PDT

PDT
  • 文章类型: Journal Article
    乳腺癌的肿瘤微环境内的缺氧微环境对克服化学疗法抗性提出了挑战。在这次调查中,我们设计了一种新策略,该策略利用了一种光控级联靶向纳米药物,专门为增强乳腺癌的免疫治疗而定制.白蛋白纳米颗粒是通过交联实现的,然后加载TPZ和Ce6,以及随后的修饰以使得能够与CD44透明质酸选择性结合以形成纳米药物。令人鼓舞的是,它被证明了纳米医学有效内化到细胞实体中的非凡能力,因此,当暴露于光照时,可以在体外有效诱导4T1细胞凋亡。体内评估显示了纳米药物的特殊才能,不仅在肿瘤组织内优先积累,而且对肿瘤生长有实质性的抑制作用.免疫机制表明纳米药物治疗促进了体内DCs的成熟,增强CD8+T细胞在脾脏和肿瘤中的比例,并同时上调有利于抗肿瘤作用的M1巨噬细胞的比例。这些结果共同为临床乳腺癌治疗提供了新的视角。
    The hypoxic microenvironment within the tumor microenvironment of breast cancer imposes a challenge in overcoming chemotherapy resistance. In this investigation, we designed a novel strategy utilizing a light-controlled cascade targeting nanomedicine specifically tailored for enhanced immune therapy of breast cancer. Albumin nanoparticle was achieved by crosslinking, followed by loading TPZ and Ce6, and subsequent modification to enable selective binding with CD44 hyaluronic acid to form nanomedicine. Encouragingly, it was demonstrated the remarkable ability of the nanomedicine to effectively internalize into cellular entities, thereby inducing apoptosis in 4T1 cells efficiently in vitro when exposed to light irradiation. In vivo assessments showcased the exceptional aptitude of the nanomedicine not only for preferential accumulation within tumor tissues, but also for substantial suppression of tumor growth. Immune mechanisms have shown that nanomedicine treatment promoted the maturation of DCs in vivo, enhanced the proportion of CD8+ T cells in the spleen and tumor, and simultaneously upregulated the ratio of M1 macrophages favorable for anti-tumor effects. These outcomes collectively advance a fresh perspective for the clinical breast cancer therapy.
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  • 文章类型: Journal Article
    利用表面增强拉曼散射(SERS)3D成像技术,提出了一种在线粒体靶向光动力治疗(PDT)过程中对单个活肿瘤细胞中ATP进行原位视觉监测的超灵敏策略。由Au-Ag2SJanus纳米颗粒组成的纳米结构被有意地用于靶向线粒体,所述Au纳米颗粒被DNA链和线粒体靶向肽(JMDANP)连接。JMDANP表现出优异的SERS活性和显著的抗肿瘤活性。ATP的量化依赖于与DNA结合的SERS探针的强度,这表明与Janus和Au之间产生的热点有很强的相关性。因此,在PDT过程中实现了单个活细胞线粒体中ATP的时空控制监测。此外,JMDANP表现出显著的线粒体靶向PDT能力,在体外和体内提供显著的抗肿瘤作用和优异的治疗安全性。我们的工作提出了一种有效的基于JMDANP的SERS成像策略,用于在线粒体靶向的PDT过程中对活肿瘤细胞中的细胞内ATP进行原位和实时3D可视化,这使得关于PDT治疗时间点的重要信息成为可能,并且有利于PDT在肿瘤治疗中的宝贵应用。
    An ultrasensitive strategy for in-situ visual monitoring of ATP in a single living tumor cell during mitochondria-targeted photodynamic therapy (PDT) process with high spatiotemporal resolution was proposed using surface-enhanced Raman scattering (SERS) 3D imaging technique. The nanostructures consisting of Au-Ag2S Janus nanoparticles functionalized with both Au nanoparticles linked by a DNA chain and a mitochondrial-targeting peptide (JMDA NPs) were deliberately employed to target mitochondria. The JMDA NPs exhibit excellent SERS activity and remarkable antitumor activity. The quantization of ATP relies on the intensity of the SERS probes bonded to the DNA, which shows a strong correlation with the generated hot spot between the Janus and the Au. Consequently, spatiotemporally controlled monitoring of ATP in the mitochondria of single living cells during the PDT process was achieved. Additionally, the JMDA NPs demonstrated remarkable capability for mitochondria-targeted PDT, providing significant antitumor effects and superior therapeutic safety both in vitro and in vivo. Our work presents an effective JMDA NPs-based SERS imaging strategy for in-situ and real-time 3D visualization of intracellular ATP in living tumor cells during the mitochondria-targeted PDT process, which enables significant information on the time point of PDT treatment and is beneficial to precious PDT applications in tumor therapy.
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  • 文章类型: Journal Article
    光动力疗法(PDT)是一种微创治疗方式,已在临床上用于早期和无法手术的癌症。文献中记载了这种无创伤疗法在骨坏死(ORN)和颌骨坏死(ONJ)中的成功使用。这篇综述的目的是系统评估光动力疗法在ORN和ONJ中的作用。
    两位独立的审阅者在PubMed中进行了精心的搜索,GoogleScholar和Cochrane的CENTRAL数据库在PDT上作为ORN/ONJ的独立或辅助治疗发表,直到2022年6月。本研究基于系统评价和荟萃分析的首选报告项目。人口统计数据,颌骨坏死的类型和阶段,site,PDT协议,评估愈合时间和随访时间。根据最终分析的纳入和排除标准,共纳入18篇文章。
    本综述共纳入94例患者,其中男性36例,女性58例。5项研究报道了在ORN中使用PDT作为辅助治疗。13项研究报告了ONJPDT的成功结果。86/94(91.48%)患者使用PDT±其他佐剂实现了完全上皮化。在本研究中,使用PDT治疗病变消退所需的时间为4天至12个月。
    综述的研究证明了PDT的有效性,作为辅助治疗,管理ORN和ONJ的各个阶段。
    UNASSIGNED: Photodynamic therapy (PDT) is a minimally invasive treatment modality that has been used clinically for early stage and inoperable cancers. Successful use of this atraumatic therapy in osteoradionecrosis (ORN) and osteonecrosis of the jaws (ONJ) has been documented in the literature. The aim of this review was to systematically evaluate the role of photodynamic therapy in ORN and ONJ.
    UNASSIGNED: Two independent reviewers conducted an elaborate search in PubMed, Google Scholar and Cochrane\'s CENTRAL database for studies published on PDT as stand-alone or adjuvant therapy in ORN/ONJ until June 2022. The present study was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Demographic data, type and stage of necrosis of the jaws, site, PDT protocol, time to heal and follow-up were evaluated. Eighteen articles were included totally based on the inclusion and exclusion criteria for final analysis.
    UNASSIGNED: A total of 94 patients were included in the present review out of which 36 were males and 58 were females. Five studies reported the use of PDT as an adjuvant therapy in ORN. Thirteen studies reported successful outcomes with PDT in ONJ. Complete epithelialization was achieved with PDT ± other adjuvants in 86/94 (91.48%) patients. The time taken for regression of the lesion ranged between 4 days and 12 months with PDT in the present study.
    UNASSIGNED: The reviewed studies demonstrate the effectiveness of PDT, as an adjuvant therapy, in managing various stages of ORN and ONJ.
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  • 文章类型: Journal Article
    光动力疗法(PDT),非侵入性癌症治疗,依赖于三个组件:光源,氧气,和光敏剂(PS)。当PS在氧气存在下被特定波长的光激发时,它导致活性氧(ROS)的产生,导致癌细胞的靶向破坏。PDT的成功主要取决于所选PS的属性,强调选择性,高吸光度,药物缀合,受控的生物分布,和低毒性。纳米材料不仅通过最大程度地吸收来自光源的光子而在光化学活性中起重要作用,而且还可以调节光活性分子的药代动力学和肿瘤选择性。因此,它们可以单独用作PS并与其他PS分子缀合。当与选择性结合时,高瞄准能力,最后,适当波长的光,该方案导致局部ROS形成和细胞死亡。然而,PDT诱导的细胞死亡的信号通路可能因细胞类型或纳米材料特性而异。出于这个原因,需要进行组学分析以阐明光动力反应的潜在机制。蛋白质组学,在分子科学中至关重要,揭示了癌症的机制,识别生物标志物和治疗靶点。在体外检查癌细胞系中基于纳米颗粒的PDT,本章旨在分子评估疗效,利用蛋白质组学分析来了解潜在的机制。
    Photodynamic therapy (PDT), a noninvasive cancer treatment, relies on three components: light source, oxygen, and photosensitizer (PS). When PS is excited by a specific wavelength of light in the presence of oxygen, it leads to the generation of reactive oxygen species (ROS), which results in targeted destruction of cancer cells. The success of PDT mainly depends on the properties of the chosen PS, emphasizing selectivity, high absorbance, drug conjugation, controlled biodistribution, and low toxicity. Nanomaterials not only play an important role in photochemical activity by maximizing the absorption of photons from the light source but can also adjust the pharmacokinetics and tumor selectivity of photoactive molecules. Therefore, they can be used as a PS on their own and conjugated with other PS molecules. When combined with selectivity, high targeting capacity, and finally, light of the appropriate wavelength, the scenario results in localized ROS formation and cell death. However, the signaling pathways of PDT-induced cell death may differ depending on the cell type or nanomaterial properties. For this reason, omics analyses are needed to clarify the mechanisms underlying photodynamic reactions. Proteomics, crucial in molecular sciences, sheds light on cancer mechanisms, identifying biomarkers and therapeutic targets. Examining nanoparticle-based PDT in cancer cell lines in vitro, this chapter aims to molecularly evaluate efficacy, utilizing proteomic analysis to understand the underlying mechanisms.
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  • 文章类型: Journal Article
    以纳米技术为基础的癌症治疗受到了相当多的关注,这些治疗通常使用药物负载的纳米粒子(NPs)来靶向和破坏癌细胞。纳米技术结合光动力疗法(PDT)已在癌症治疗中显示出积极的结果。结合纳米技术和PDT在靶向转移性癌细胞方面是有效的。纳米技术还可以通过在分子水平上靶向细胞来提高PDT的有效性。基于树枝状聚合物的纳米缀合物(DBNs)是高度稳定和生物相容性的,使它们适用于药物输送应用。此外,DBN中的超支化结构具有负载疏水化合物的能力,如光敏剂(PSs)和化疗药物,并将它们有效地传递给肿瘤细胞。这篇综述主要集中在DBN及其在癌症治疗中的潜在应用。我们讨论化学设计,作用机制,以及DBN在肿瘤转移中的靶向效率,细胞内运输在癌症治疗中,和DBNs的生物相容性,生物降解性和清除性能。总的来说,这项研究将为DBNs和PDT在癌症治疗中的应用提供最新见解.
    DBNs在癌症-PDT中的细胞内旅程完善了靶向治疗,增强功效。PDT中的DBN用于肿瘤转移:靶向和药物释放机制。DBN的生物相容性,对生物降解性和清除率进行了彻底探索。
    Nanotechnology-based cancer treatment has received considerable attention, and these treatments generally use drug-loaded nanoparticles (NPs) to target and destroy cancer cells. Nanotechnology combined with photodynamic therapy (PDT) has demonstrated positive outcomes in cancer therapy. Combining nanotechnology and PDT is effective in targeting metastatic cancer cells. Nanotechnology can also increase the effectiveness of PDT by targeting cells at a molecular level. Dendrimer-based nanoconjugates (DBNs) are highly stable and biocompatible, making them suitable for drug delivery applications. Moreover, the hyperbranched structures in DBNs have the capacity to load hydrophobic compounds, such as photosensitizers (PSs) and chemotherapy drugs, and deliver them efficiently to tumour cells. This review primarily focuses on DBNs and their potential applications in cancer treatment. We discuss the chemical design, mechanism of action, and targeting efficiency of DBNs in tumour metastasis, intracellular trafficking in cancer treatment, and DBNs\' biocompatibility, biodegradability and clearance properties. Overall, this study will provide the most recent insights into the application of DBNs and PDT in cancer therapy.
    DBNs’ intracellular journey in cancer-PDT refines targeted therapy, boosting efficacy.DBN in PDT for tumour metastasis: targeting and drug release mechanisms.DBNs’ biocompatibility, biodegradability and clearance were explored thoroughly.
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  • 文章类型: Journal Article
    基于光敏剂的光疗,包括光动力疗法(PDT)和光热疗法(PTT),为时空精确的肿瘤消融提供安全的治疗方式。光子被吸收后,PDT通过产生活性氧(ROS)产生局部化学损伤,而PTT引起局部热损伤。然而,PDT仍然面临着肿瘤缺氧的挑战,而PTT遇到与耐热性和潜在过热相关的问题。PDT和PTT的组合显示出作为有效抗癌策略的巨大潜力。通过使用精心设计的光疗试剂针对溶酶体进行联合光疗,可以诱导癌细胞的快速功能障碍和细胞死亡,显示出癌症治疗的希望。在这里,设计并合成了两个具有四苯基乙烯(TPE)部分的α-α-连接的双BODIPY。这些TPE取代的双BODIPY将吸收扩展到NIR范围(λmaxabs/λmaxem〜740/810nm),并赋予聚集诱导发射(AIE)活性(λmaxem〜912nm)。此外,这些双BODIPY与表面活性剂F-127自组装成纳米颗粒(NP),在溶液和细胞环境中有效地产生ROS(1O2和•OH),并表现出优异的光热转换效率(η〜68.3%)以及出色的光热稳定性。更重要的是,这些NP在细胞和小鼠模型中显示溶酶体靶向和显着的肿瘤消融,表明他们在精确肿瘤治疗中的潜力。
    Photosensitizer-based phototherapies, including photodynamic therapy (PDT) and photothermal therapy (PTT), offer safe treatment modalities for tumor ablation with spatiotemporal precision. After photons are absorbed, PDT creates localized chemical damage by generating reactive oxygen species (ROS), while PTT induces localized thermal damage. However, PDT still faces hypoxic tumor challenges, while PTT encounters issues related to heat resistance and potential overheating. The combination of PDT and PTT shows great potential as an effective anticancer strategy. By targeting lysosomes with carefully designed phototherapeutic reagents for combined phototherapy, rapid dysfunction and cell death in cancer cells can be induced, showing promise for cancer treatment. Herein, two α-α-linked bisBODIPYs with tetraphenylethene (TPE) moieties are designed and synthesized. These TPE-substituted bisBODIPYs expand the absorption into NIR range (λmaxabs/λmaxem ∼ 740/810 nm) and confer aggregation-induced emission (AIE) activity (λmaxem ∼ 912 nm). Moreover, these bisBODIPYs self-assemble with surfactant F-127 into nanoparticles (NPs), which efficiently generate ROS (1O2 and •OH) in both solution and cellular environments and demonstrate superior photothermal conversion efficiencies (η ∼ 68.3%) along with exceptional photothermal stability. More importantly, these NPs showed lysosomal targeting and remarkable tumor ablation in cellular and murine models, indicating their potential in precision tumor therapy.
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  • 文章类型: Journal Article
    尽管癌症治疗有广泛的治疗选择,包括化疗,放射治疗,和外科手术,这些治疗方法中的每一种都有不同的副作用,使患者别无选择,只能选择.由于它们的不敏感性和非特异性,常规治疗会损害正常细胞和癌细胞。近年来,光动力疗法(PDT)作为癌症和耐药微生物的治疗方法受到了大量关注.活化的光敏剂与氧分子和属于可见或NIR光谱区的特定波长的光一起用作程序的一部分。一种光敏激光染料,罗丹明6G(R6G),在本研究中用作光敏剂,使用最佳浓度(160mg/ml)的壳聚糖-藻酸盐(Cs-Alg)共混的聚合物纳米制剂来提高水溶性和ROS量子产率。正如稳态分光光度和荧光测量所证明的那样,与水溶液相比,ROS量子产率增加了三倍,同时溶解度增加,这通过使用人上皮癌(KB)细胞系的PDT实验得到了验证。使用IVIS成像系统进行体模光学成像,以建立作为基于荧光的光学造影剂的制剂,和斑马鱼胚胎被用来建立其在体内的安全使用。使用动力学模型拟合了R6G的释放曲线,遵循非菲克动力学轮廓。总之,我们推荐该制剂作为一种潜在的治疗学诊断药物,将有助于基于PDT的治疗以及基于光学成像的诊断.
    Despite the wide range of treatment options available for cancer therapy, including chemotherapy, radiation therapy, and surgical procedures, each of these treatments has a different side-effect profile and leaves the patient with no option but to choose. Due to their insensitivity and nonspecificity, conventional treatments damage normal cells together with cancer cells. In recent years, a significant amount of attention has been focused on photodynamic therapy (PDT) as a treatment for cancer and drug-resistant microbes. An activated photosensitizer is used as a part of the procedure along with oxygen molecules and a specific wavelength of light belonging to the visible or NIR spectral zone. A light-sensitive laser dye, rhodamine 6G (R6G), was used in the present study as a photosensitizer, taking a challenge to improve the aqueous solubility and ROS quantum yield using optimum concentration (160 mg/ml) of chitosan-alginate (Cs-Alg) blended polymeric nanoformulations. As evidenced by steady-state spectrophotometric and fluorometric measurements, ROS quantum yield increases three-fold over aqueous solution along with solubility gaining that was validated by PDT experiment using human epithelial carcinoma (KB) cell line. Phantom optical imaging was taken using the IVIS imaging system to establish the formulations as a fluorescence-based optical contrast agent, and zebrafish embryos were used to establish their safe in vivo use. The release profile of R6G was fitted using kinetic models, which followed the Non-Fickian kinetic profile. In conclusion, we recommend the formulations as a potential theranostic agent that will aid in PDT-based therapy in conjunction with optical imaging-based diagnosis.
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  • 文章类型: Journal Article
    光动力疗法(PDT)是一种有前途的癌症治疗方法,它使用光敏(PS)化合物使用激光选择性地破坏肿瘤细胞。这篇综述讨论了PDT的主要优点,比如它的低侵入性,全身毒性最小,并发症风险低。特别注意通过化学合成获得的光敏剂。介绍了三代光敏剂,从第一个开始,基于卟啉,通过第二代,包括改性卟啉,二氯,5-氨基乙酰丙酸(ALA)及其衍生物氨基乙酰丙酸己酯(HAL),到第三代,这是基于使用纳米技术来增加治疗的选择性。此外,突出了当前的研究趋势,包括寻找可以克服现有疗法局限性的新光敏剂,如不含重原子的非卟啉类光敏剂,抗体-药物缀合物(ADC)或具有近红外(NIR)吸收峰的光敏剂。最后,介绍了PDT的发展前景,考虑到纳米技术和生物医学工程的进步。参考文献包括较旧和较新的作品。在许多情况下,当写一组给定的第一代或第二代光敏剂时,使用较早的出版物,因为其中描述的化合物的性质多年来没有改变。此外,较早的文章提供了作为一组药物的介绍的信息。
    Photodynamic therapy (PDT) is a promising cancer treatment method that uses photosensitizing (PS) compounds to selectively destroy tumor cells using laser light. This review discusses the main advantages of PDT, such as its low invasiveness, minimal systemic toxicity and low risk of complications. Special attention is paid to photosensitizers obtained by chemical synthesis. Three generations of photosensitizers are presented, starting with the first, based on porphyrins, through the second generation, including modified porphyrins, chlorins, 5-aminolevulinic acid (ALA) and its derivative hexyl aminolevulinate (HAL), to the third generation, which is based on the use of nanotechnology to increase the selectivity of therapy. In addition, current research trends are highlighted, including the search for new photosensitizers that can overcome the limitations of existing therapies, such as heavy-atom-free nonporphyrinoid photosensitizers, antibody-drug conjugates (ADCs) or photosensitizers with a near-infrared (NIR) absorption peak. Finally, the prospects for the development of PDTs are presented, taking into account advances in nanotechnology and biomedical engineering. The references include both older and newer works. In many cases, when writing about a given group of first- or second-generation photosensitizers, older publications are used because the properties of the compounds described therein have not changed over the years. Moreover, older articles provide information that serves as an introduction to a given group of drugs.
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  • 文章类型: Journal Article
    光动力疗法(PDT)不仅可以直接消除癌细胞,还能刺激抗肿瘤免疫反应。它还影响免疫检查点的表达。这次审查的目的是收集,分析,总结最近关于PDT和免疫检查点的新闻,以及它们的抑制剂,并确定可能提高这种方法有效性的未来研究方向。在PubMed/MEDLINE上搜索了2023年1月至2024年3月之间发表的研究文章。合格标准如下:(1)描述PDT和免疫检查点的论文,(2)只有原创性研究论文,(3)仅描述PDT和免疫检查点领域的新报告的论文,和(4)体外和体内论文。排除标准包括(1)用波兰语或英语以外的语言撰写的论文,(2)复习论文,(3)2023年1月之前发表的论文。自2023年1月以来,已经发表了24篇描述PDT和免疫检查点新数据的论文。其中包括PDT对免疫检查点影响的信息,并试图将PDT与ICI和其他分子联系起来以调节免疫检查点,改善肿瘤的免疫抑制环境,并解决PDT相关问题。他们还专注于开发新的纳米颗粒,这些纳米颗粒可以改善光敏剂和药物选择性地向肿瘤的递送。PDT对免疫检查点水平和免疫系统相关活性的影响尚未得到进一步充分阐明。这方面的报道有分歧,表明PDT和免疫系统之间相互作用的复杂性。已经显示基于PDT的策略对ICI向肿瘤的递送具有有益效果。PDT通过参与免疫原性细胞死亡的触发来增强抗肿瘤反应的诱导,肿瘤抗原的暴露,以及各种警报信号的释放,共同促进树突状细胞和免疫系统其他成分的激活也已被证明,结果PDT可以增强ICI治疗诱导的抗肿瘤免疫应答。PDT还可以对肿瘤的免疫抑制环境进行多方面的调节,因此,ICI治疗有可能获得更好的抗肿瘤疗效。当前的综述提供了PDT调节免疫检查点水平的能力以及PDT与ICI和其他分子在诱导针对癌细胞的有效免疫反应中的有效性的证据。然而,这些研究还处于早期阶段,需要进行更多的观察以证实其疗效.指出的新研究方向可能有助于制定进一步的战略。
    Photodynamic therapy (PDT) can not only directly eliminate cancer cells, but can also stimulate antitumor immune responses. It also affects the expression of immune checkpoints. The purpose of this review is to collect, analyze, and summarize recent news about PDT and immune checkpoints, along with their inhibitors, and to identify future research directions that may enhance the effectiveness of this approach. A search for research articles published between January 2023 and March 2024 was conducted in PubMed/MEDLINE. Eligibility criteria were as follows: (1) papers describing PDT and immune checkpoints, (2) only original research papers, (3) only papers describing new reports in the field of PDT and immune checkpoints, and (4) both in vitro and in vivo papers. Exclusion criteria included (1) papers written in a language other than Polish or English, (2) review papers, and (3) papers published before January 2023. 24 papers describing new data on PDT and immune checkpoints have been published since January 2023. These included information on the effects of PDT on immune checkpoints, and attempts to associate PDT with ICI and with other molecules to modulate immune checkpoints, improve the immunosuppressive environment of the tumor, and resolve PDT-related problems. They also focused on the development of new nanoparticles that can improve the delivery of photosensitizers and drugs selectively to the tumor. The effect of PDT on the level of immune checkpoints and the associated activity of the immune system has not been fully elucidated further, and reports in this area are divergent, indicating the complexity of the interaction between PDT and the immune system. PDT-based strategies have been shown to have a beneficial effect on the delivery of ICI to the tumor. The utility of PDT in enhancing the induction of the antitumor response by participating in the triggering of immunogenic cell death, the exposure of tumor antigens, and the release of various alarm signals that together promote the activation of dendritic cells and other components of the immune system has also been demonstrated, with the result that PDT can enhance the antitumor immune response induced by ICI therapy. PDT also enables multifaceted regulation of the tumor\'s immunosuppressive environment, as a result of which ICI therapy has the potential to achieve better antitumor efficacy. The current review has presented evidence of PDT\'s ability to modulate the level of immune checkpoints and the effectiveness of the association of PDT with ICIs and other molecules in inducing an effective immune response against cancer cells. However, these studies are at an early stage and many more observations need to be made to confirm their efficacy. The new research directions indicated may contribute to the development of further strategies.
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  • 文章类型: Journal Article
    目的:介绍一种新型的经皮扩张气管切开术(PDT)成像装置和技术,并评估其临床应用价值。方法:我们对支气管镜进行了修改,以生成一种新型的成像设备。移除支气管镜的手柄并用附加的固定件替换,以将新装置固定到气管内导管。在2023年7月至2024年1月期间,山东省公共卫生临床中心重症监护室收治的9名机械通气患者接受了PDT治疗。手术所需的医护人员人数,针头干预的数量,操作时间,动脉血气分析,观察术中并发症。结果:该过程涉及三名医务人员:一名操作员,一个助手,还有一个护士.第一次尝试的针头干预在所有患者中都是成功的,无大出血等严重并发症,气胸,纵隔气肿,意外拔管,去饱和,hypercarbia,呼吸性酸中毒,血液动力学异常,或后气管穿刺发生。从皮肤切口到针头插入的平均时间为11.63±1.56分钟,从针头插入到气管放置的平均时间为4.43±1.99分钟。结论:该新型装置引导下的PDT是安全的,保留人力资源,节省操作空间,保持视图稳定,并使程序变得容易。值得进一步研讨和运用。
    Objective: The purpose of this article is to introduce a novel imaging device and technique for percutaneous dilatational tracheostomy (PDT) and evaluate its clinical application. Methods: We have modified the bronchoscope to generate a novel imaging device. The handle of the bronchoscope was removed and replaced with added fixation pieces to secure the new device to the endotracheal tube. Nine mechanically ventilated patients admitted to the intensive care department of Shandong Public Health Clinical Center who underwent PDT between July 2023 and January 2024 have been treated with this novel imaging device. The number of medical staff members needed for the operation, number of needle interventions, operation time, arterial blood gas analysis, and intraoperative complications were observed. Results: Three medical staff were involved in the procedure: an operator, an assistant, and a nurse. The first attempted needle intervention was successful in all patients, and no serious complications such as major bleeding, pneumothorax, mediastinal emphysema, accidental extubation, desaturation, hypercarbia, respiratory acidosis, hemodynamic abnormality, or posterior tracheal puncture occurred. The average time was 11.63 ± 1.56 minutes from skin incision to the needle insertion and 4.43 ± 1.99 minutes from needle insertion to tracheal placement. Conclusions: PDT guided by the novel device is safe, preserves human resources, saves operating space, keeps the view stable, and makes the procedure easy. It is worthy of further research and application.
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