a desired ncAA to a stop codon decoding tRNA, and both the o-tRNA and o-AARS are assumed not to cross-react with endogenous AARSs or tRNAs. Although some AARSs evolved in nature to recognize certain ncAAs (10–12), many genetic code expansion systems require a mutated AARS active site. The active site of the o-AARS is usually redesigned via directed evolution (6), including positive and negative selective rounds, to produce an enzyme that is assumed to be specific for an ncAA and not active with the 20 canonical amino acids. Genetic code expansion technology is rapidly evolving (13), and the ability to incorporate multiple ncAAs into a protein using quadruplet-codon decoding (14) or sense-codon recoding (15–19) is now becoming feasible. Protein synthesis with multiple ncAAs will require o-AARSs that are able to discriminate their ncAA substrate not only from canonical amino acids in the cell but from other ncAAs that are added to the cell.Probing the effects of amino acid analogs on bacterial cell growth revealed, over 50 y ago, that many ncAAs were incorporated into proteins by the regular translation machinery (10). Thus, it was not surprising to see that many of the successful orthogonal Methanococcus jannaschii tyrosyl-tRNA synthetase variants (20) facilitate incorporation of multiple different ncAAs (21–23). This polyspecificity is also a property of the orthogonal pyrrolysyl-tRNA synthetase (PylRS)/tRNA^Pyl pair (reviewed in ref. 24).PylRS variants that facilitate site-specific insertion of N^ε-acetyl-l-Lys (AcK; 2) (Fig. 1A) into proteins were derived from directed evolution experiments (25–28). These AcK-tRNA synthetase (AcKRS) enzymes have been used to investigate the role of acetylation sites in tumor suppressor p53 (29) and histone H3 (30). Here, we present biochemical and structural studies showing that AcKRS variants are polyspecific and catalytically deficient enzymes compared with canonical AARSs. These AcKRSs selected by directed evolution to ligate AcK to tRNA^Pyl are actually ∼30-fold more efficient in activation with Phe derivatives. Crystallographic structures of AcKRS and PylRS variants in complex with AcK, 3-iodo-l-Phe (3-I-Phe; 4) (Fig. 1A), or 2-(5-bromothienyl)-l-Ala (3-Br-ThA; 10) (Fig. 1A) reveal the structural basis of polyspecificity in these engineered PylRS enzymes.Open in a separate windowFig. 1.(A) Chemical structures of nsAAs used in the study: 1, l-pyrrolysine (Pyl); 2, AcK; 3, N^ε-trifluoroacetyl-l-Lys (CF₃-AcK); 4, 3-I-Phe; 5, 3-bromo-l-Phe (3-Br-Phe); 6, 3-chloro-l-Phe (3-Cl-Phe); 7, 3-trifluoromethyl-l-Phe (3-CF₃-Phe); 8, 3-methyl-l-Phe (3-Me-Phe); 9, 3-methoxyl-l-Phe (3-MeO-Phe); 10, 3-Br-ThA. (B) Range of substrate specificity of AcKRS3. Translation of the sfGFP reporter (UAG codon at position 2) by the library of ncAA-tRNA^Pyl was measured by fluorescence intensity. A library of 94 different Lys and Phe analogs (Dataset S1) was tested. Fluorescence signals from the incorporation of ncAAs 2–5, 7, 9, and 10 are labeled in A. Well A12 is a control without added ncAA. Well A1 was a positive control experiment to detect the production signal of WT sfGFP (100%). Fluorescence data and error values (SD) are represented by bars from three independent experiments (also given in Dataset S1). Colors (0–4% in purple, 4–8% in blue, 18–24% in red, and 95–100% in brown) have been used to indicate the level of UAG read-through.     

The role of the hypervariable C-terminal domain in Rab GTPases membrane targeting

Intracellular membrane trafficking requires correct and specific localization of Rab GTPases. The hypervariable C-terminal domain (HVD) of Rabs is posttranslationally modified by isoprenyl moieties that enable membrane association. A model asserting HVD-directed targeting has been contested in previous studies, but the role of the Rab HVD and the mechanism of Rab membrane targeting remain elusive. To elucidate the function of the HVD, we have substituted this region with an unnatural polyethylenglycol (PEG) linker by using oxime ligation. The PEGylated Rab proteins undergo normal prenylation, underlining the unique ability of the Rab prenylation machinery to process the Rab family with diverse C-terminal sequences. Through localization studies and functional analyses of semisynthetic PEGylated Rab1, Rab5, Rab7, and Rab35 proteins, we demonstrate that the role of the HVD of Rabs in membrane targeting is more complex than previously understood. The HVD of Rab1 and Rab5 is dispensable for membrane targeting and appears to function simply as a linker between the GTPase domain and the membrane. The N-terminal residues of the Rab7 HVD are important for late endosomal/lysosomal localization, apparently due to their involvement in interaction with the Rab7 effector Rab-interacting lysosomal protein. The C-terminal polybasic cluster of the Rab35 HVD is essential for plasma membrane (PM) targeting, presumably because of the electrostatic interaction with negatively charged lipids on the PM. Our findings suggest that Rab membrane targeting is dictated by a complex mechanism involving GEFs, GAPs, effectors, and C-terminal interaction with membranes to varying extents, and possibly other binding partners.Rab proteins are key regulators of intracellular vesicle transport in eukaryotic cells (1, 2). They comprise the largest subgroup of the Ras superfamily of small GTPases, with more than 60 members in humans and 11 members in yeast (3). Interacting with a complex network of Rab regulators and effectors, Rab GTPases regulate these processes through a spatiotemporally controlled GTPase cycle and their distribution in cells. The GTPase cycle is strictly regulated by guanine nucleotide exchange factors (GEFs) that mediate GDP/GTP exchange and by GTPase-activating proteins (GAPs) that accelerate the hydrolysis of GTP. Active (GTP-bound) Rab proteins associate with distinct intracellular compartments and direct vesicular transport by recruiting a multitude of Rab-specific effectors, including tethering complexes and motor proteins.Rab proteins are posttranslationally modified at the C terminus with prenyl groups that function as membrane anchors. Rab prenylation involves covalent attachment of the geranylgeranyl (C-20 isoprenyl) moiety to one or two C-terminal cysteine residues of the protein substrate via a stable thioether linkage (4). Unlike other protein prenyltransferases that recognize the C-terminal CaaX motif of protein substrates (e.g., Ras and Rho), Rab geranylgeranyl transferase (RabGGTase) does not recognize its protein substrates (Rab proteins) directly but requires the adaptor Rab escort protein (REP). Rab prenylation requires the formation of a ternary catalytic Rab:REP:RabGGTase complex (5–7). It remains elusive how the single Rab prenylation machinery can process the whole Rab family with diverse C termini.Cycling between the cytosol and membranes is an essential feature of the mode of action of Rabs and is made possible by reversible interaction with GDP dissociation inhibitor (GDI), which can solubilize the otherwise water-insoluble geranylgeranylated Rab molecules (8). Membrane-bound GDI displacement factors were proposed to disrupt GDI:Rab complexes, leading to insertion of the prenylated Rab into the membrane in the GDP form and release of GDI into the cytosol (9, 10). One of the most perplexing questions is how Rab proteins are specifically targeted to their cognate membranes. The hypervariable C-terminal domain (HVD) was proposed to function as a signal for targeting Rab proteins to specific subcellular membranes (11). However, later studies suggested that several features of Rab molecules, Rab effectors, and GEFs are involved in the targeting process (12–15). The role of the Rab HVD in membrane targeting is controversial, because contradictory results were obtained by swapping the hypervariable domains of Rab proteins (11–13). Thus, the function of the Rab HVD and a complete model for Rab membrane targeting remain to be established. To further understand the significance of the HVD in Rab membrane targeting and prenylation, unique methods are needed to manipulate the structure of Rab C terminus.In this study, we replaced the Rab C-terminal sequence with the polyethylenglycol (PEG) linker as a nonpeptidic chain. The PEG chain containing two cysteine residues or a simple thiol group at one end was coupled to truncated Rab proteins by oxime ligation. We found that the PEGylated Rab proteins undergo normal prenylation in vitro, confirming that the Rab prenylation machinery does not require a specific C-terminal sequence but rather outsources the specificity to the REP molecule. By combining this semisynthetic strategy with cell imaging, we elucidate the role of the hypervariable C-terminal domain for subcellular Rab targeting. In some instances, the HVD is dispensable for correct subcellular localization (Rab1, Rab5), but is essential in other cases because of specific interactions with effectors (Rab7) or electrostatic interactions with membranes (Rab35). The results further elaborate the model for Rab prenylation and membrane targeting.     

The Plasmodium falciparum eIK1 kinase (PfeIK1) is central for melatonin synchronization in the human malaria parasite. Melatotosil blocks melatonin action on parasite cell cycle

Melatonin and its indoles derivatives are central in the synchronization of malaria parasites. In this research, we discovered that melatonin is unable to increase the parasitemia in the human malaria Plasmodium falciparum that lacks the kinase PfeIK1. The PfeIK1 knockout strain is a valuable tool in the screening of indol-related compound that blocks the melatonin effect in wild-type (WT) parasite development. The assays were performed by using flow cytometry with simultaneous labeling for mitochondria viability with MitoTracker Deep Red and nucleus staining with SYBR Green. We found that Melatotosil leads to an increase in parasitemia in P. falciparum and blocks melatonin effect in the WT parasite. Using microscopy imaging system, we found that Melatotosil at 500 nM is able to induce cytosolic calcium rise in transgenic PfGCaMP3 parasites. On the contrary, the compound Triptiofen blocks P. falciparum cell cycle with IC₅₀ 9.76 µM ± 0.6, inhibits melatonin action, and does not lead to a cytosolic calcium rise in PfGCaMP3 parasites. We also found that the synthetic indol-related compounds arrested parasite cycle for PfeIK1 knockout and (WT) P. falciparum (3D7) in 72 hours culture assays with the IC₅₀ values slighting lower for the WT strain. We concluded that the kinase PfeIK1 is central for melatonin downstream signaling pathways involved in parasite cell cycle progression. More importantly, the indol-related compounds block its cycle as an upstream essential mechanism for parasite survival. Our data clearly show that this class of compounds emerge as an alternative for the problem of resistance with the classical antimalarials.     

Imputation of confidential data sets with spatial locations using disease mapping models

Data that include fine geographic information, such as census tract or street block identifiers, can be difficult to release as public use files. Fine geography provides information that ill‐intentioned data users can use to identify individuals. We propose to release data with simulated geographies, so as to enable spatial analyses while reducing disclosure risks. We fit disease mapping models that predict areal‐level counts from attributes in the file and sample new locations based on the estimated models. We illustrate this approach using data on causes of death in North Carolina, including evaluations of the disclosure risks and analytic validity that can result from releasing synthetic geographies. Copyright © 2014 John Wiley & Sons, Ltd.     

Identification of novel helper epitope peptides of Survivin cancer-associated antigen applicable to developing helper/killer-hybrid epitope long peptide cancer vaccine

We identified novel helper epitope peptides of Survivin cancer antigen, which are presented to both HLA-DRB1*01:01 and DQB1*06:01. The helper epitope also contained three distinct Survivin-killer epitopes presented to HLA-A*02:01 and A*24:02. This 19 amino-acids epitope peptide (SU18) induced weak responses of Survivin-specific CD4⁺ and CD8⁺ T cells though it contained both helper and killer epitopes. To enhance the vaccine efficacy, we synthesized a long peptide by conjugating SU18 peptide and another DR53-restricted helper epitope peptide (SU22; 12 amino-acids) using glycine-linker. We designated this artificial 40 amino-acids long peptide containing two helper and three killer epitopes as Survivin-helper/killer-hybrid epitope long peptide (Survivin-H/K-HELP). Survivin-H/K-HELP allowed superior activation of IFN-γ-producing CD4⁺ Th1 cells and CD8⁺ Tc1 cells compared with the mixture of its component peptides (SU18 and SU22) in the presence of OK-432-treated monocyte-derived DC (Mo-DC). Survivin-H/K-HELP-pulsed Mo-DC pretreated with OK-432 also exhibited sustained antigen-presentation capability of stimulating Survivin-specific Th1 cells compared with Mo-DC pulsed with a mixture of SU18 and SU22 short peptides. Moreover, we demonstrated that Survivin-H/K-HELP induced a complete response in a breast cancer patient with the induction of cellular and humoral immune responses. Thus, we believe that an artificially synthesized Survivin-H/K-HELP will become an innovative cancer vaccine.     

Systematic Study of Effective Hydrothermal Synthesis to Fabricate Nb-Incorporated TiO2 for Oxygen Reduction Reaction

Fuel cells are expected to serve as next-generation energy conversion devices owing to their high energy density, high power, and long life performance. The oxygen reduction reaction (ORR) is important for determining the performance of fuel cells; therefore, using catalysts to promote the ORR is essential for realizing the practical applications of fuel cells. Herein, we propose Nb-incorporated TiO₂ as a suitable alternative to conventional Pt-based catalysts, because Nb doping has been reported to improve the conductivity and electron transfer number of TiO₂. In addition, Nb-incorporated TiO₂ can induce the electrocatalytic activity for the ORR. In this paper, we report the synthesis method for Nb-incorporated TiO₂ through a hydrothermal process with and without additional load pressures. The electrocatalytic activity of the synthesized samples for the ORR was also demonstrated. In this process, the samples obtained under various load pressures exceeding the saturated vapor pressure featured a high content of Nb and crystalline TiNb₂O₇, resulting in an ellipsoidal morphology. X-ray diffraction results also revealed that, on increasing the Nb doping amounts, the diffraction peak of the anatase TiO₂ shifted to a lower angle and the full width at half maximum decreased. This implies that the Ti atom is exchanged with the Nb atom during this process, resulting in a decrease in TiO₂ crystallinity. At a doping level of 10%, Nb-incorporated TiO₂ exhibited the best electrocatalytic activity in terms of the oxygen reduction current (i_ORR) and onset potential for the ORR (E_ORR); this suggests that 10% Nb-doped samples have the potential for enhancing electrocatalytic activity.     

乳腺断层摄影合成技术的临床价值

目的:探讨数字乳腺断层合成X线成像(DBT)结合合成2D图像(SM)对乳腺微钙化的检出和诊断效能。方法:回顾性分析228例乳腺影像及病理资料。3名影像医师独立阅读DBT结合全视野数字化乳腺摄影(FFDM)、DBT结合SM、FFDM、SM 4种模式下影像资料,记录微钙化有无,根据BI-RADS 2013版对微钙化进行分类,分析不同密度乳腺类型中良、恶性微钙化的检出率及诊断效能。结果:不管在致密型乳腺或所有腺体类型乳腺中,4种阅片模式对微钙化检出敏感度的差异无统计学意义(P>0.05),特异度均为100%。DBT结合SM与DBT结合FFDM对微钙化诊断敏感度、特异度及ROC曲线下面积的差异无统计学意义(P>0.05);FFDM的敏感度高于SM,特异度低于SM,ROC曲线下面积高于SM,差异均具有统计学意义(P<0.05)。结论:DBT结合SM与DBT结合FFDM对乳腺微钙化的检出、诊断效能相似。