PDT, photodynamic therapy

PDT,光动力疗法
  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    甲状腺癌,作为最常见的内分泌癌症之一,近年来发病率激增。这很可能是由于其传统诊断方式缺乏特异性和准确性,导致甲状腺结节的过度诊断。虽然有几种治疗选择,它们仅限于手术和131I放射治疗,这些治疗具有显著的副作用,因此不能满足恶性程度非常高的未分化甲状腺癌的治疗需求.利用光吸收的光学成像,折射和散射特性,不仅观察细胞的结构和功能,组织,器官,甚至整个有机体来协助诊断,但也可用于进行光学治疗,以实现甲状腺癌的靶向非侵入性和精确治疗。这些筛选的应用,诊断,和治疗,赋予光学成像在甲状腺癌手术导航领域的潜力。在过去的十年里,光学成像在甲状腺癌诊断和治疗中的研究逐年增长,但是没有发表关于这个主题的全面评论。这里,我们回顾了光学成像在甲状腺癌诊断和治疗中应用的关键进展,并讨论了该技术在临床应用中的挑战和潜力。
    Thyroid cancer, as one of the most common endocrine cancers, has seen a surge in incidence in recent years. This is most likely due to the lack of specificity and accuracy of its traditional diagnostic modalities, leading to the overdiagnosis of thyroid nodules. Although there are several treatment options available, they are limited to surgery and 131I radiation therapy that come with significant side effects and hence cannot meet the treatment needs of anaplastic thyroid carcinoma with very high malignancy. Optical imaging that utilizes optical absorption, refraction and scattering properties, not only observes the structure and function of cells, tissues, organs, or even the whole organism to assist in diagnosis, but can also be used to perform optical therapy to achieve targeted non-invasive and precise treatment of thyroid cancer. These applications of screening, diagnosis, and treatment, lend to optical imaging\'s promising potential within the realm of thyroid cancer surgical navigation. Over the past decade, research on optical imaging in the diagnosis and treatment of thyroid cancer has been growing year by year, but no comprehensive review on this topic has been published. Here, we review key advances in the application of optical imaging in the diagnosis and treatment of thyroid cancer and discuss the challenges and potential for clinical translation of this technology.
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  • 文章类型: Journal Article
    UNASSIGNED:目的研究低通量光动力疗法(rf-PDT)治疗慢性中心性浆液性脉络膜视网膜病变(cCSC)的2年有效性。
    未经评估:回顾性队列研究。
    UNASSIGNED:从2007年5月至2017年6月,共纳入223例新诊断的cCSC伴活动性浆液性视网膜脱离(SRD)的连续患者,并随访至少2年。除白内障手术外,在招募开始前接受眼部治疗的患者和基线时黄斑新生血管形成的患者被排除在外。
    未经评估:所有患者都接受了全面的眼科评估,包括最佳矫正视力(BCVA)的测量,裂隙灯检查,扩张眼底检查,彩色眼底摄影,眼底自发荧光,荧光素血管造影,吲哚菁绿血管造影,和谱域OCT。应用逆概率加权(IPTW)方法来平衡接受rf-PDT(rf-PDT组)的患者和未接受治疗(对照)的患者之间的18个基线特征。进行治疗加权生存的逆概率分析和回归。
    UNASSIGNED:与基线视力(VA)相比,24个月时BCVA相同或改善的患者比例(VA维持率)。
    未经证实:共分析了155只眼(rf-PDT组:74只;对照:81只)。IPTW后患者的背景平衡良好,标准化差异<0.10。IPTW回归分析显示,rf-PDT组的VA维持率明显高于对照组(93.6%vs.70.9%,P<0.001,12个月;85.7%vs.69.8%,P=0.019,24个月)。rf-PDT组倾向于表现出更好的VA改善,但没有统计学意义(-0.06vs.-0.008,P=0.07,12个月;-0.06vs.-0.03,P=0.32,24个月)。IPTWCox回归显示rf-PDT组SRD完全缓解率显著较高(风险比,5.05;95%置信区间,3.24-7.89;P<0.001)。
    UNASSIGNED:该研究表明rf-PDT对cCSC的有益作用,既可以维持VA,也可以提高临床上SRD完全缓解的比例。
    UNASSIGNED: To investigate the 2-year effectiveness of reduced-fluence photodynamic therapy (rf-PDT) for chronic central serous chorioretinopathy (cCSC).
    UNASSIGNED: Retrospective cohort study.
    UNASSIGNED: A total of 223 consecutive patients with newly diagnosed cCSC with active serous retinal detachment (SRD) were included from May 2007 to June 2017 and followed up for at least 2 years. Patients who underwent ocular treatment other than cataract surgery before the beginning of recruitment and those who had macular neovascularization at baseline were excluded.
    UNASSIGNED: All patients underwent a comprehensive ophthalmic evaluation, including measurements of best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and spectral-domain OCT. An inverse probability of treatment weighting (IPTW) methodology was applied to balance 18 baseline characteristics between patients who received rf-PDT (rf-PDT group) and those who did not receive treatment (controls). Inverse probability of treatment weighting survival analysis and regression were performed.
    UNASSIGNED: The proportion of patients whose BCVA at 24 months was the same or improved compared with the baseline visual acuity (VA) (VA maintenance rate).
    UNASSIGNED: A total of 155 eyes (rf-PDT group: 74; controls: 81) were analyzed. The patients\' backgrounds were well balanced after IPTW with standardized differences of < 0.10. An IPTW regression analysis revealed that the VA maintenance rate was significantly higher in the rf-PDT group than in the controls (93.6% vs. 70.9%, P < 0.001, 12 months; 85.7% vs. 69.8%, P = 0.019, 24 months). The rf-PDT group tended to show better VA improvement, but was not statistically significant (-0.06 vs. -0.008, P = 0.07, 12 months; -0.06 vs. -0.03, P = 0.32, 24 months). An IPTW Cox regression showed a significantly higher rate of complete SRD remission in the rf-PDT group (hazard ratio, 5.05; 95% confidence interval, 3.24-7.89; P < 0.001).
    UNASSIGNED: The study suggests the beneficial effect of rf-PDT for cCSC for both VA maintenance and higher proportion of complete SRD remission in the clinical setting.
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  • 文章类型: Journal Article
    UNASSIGNED:评估症状性黄斑息肉状脉络膜血管病变(PCV)患者治疗过程中息肉状病变的状态和演变。
    UNASSIGNED:多中心随机选择患者的比较队列研究,随机对照临床试验。
    UNASSIGNED:从EVERESTII研究中随机选择的30名患者接受雷珠单抗和维替泊芬光动力疗法(n=15)或雷珠单抗单药疗法(n=15)联合治疗。
    UNASSIGNED:所有患者在基线时进行随机分组,并采用标准化治疗方案进行治疗。在基线和第3、6、12和24个月,在中央阅读中心对吲哚菁绿血管造影(ICGA)图像进行分级。在随后的访问中将基线时存在的息肉状病变覆盖在ICGA图像上,以确定这些病变是否仍然灌注或完全消退。类似地跟踪在随后的访问中出现的新息肉状病变,以详细说明每个息肉状病变的演变。
    未经证实:息肉样病变随时间完全消退。
    UNASSIGNED:在所有就诊时,联合治疗组的息肉样病变完全消退高于单一治疗组(12个月,15例患者中的12例[80%]vs.14例患者中有5例[35.7%];P=0.016)。在联合治疗组中,基线息肉样病变的持续时间较低:在12个月时,15名患者中有1名(6.7%),而单药治疗组中有14名患者中有7名(50%)。在较早时间点完全消退的息肉样病变的复发并不常见:联合治疗组为0%,单一治疗组为6和12个月时各1名患者。在所有访问中,联合治疗组中发现的新息肉样病变(在基线访问后出现)较少(联合治疗:15个中的2个[13.3%]与单一疗法:14只眼中的4只眼[28.6%]在12个月时)。在整个研究过程中,与单药治疗组相比,联合治疗组的息肉状病变总面积明显较小(0.013mm2vs.0.110mm2;12个月时P<0.01)。
    UNASSIGNED:与单药治疗相比,联合治疗与更高的息肉样病变完全性消退率和更少的持续性息肉样病变相关。闭合性息肉样病变很少再开放,不管治疗。
    UNASSIGNED: To evaluate the status and evolution of polypoidal lesions during the course of treatment of patients with symptomatic macular polypoidal choroidal vasculopathy (PCV).
    UNASSIGNED: Comparative cohort study of randomly selected patients from a multicenter, randomized controlled clinical trial.
    UNASSIGNED: Thirty randomly selected patients from the EVEREST II study who were treated with combination ranibizumab and verteporfin photodynamic therapy (n = 15) or ranibizumab monotherapy (n = 15).
    UNASSIGNED: All patients were randomized at baseline and treated with a standardized treatment protocol. Indocyanine green angiography (ICGA) images were graded at the central reading center at baseline and months 3, 6, 12, and 24. Polypoidal lesions present at baseline were overlaid on ICGA images at subsequent visits to determine if these remained perfused or had regressed completely. New polypoidal lesions occurring at subsequent visits were similarly tracked to detail the evolution of each polypoidal lesion.
    UNASSIGNED: Complete polypoidal lesion regression over time.
    UNASSIGNED: Complete polypoidal lesion regression was higher in the combination therapy group compared with the monotherapy group at all visits (month 12, 12 of 15 patients [80%] vs. 5 of 14 patients [35.7%]; P = 0.016). Persistence of baseline polypoidal lesions was lower in the combination therapy group: 1 of 15 patients (6.7%) versus 7 of 14 patients (50%) in the monotherapy group at month 12. Recurrences of polypoidal lesions that had regressed completely at an earlier time point were uncommon: 0% in the combination therapy group and 1 patient each at months 6 and 12 in the monotherapy group. Fewer new polypoidal lesions (arising after the baseline visit) were found in the combination therapy group at all visits (combination therapy: 2 of 15 [13.3%] vs. monotherapy: 4 of 14 eyes [28.6%] at month 12). Total polypoidal lesion area was significantly smaller in the combination therapy group compared with the monotherapy group throughout the study (0.013 mm2 vs. 0.110 mm2; P < 0.01 at month 12).
    UNASSIGNED: Combination therapy was associated with higher rates of complete polypoidal lesion regression and fewer persistent polypoidal lesions compared with monotherapy. Closed polypoidal lesions rarely reopened, regardless of the treatment.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    光热疗法具有微创的特点,可控性,效率高,特异性强,能有效弥补传统药物治疗带来的毒副作用和肿瘤耐药性。然而,由于红外光的组织穿透力有限,很难在临床上推广应用。眼睛是人类唯一的透明组织,红外光可以很容易地穿透眼睛组织,因此光热疗法有望用于治疗眼底疾病。在这里,由脂质体和吲哚菁绿(ICG)组装而成的新型纳米平台用于治疗视网膜母细胞瘤.将ICG组装在脂质体中以克服ICG本身的一些问题。例如,ICG很容易淬火,自我聚集和不稳定。此外,脂质体可以防止游离ICG通过体循环被清除。纳米平台的构建不仅保证了ICG在体内的稳定性,而且还实现了成像引导光热治疗,这创造了一种治疗视网膜母细胞瘤的新策略。
    Photothermal therapy has the characteristics of minimal invasiveness, controllability, high efficiency, and strong specificity, which can effectively make up for the toxic side effects and tumor resistance caused by traditional drug treatment. However, due to the limited tissue penetration of infrared light, it is difficult to promote and apply in clinical practice. The eye is the only transparent tissue in human, and infrared light can easily penetrate the eye tissue, so it is expected that photothermal therapy can be used to treat fundus diseases. Here in, a new nano-platform assembled by liposome and indocyanine green (ICG) was used to treat retinoblastoma. ICG was assembled in liposomes to overcome some problems of ICG itself. For example, ICG is easily quenched, self-aggregating and instability. Moreover, liposomes can prevent free ICG from being cleared through the systemic circulation. The construction of the nano-platform not only ensured the stability of ICG in vivo, but also realized imaging-guide photothermal therapy, which created a new strategy for the treatment of retinoblastoma.
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  • 文章类型: Journal Article
    虽然作为癌症治疗的主要模式,放疗(RT)的临床效果尚不能满足癌症患者的需要。开发肿瘤优先放射增敏剂或将RT与其他治疗结合已被认为是增强RT功效的高度必要的。本研究报道了一种多功能生物活性小分子(称为IR-83),同时表现出肿瘤优先积累,近红外成像和无线电/光动力/光热治疗效果。IR-83是通过将2-硝基咪唑作为放射增敏剂引入具有肿瘤靶向和光敏作用的七甲基花青染料的框架中来设计和合成的。作为结果,IR-83优先积累在肿瘤中,通过整合放射/光动力/光热多模式疗法抑制肿瘤生长和转移。机制研究表明,IR-83在癌细胞线粒体中积累,诱导过量的活性氧(ROS),激光照射后产生高热。一方面,这些现象导致线粒体功能障碍和氧化磷酸化急剧下降,从而减少了组织耗氧量。另一方面,线粒体中过量的ROS通过下调细胞内抗氧化系统来破坏抗氧化剂的平衡和氧化应激平衡,随后敏化电离辐射产生不可逆的DNA双链断裂。因此,这项研究提出了一种有前景的放射增敏剂和一种新的替代策略,通过线粒体靶向多模式协同治疗增强RT疗效.
    Although as a mainstay modal for cancer treatment, the clinical effect of radiotherapy (RT) does not yet meet the need of cancer patients. Developing tumour-preferential radiosensitizers or combining RT with other treatments has been acknowledged highly necessary to enhance the efficacy of RT. The present study reported a multifunctional bioactive small-molecule (designated as IR-83) simultaneously exhibiting tumour-preferential accumulation, near-infrared imaging and radio/photodynamic/photothermal therapeutic effects. IR-83 was designed and synthesized by introducing 2-nitroimidazole as a radiosensitizer into the framework of heptamethine cyanine dyes inherently with tumour-targeting and photosensitizing effects. As results, IR-83 preferentially accumulated in tumours, suppressed tumour growth and metastasis by integrating radio/photodynamic/photothermal multimodal therapies. Mechanism studies showed that IR-83 accumulated in cancer cell mitochondria, induced excessive reactive oxygen species (ROS), and generated high heat after laser irradiation. On one hand, these phenomena led to mitochondrial dysfunction and a sharp decline in oxidative phosphorylation to lessen tissue oxygen consumption. On the other hand, excessive ROS in mitochondria destroyed the balance of antioxidants and oxidative stress balance by down-regulating the intracellular antioxidant system, and subsequently sensitized ionizing radiation-generated irreversible DNA double-strand breaks. Therefore, this study presented a promising radiosensitizer and a new alternative strategy to enhance RT efficacy via mitochondria-targeting multimodal synergistic treatment.
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  • 文章类型: Journal Article
    视频1光动力疗法治疗肝门部胆管导管内乳头状瘤1例。
    Video 1Photodynamic therapy for hepatic hilar intraductal papillary neoplasm of the bile duct: a case report.
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  • 文章类型: Journal Article
    炎症性关节炎是老年人致残的主要原因。这种情况会导致关节疼痛,功能丧失,生活质量下降,主要是由于骨关节炎(OA)和类风湿性关节炎(RA)。目前,炎性关节炎的可用治疗选择包括口服抗炎药,topic,或关节内路线,手术,和身体康复。治疗炎症性关节炎的新替代方法,到目前为止,由于灾难性的经济负担和微不足道的治疗益处,仍然是巨大的挑战。鉴于非靶向的全身细胞毒性和药物治疗的生物利用度有限,一个主要关注的问题是使用纳米材料建立刺激响应性药物递送系统,在生物医学应用中具有开关潜力.这篇综述总结了取决于各种内部刺激(包括还原-氧化(氧化还原),pH值,和酶)和外部刺激(包括温度,超声(美国),磁性,照片,电压,和机械摩擦)。该综述还探讨了基于病理变化使用刺激响应性纳米材料来管理炎症性关节炎的进展和挑战。包括软骨退化,滑膜炎,软骨下骨破坏.暴露于由这种组织病理学改变引起的适当刺激可以触发治疗药物的释放。在炎性关节炎的关节靶向治疗中势在必行。
    Inflammatory arthritis is a major cause of disability in the elderly. This condition causes joint pain, loss of function, and deterioration of quality of life, mainly due to osteoarthritis (OA) and rheumatoid arthritis (RA). Currently, available treatment options for inflammatory arthritis include anti-inflammatory medications administered via oral, topical, or intra-articular routes, surgery, and physical rehabilitation. Novel alternative approaches to managing inflammatory arthritis, so far, remain the grand challenge owing to catastrophic financial burden and insignificant therapeutic benefit. In the view of non-targeted systemic cytotoxicity and limited bioavailability of drug therapies, a major concern is to establish stimuli-responsive drug delivery systems using nanomaterials with on-off switching potential for biomedical applications. This review summarizes the advanced applications of triggerable nanomaterials dependent on various internal stimuli (including reduction-oxidation (redox), pH, and enzymes) and external stimuli (including temperature, ultrasound (US), magnetic, photo, voltage, and mechanical friction). The review also explores the progress and challenges with the use of stimuli-responsive nanomaterials to manage inflammatory arthritis based on pathological changes, including cartilage degeneration, synovitis, and subchondral bone destruction. Exposure to appropriate stimuli induced by such histopathological alterations can trigger the release of therapeutic medications, imperative in the joint-targeted treatment of inflammatory arthritis.
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  • 文章类型: Case Reports
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