thermotherapy

热疗
  • 文章类型: Journal Article
    尽管在手术后实施了多模式治疗,胶质母细胞瘤(GBM)仍然是一种无法治愈的疾病,在神经肿瘤学中构成重大挑战。在这种临床环境中,局部治疗(LT),一个发展中的范式,随着时间的推移,由于其克服GBM常规治疗选择的缺点的潜力而受到了极大的关注。本综述旨在追溯历史发展,突出当代的进步,并提供对LT在GBM管理中的未来视野的见解。符合系统审查和荟萃分析方案标准的首选报告项目,我们对LT在GBM管理中的作用进行了系统综述.共发现2,467篇潜在相关文章,删除副本后,通过标题和摘要筛选了2,007项研究(科恩κ系数=0.92)。总的来说,有15、10和6项临床研究探讨了术中局部治疗方式的临床效率,局部放疗和局部免疫治疗,分别。在80%的病例中,GBM复发发生在辐射场的2厘米范围内,强调局部因素对复发的显著影响。这突出了对LT战略的迫切需要。总的来说,因此,近几十年来,三个主要原因导致了许多LT解决方案的发展:i)肿瘤内植入物允许绕过血脑屏障,导致有限的全身毒性;ii)LT促进手术和标准治疗之间的桥接治疗;和iii)考虑到GBM的复杂性,通过对各种元素具有特异性的配体靶向肿瘤微环境的多种成分可能在治疗中具有协同作用。考虑到GBM的时空异质性,在精准医学时代,通过联合治疗策略可以显著改善疾病预后.
    Despite the implementation of multimodal treatments after surgery, glioblastoma (GBM) remains an incurable disease, posing a significant challenge in neuro-oncology. In this clinical setting, local therapy (LT), a developing paradigm, has received significant interest over time due to its potential to overcome the drawbacks of conventional therapy options for GBM. The present review aimed to trace the historical development, highlight contemporary advances and provide insights into the future horizons of LT in GBM management. In compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols criteria, a systematic review of the literature on the role of LT in GBM management was conducted. A total of 2,467 potentially relevant articles were found and, after removal of duplicates, 2,007 studies were screened by title and abstract (Cohen\'s κ coefficient=0.92). Overall, it emerged that 15, 10 and 6 clinical studies explored the clinical efficiency of intraoperative local treatment modalities, local radiotherapy and local immunotherapy, respectively. GBM recurrences occur within 2 cm of the radiation field in 80% of cases, emphasizing the significant influence of local factors on recurrence. This highlights the urgent requirement for LT strategies. In total, three primary reasons have thus led to the development of numerous LT solutions in recent decades: i) Intratumoral implants allow the blood-brain barrier to be bypassed, resulting in limited systemic toxicity; ii) LT facilitates bridging therapy between surgery and standard treatments; and iii) given the complexity of GBM, targeting multiple components of the tumor microenvironment through ligands specific to various elements could have a synergistic effect in treatments. Considering the spatial and temporal heterogeneity of GBM, the disease prognosis could be significantly improved by a combination of therapeutic strategies in the era of precision medicine.
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  • 文章类型: Journal Article
    我们的目标是比较水蒸气疗法(Rezüm)的疗效和安全性,经尿道针消融术(TUNA)和经尿道微波治疗(TUMT)用于治疗有中度至重度良性前列腺增生(BPH)症状的男性。
    PubMed/MEDLINE,从开始到2023年7月30日搜索EMBASE和Cochrane图书馆,然后进行参考搜索和双重独立研究选择。我们只分析了随机临床试验。RoB-2,NIH质量评估工具和GRADE指南用于证据质量(QoE)评估。纳入了没有严重偏倚风险的相关前瞻性研究。
    在12个月时,Rez表现出与TUNA和TUMT相似的疗效,以改善国际前列腺症状评分-Rezüm与TUMT:1.33分(95%CI:-1.66至4.35)有利于TUMT(QoE:中度),Rezüm与TUNA:0.07分(95%CI:-3.64至3.88)有利于TUNA(QoE:低)。Rezum在最大峰值流速(Qmax)方面与TUNA和TUMT具有相似的结果:Rezüm与TUMT:1.05mL/s(95%CI:-4.88至2.82)有利于Rezüm(QoE:低)和Rezüm与TUNA:0.37mL/s(95%CI:-4.61至4.21)有利于TUNA(QoE:低)此外,后空隙剩余体积(PVR)比较表明Rezüm相似,或在12个月时不如其他技术-Rezüm与TUMT:11.20mL(95%CI:-32.40至10.30)有利于TUMT(QoE:低),Rezüm与TUNA:24.10mL(95%CI:2.81至45.10)有利于TUNA(QoE:低)。Rezüm与TUMT和TUNA的手术再治疗率也相似,长达3年-TUMT与RezümRR:1.21(95%CI:0.20至15.90)(QoE:低),TUNA与Rezüm显示RR:1.81(95%CI:0.2至24.60)(QoE:低)。在治疗后的前12个月,Rezüm的严重不良事件发生率(Clavien-Dindo≥3级)高于TUMT和TUNA。TUMT与Rezüm的RR=0.53(95%CI:0.13至3.14)(QoE:低),TUNA与Rezüm的RR=0.38(95%CI:0.04至3.49)(QoE:低)。
    中度至微弱的证据表明,在所有研究领域中,Rezüm并不优于TUNA和TUMT。
    UNASSIGNED: We aim to compare efficacy and safety of water vapour therapy (Rezūm), transurethral needle ablation (TUNA) and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms.
    UNASSIGNED: PubMed/MEDLINE, EMBASE and Cochrane Library were searched from inception to 30 July 2023, followed by reference searching and dual-independent study selection. We analysed only randomized clinical trials. RoB-2, NIH-quality assessment tool and GRADE guidelines were used for quality-of-evidence (QoE) assessment. Relevant prospective studies without a critical risk-of-bias were included.
    UNASSIGNED: At 12 months, Rezūm showed similar efficacy to TUNA and TUMT for improvement in International Prostate Symptoms Score - Rezūm versus TUMT: 1.33 points (95% CI: -1.66 to 4.35) favouring TUMT (QoE: Moderate) and Rezūm versus TUNA: 0.07 points (95% CI: -3.64 to 3.88) favouring TUNA (QoE: Low). Rezum had similar outcomes to TUNA and TUMT for Maximum Peak-Flow Rate (Qmax): Rezūm versus TUMT: 1.05 mL/s (95% CI: -4.88 to 2.82) favouring Rezūm (QoE: Low) and Rezūm versus TUNA: 0.37 mL/s (95% CI: -4.61 to 4.21) favouring TUNA (QoE: Low). Furthermore, post-void residual volume (PVR) comparisons demonstrated that Rezūm was similar, or inferior to other techniques at 12 months - Rezūm versus TUMT: 11.20 mL (95% CI: -32.40 to 10.30) favouring TUMT (QoE: Low) and Rezūm versus TUNA: 24.10 mL (95% CI: 2.81 to 45.10) favouring TUNA (QoE: Low). Rezūm also had a similar surgical retreatment rate with TUMT and TUNA up to 3-years - TUMT versus Rezūm RR: 1.21 (95% CI: 0.20 to 15.90) (QoE: Low) and TUNA versus Rezūm showed RR: 1.81 (95% CI: 0.2 to 24.60) (QoE: Low). In the first 12 months after treatment, Rezūm had a higher rate of serious adverse events (Clavien-Dindo ≥ Grade 3) than TUMT and TUNA. TUMT versus Rezūm with RR = 0.53 (95% CI: 0.13 to 3.14) (QoE: Low) and TUNA versus Rezūm with RR = 0.38 (95% CI: 0.04 to 3.49) (QoE: Low).
    UNASSIGNED: Moderate to weak evidence suggests that Rezūm is not superior to TUNA and TUMT in all domains studied.
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  • 文章类型: Journal Article
    由癌细胞侵袭形成的门静脉癌栓(PVTT)是肝细胞癌(HCC)高死亡率的主要原因,手术后植入物表面的细菌定植会加速血栓的形成。在这项工作中,在镍钛合金上原位构建了聚吡咯包覆的载砷层状双氢氧化物膜,以通过热疗协同化学疗法有效杀死肿瘤细胞。聚吡咯良好的近红外光热转化能力使样品表面温度在低光热功率(0.5w/cm2)下升高至约51°C,而升高的温度可以进一步加速药物砷的释放。此外,当未施加NIR光时,聚吡咯涂层还巧妙地充当“屏障层”,以减少正常组织中砷的自然释放,从而避免毒性问题。体内和体外实验表明,该平台表现出优异的抗肿瘤和抗菌能力。与纳米治疗药物的全身循环相关的全身毒性问题相反,这种原位功能膜有望用于精确药物输送的局部干预,也更适合PVTT手术中的手术治疗方案。
    Portal vein tumor thrombus (PVTT) formed by cancer cell invasion is a major cause of high mortality in hepatocellular carcinoma (HCC), and the formation of thrombus will be accelerated by bacterial colonization on the surface of the implant after surgery. In this work, Polypyrrole-coated arsenic-loaded layered double hydroxide films were in situ constructed on the nickel-titanium alloy for the efficient killing of tumour cells by thermo-therapeutic synergistic chemotherapy. The good near-infrared photothermal conversion ability of polypyrrole enables the sample surface temperature to be raised to about 51 °C at a low photothermal power (0.5 w/cm2), while the elevated temperature could further accelerate the release of drug arsenic. In addition, when NIR light is not applied, the polypyrrole coating also cleverly acts as a \"barrier layer\" to reduce the natural release of arsenic in normal tissues to avoid toxicity issues. In vivo and in vitro experiments have demonstrated that the platform exhibits excellent antitumor and antibacterial abilities. In contrast to the systemic toxicity issues associated with systemic circulation of nanotherapeutic drugs, this in situ functional film is expected to be used in localised interventions for precise drug delivery, and is also more suitable for surgical treatment scenarios in PVTT surgeries.
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  • 文章类型: Journal Article
    如今,可穿戴设备产生的不断增加的电磁波正在成为人类健康的新兴问题,因此,对可拉伸的电磁干扰(EMI)屏蔽材料的要求很高。大象树干能够抓住脆弱的植被和撕裂树木,这不仅归功于它们的肌肉,也归功于它们折叠的皮肤。灵感来自大象树干的皱纹皮肤,在这里,我们提出了一种基于单壁碳纳米管(SWCNT)的闪烁导电膜,用于多功能EMI应用。导电膜具有夹层结构,通过在拉伸的弹性乳胶圆柱形基材的两侧涂覆SWCNTs来制备。收缩引起的扭曲导电网络可以承受高达200%的拉伸应变。通常,当拉伸方向平行于电场的极化方向时,在200%的拉伸应变下,总的EMI屏蔽效率可以令人惊讶地从38.4增加到52.7dB。这主要是由SWCNT的连接增加造成的。此外,该薄膜在多个电压下也具有良好的焦耳加热性能,能够释放受伤关节的疼痛。这种独特的特性使得应变可调的多功能EMI屏蔽和可穿戴的热疗应用成为可能。
    Nowadays, the increasing electromagnetic waves generated by wearable devices are becoming an emerging issue for human health, so stretchable electromagnetic interference (EMI) shielding materials are highly demanded. Elephant trunks are capable of grabbing fragile vegetation and tearing trees thanks not only to their muscles but also to their folded skins. Inspired by the wrinkled skin of the elephant trunks, herein, we propose a winkled conductive film based on single-walled carbon nanotubes (SWCNTs) for multifunctional EMI applications. The conductive film has a sandwich structure, which was prepared by coating SWCNTs on both sides of the stretched elastic latex cylindrical substrate. The shrinking-induced winkled conductive network could withstand up to 200% tensile strain. Typically, when the stretching direction is parallel to the polarization direction of the electric field, the total EMI shielding effectiveness could surprisingly increase from 38.4 to 52.7 dB at 200% tensile strain. It is mainly contributed by the increased connection of the SWCNTs. In addition, the film also has good Joule heating performance at several voltages, capable of releasing pains in injured joints. This unique property makes it possible for strain-adjustable multifunctional EMI shielding and wearable thermotherapy applications.
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  • 文章类型: Journal Article
    虽然关节软骨的适度热刺激发挥软骨保护作用,传统方法难以有效加热深关节软骨。光敏剂使用近红外(NIR)辐射提高环境温度,具有高组织渗透性。我们假设关节内施用光敏剂和NIR照射会对关节软骨产生更大的加热作用。我们旨在评估该方法对培养的软骨细胞和大鼠膝关节软骨的加热效果。体外,我们用近红外辐照含光敏剂的介质,并测量介质温度的变化,细胞毒性,以及热休克蛋白(HSP)70和聚集蛋白聚糖(ACAN)的基因表达。在体内,用NIR照射用光敏剂治疗的大鼠的膝关节,测量关节内温度和基因表达的变化,除了组织学分析。结果表明,培养基和关节内温度升高至约40°C,关节软骨无明显破坏或软骨细胞中HSP70的免疫组织化学增强染色。HSP70和ACAN的基因表达在培养和关节软骨中均增加。总之,该方法可以通过诱导关节软骨中HSP70的表达来安全地加热关节并增强软骨代谢。它提出了一种新的热疗疗法,具有有效的软骨保护作用。
    Although the moderate thermal stimulation of articular cartilage exerts chondroprotective effects, it is difficult to effectively heat deep articular cartilage with conventional methods. Photosensitizers increase the ambient temperature using near-infrared (NIR) radiation, which has high tissue permeability. We hypothesized that the intra-articular administration of photosensitizers and NIR irradiation would exert a greater heating effect on articular cartilage. We aimed to evaluate the heating effect of this method on cultured chondrocytes and rat knee cartilage. In vitro, we irradiated a photosensitizer-containing medium with NIR and measured changes in the medium temperature, cytotoxicity, and gene expression of heat shock protein (HSP) 70 and aggrecan (ACAN). In vivo, the knee joints of rats treated with photosensitizers were irradiated with NIR, and changes in intra-articular temperature and gene expression were measured, alongside histological analysis. The results showed that the medium and intra-articular temperature were raised to approximately 40 °C with no apparent disruption to articular cartilage or the immunohistochemically enhanced staining of HSP70 in chondrocytes. The gene expression of HSP70 and ACAN was increased in both cultured and articular cartilage. In summary, this method can safely heat joints and enhance cartilage metabolism by inducing HSP70 expression in articular cartilage. It presents a new hyperthermia therapy with effective cartilage protection.
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  • 文章类型: Journal Article
    激光间质热疗是神经外科治疗颅内肿瘤的一种微创治疗选择,包括复发性胶质瘤.该技术采用靶组织的热消融来实现肿瘤控制,并通过磁共振测温实时监测肿瘤的范围,允许对病变进行有针对性的热损伤。激光间质热疗作为复发性神经胶质瘤的治疗选择,由于其微创性质,已经引起了人们的兴趣。更短的恢复时间,即使在患有多种合并症的患者中也能使用,并有可能提供局部肿瘤控制。它可以用作独立治疗或与其他疗法结合使用,如化疗或放疗。我们描述了有关多项研究和病例报告的最新更新,这些研究和病例报告已评估了激光间质热疗对复发性胶质瘤的疗效和安全性。这些研究报告了不同的结果,在肿瘤控制和患者生存方面,一些人证明了有希望的结果,而其他人则表现出不同的结果。激光间质热疗的成功取决于各种因素,包括肿瘤特征,患者选择,以及手术团队的经验,但是未来复发胶质瘤的治疗方向将包括联合治疗方法,包括激光间质热疗,特别是在深层的大脑区域。需要精心设计的前瞻性研究来确定激光间质热疗在复发性神经胶质瘤治疗中的作用。
    Laser Interstitial Thermotherapy is a minimally invasive treatment option in neurosurgery for intracranial tumors, including recurrent gliomas. The technique employs the thermal ablation of target tissue to achieve tumor control with real-time monitoring of the extent by magnetic resonance thermometry, allowing targeted thermal injury to the lesion. Laser Interstitial Thermotherapy has gained interest as a treatment option for recurrent gliomas due to its minimally invasive nature, shorter recovery times, ability to be used even in patients with numerous comorbidities, and potential to provide local tumor control. It can be used as a standalone treatment or combined with other therapies, such as chemotherapy or radiation therapy. We describe the most recent updates regarding several studies and case reports that have evaluated the efficacy and safety of Laser Interstitial Thermotherapy for recurrent gliomas. These studies have reported different outcomes, with some demonstrating promising results in terms of tumor control and patient survival, while others have shown mixed outcomes. The success of Laser Interstitial Thermotherapy depends on various factors, including tumor characteristics, patient selection, and the experience of the surgical team, but the future direction of treatment of recurrent gliomas will include a combined approach, comprising Laser Interstitial Thermotherapy, particularly in deep-seated brain regions. Well-designed prospective studies will be needed to establish with certainty the role of Laser Interstitial Thermotherapy in the treatment of recurrent glioma.
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    文章类型: Journal Article
    The formation of pathological scars is a common medical and aesthetic problem worldwide. Surgical interventions, burns and injuries are the most common cause. Treating these scars is a challenge for any surgeon. The Clinic of Plastic-Reconstructive and Aesthetic Surgery with Thermal Trauma and Imaging Diagnostics applied an innovative method of thermotherapy with high-intensity, focused ultrasound in 20 patients with hypertrophic scars and keloids of different age, etiology and parameters. After a series of procedures, we got excellent results, reducing scar size, pigmentation, pain and itching. This type of thermotherapy is successfully applied to pathological scars. In this way, a change in scar density is achieved by converting hard collagen into a gelatin-like mass.As a subsequent procedure, moderately compressive massages are applied for faster resorption of the pathological collection. Our results show that high-intensity focused ultrasound thermotherapy of pathological scars is a non-invasive method of treatment with reasonably good results as regards both aesthetic and functional aspects.
    Les cicatrices pathologiques sont un problème médical et esthétique ubiquitaire, rencontré principalement après traumatisme, brûlure ou intervention chirurgicale, dont le traitement est un défi pour tout chirurgien. Le service de chirurgie plastique, reconstructrice et esthétique a utilisé une méthode innovante de thermothérapie par ultrasons à haute intensité focalisés pour traiter les cicatrices hypertrophiques ou chéloïdes, d’origine variée, de 20 patients. Après une série de procédures, nous avons obtenu d’excellents résultats sur la taille, la pigmentation, la douleur et le prurit. Cette technique permet de transformer les fibres collagènes en une masse gélatineuse, qui se résorbe plus rapidement après massages. La thermothérapie ultrasonique focalisée à haute intensité est une méthode non invasive de traitement des cicatrices pathologiques qui donne des résultats corrects, tant du point de vue esthétique que fonctionnel.
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  • 文章类型: Journal Article
    Soft materials are crucial for epidermal interfaces in biomedical devices due to their capability to conform to the body compared to rigid inorganic materials. Gels, liquids, and polymers have been extensively explored, but they lack sufficient electrical and thermal conductivity required for many application settings. Gallium-based alloys are molten metals at room temperature with exceptional electrical and thermal conductivity. These liquid metals and their composites can be directly applied onto the skin as interface materials. In this Spotlight on Applications, we focus on the rapidly evolving field of liquid metal-enabled epidermal interfaces featuring unique physical properties beyond traditional gels and polymers. We delve into the role of liquid metal in electrical and thermal biointerfaces in various epidermal applications. Current challenges and future directions in this active area are also discussed.
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  • 文章类型: Journal Article
    这项研究的目的是研究远红外(FIR)热量对老年人生活质量(QOL)的影响。参与者被分配到对流热组(CON)或对流和FIR组。参与者收到了六个,在三周的时间内进行30分钟的加热。前和后评估包括活动范围等物理措施,步态速度,定时和去,和手的握力。标准化问卷用于确定疼痛严重程度及其对日常生活的干扰,疼痛对整体生活质量的影响。疼痛严重程度显着降低(从3.31到2.5,p<.05)在FIR组,和疼痛干扰显着降低(从1.26到0.43,p<0.05)在CON组。研究结果表明,随着时间的推移,热疗可以成功地减轻疼痛。
    The purpose of this study was to examine the effects of far-infrared (FIR) heat on quality of life (QOL) in older adults. Participants were assigned to either a convective heat group (CON) or a convective and FIR group. Participants received six, 30-min heat sessions over the course of three weeks. Pre- and post-assessments included physical measures such as range of motion, gait speed, Timed Up and Go, and hand grip strength. Standardized questionnaires were used to determine pain severity and its interference with daily life, and the impact pain had on overall QOL. Pain severity was significantly reduced (from 3.31 to 2.5, p < .05) in the FIR group from pre-to-post, and pain interference was significantly reduced (from 1.26 to 0.43, p < .05) in the CON group from pre-to-post testing. Findings suggest that heat therapy was successful in reducing pain over time.
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  • 文章类型: Journal Article
    pome水果作物的可持续生产取决于无病毒种植材料。来自病毒和类病毒阴性来源的植物的生产和分布不仅对于控制pome果实病毒病而且对于可持续的育种活动都是必要的。以及植物材料的安全跨境移动。随着成功率的变化,不同的体外技术,包括茎尖培养,微接枝,热疗,化疗,和射击尖端冷冻疗法,已被用来消除pome水果中的病毒。通过组合这些技术中的两种或更多种实现了更高的病原体根除效率。确认完全消除病毒的准确诊断对于制定有效的管理策略至关重要。近年来,相当大的努力产生了新的可靠和有效的病毒检测方法。这篇全面的综述记录了生产健康pome果实植物的生物技术方法的发展和最新进展。
    Sustainable production of pome fruit crops is dependent upon having virus-free planting materials. The production and distribution of plants derived from virus- and viroid-negative sources is necessary not only to control pome fruit viral diseases but also for sustainable breeding activities, as well as the safe movement of plant materials across borders. With variable success rates, different in vitro-based techniques, including shoot tip culture, micrografting, thermotherapy, chemotherapy, and shoot tip cryotherapy, have been employed to eliminate viruses from pome fruits. Higher pathogen eradication efficiencies have been achieved by combining two or more of these techniques. An accurate diagnosis that confirms complete viral elimination is crucial for developing effective management strategies. In recent years, considerable efforts have resulted in new reliable and efficient virus detection methods. This comprehensive review documents the development and recent advances in biotechnological methods that produce healthy pome fruit plants. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.
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