thulium

Thulium
  • 文章类型: Journal Article
    比较thus光纤激光(TFL)和钬:钇-铝-石榴石(Ho:YAG)激光在半刚性输尿管镜下治疗输尿管结石的疗效和安全性。
    在2020年1月至2021年12月的一项前瞻性研究中,我们比较了每组40例接受半刚性输尿管镜下TFL碎石术和Ho:YAG激光碎石术的患者。石材体积,石材密度,碎石率,总激射时间,总手术时间,内窥镜视觉,分析并比较两组患者的逆行率和结石游离率。
    TFL组和Ho:YAG激光组的平均结石体积相当(282.45[标准偏差,SD139.79]mm3与279.49[标准差312.52]mm3;p=0.964)。TFL组和Ho:YAG激光组的平均结石密度也相当(1135.30[SD317.04]Hounsfield单位与1131.75[SD283.03]亨氏单位;p=0.959)。在TFL组和Ho:YAG激光组中,以结石体积除以激光时间计算的平均结石破碎率为25.85(SD10.61)mm3/min和21.37(SD14.13)mm3/min,分别(p=0.113)。平均总激射时间(10.15[SD]4.69minvs.11.43[SD4.56]min;p=0.222),平均手术时间(25.13[SD9.51]minvs.25.54[SD10.32]min;p=0.866),和平均总住院时间(2.62[SD0.77]天vs.2.61[SD0.84]天;p=0.893)在TFL组和Ho:YAG组中具有可比性。TFL组视力较好,逆行较少。TFL组术后1个月的结石清除率略好(100%vs.90%;p=0.095)。
    TFL技术与可比的总手术时间相关,总激射时间,Ho:YAG激光碎石率。然而,TFL具有更好的内窥镜视觉,较小的石头逆行,和稍微更好的无石率。
    UNASSIGNED: To compare the efficacy and safety of thulium fiber laser (TFL) and holmium:yttrium-aluminum-garnet (Ho:YAG) laser for ureteric stone management with semi-rigid ureteroscopy.
    UNASSIGNED: In a prospective study from January 2020 to December 2021, we compared 40 patients in each group who underwent semi-rigid ureteroscopic lithotripsy with TFL and that with Ho:YAG laser. Stone volume, stone density, stone fragmentation rates, total lasing time, total operative time, endoscopic vision, retropulsion and stone free rates were analyzed in both groups and compared.
    UNASSIGNED: Mean stone volume was comparable in the TFL group and the Ho:YAG laser group (282.45 [standard deviation, SD 139.79] mm3 vs. 279.49 [SD 312.52] mm3; p=0.964). Mean stone density was also comparable in the TFL group and the Ho:YAG laser group (1135.30 [SD 317.04] Hounsfield unit vs. 1131.75 [SD 283.03] Hounsfield unit; p=0.959). The mean stone fragmentation rates calculated as stone volume divided by lasing time were 25.85 (SD 10.61) mm3/min and 21.37 (SD 14.13) mm3/min in the TFL group and the Ho:YAG laser group, respectively (p=0.113). The mean total lasing time (10.15 [SD] 4.69 min vs. 11.43 [SD 4.56] min; p=0.222), mean operative time (25.13 [SD 9.51] min vs. 25.54 [SD 10.32] min; p=0.866), and mean total hospital stay (2.62 [SD 0.77] days vs. 2.61 [SD 0.84] days; p=0.893) were comparable in the TFL group and in the Ho:YAG group. The vision was better and retropulsion was less in the TFL group. The stone-free rate at 1 month postoperatively was slightly better in the TFL group (100% vs. 90%; p=0.095).
    UNASSIGNED: TFL technology was associated with the comparable total surgical time, total lasing time, and stone fragmentation rate with Ho:YAG laser. However, TFL had better endoscopic vision, lesser stone retropulsion, and slightly better stone-free rates.
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  • 文章类型: Journal Article
    CO2还原光催化剂有利于获得可再生能源。富集的活性位点和有效的光生载流子分离是改善CO2光还原的关键。一种在多孔管状石墨氮化碳(g-C3N4)中引入碳空位的of(Tm)单原子定制策略,超过了以往报道的g-C3N4基光催化剂,CO产率为199.47µmolg-1h-1,96.8%CO选择性,0.84%的表观量子效率和优异的光催化稳定性,在这项工作中实现。结果表明,平面内Tm位点和层间桥接的Tm-N电荷转移通道显着增强了光生电子的聚集/转移,从而促进了CO2吸附/活化并有助于*COOH中间体的形成。同时,Tm原子和碳空位都有利于丰富的活性位点和增强的光生电荷分离,从而优化反应途径并导致优异的CO2光还原。这项工作不仅为CO2光还原催化剂设计提供了指导,而且还为太阳能燃料生产中的单原子光催化剂提供了机械见解。
    CO2 reduction photocatalysts are favorable for obtaining renewable energy. Enriched active sites and effective photogenerated-carriers separation are keys for improving CO2 photo-reduction. A thulium (Tm) single atom tailoring strategy introducing carbon vacancies in porous tubular graphitic carbon nitride (g-C3N4) surpassing the ever-reported g-C3N4 based photocatalysts, with 199.47 µmol g-1 h-1 CO yield, 96.8% CO selectivity, 0.84% apparent quantum efficiency and excellent photocatalytic stability, is implemented in this work. Results revealed that in-plane Tm sites and interlayer-bridged Tm-N charge transfer channels significantly enhanced the aggregation/transfer of photogenerated electrons thus promoting CO2 adsorption/activation and contributing to *COOH intermediates formation. Meanwhile, Tm atoms and carbon vacancies both benefit for rich active sites and enhanced photogenerated-charge separation, thus optimizing reaction pathway and leading to excellent CO2 photo-reduction. This work not only provides guidelines for CO2 photo-reduction catalysts design but also offers mechanistic insights into single-atom based photocatalysts for solar fuel production.
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  • 文章类型: Journal Article
    目的:由于其相对较高的峰值功率,固态Thulium激光(Tm:YAG)是广泛用于内窥镜前列腺摘除术(EEP)的新型替代品。这项研究的目的是检查新型脉冲Tm:YAG激光在人类中的首次应用的有效性和安全性。
    方法:回顾性收集了使用新的脉冲固态Tm:YAG激光(Thulio®,DornierMedTechSystemsGmbH,韦斯林,德国)。评估围手术期和术后数据。使用Clavien-Dindo分类(CDC)对手术特异性并发症进行分级。手术后15个月对患者进行访谈,以评估功能和长期结果。用社会科学统计软件包(SPSS®)进行统计分析。
    结果:术前平均前列腺体积为105.6±55.0ml。中值去核速度为4.1g/分钟(范围1.1-9.7)。术后发生短期并发症21例(20.4%),但未观察到高级别并发症(CDC≥IV).五名患者患有严重血尿,需要再次干预(CDCIIIb;4.9%)。15个月后,76例(73.8%)患者参加了随访访谈,其中7名患者(9.2%)报告有并发症,包括两次尿道狭窄的再干预(CDCIIIb;2.6%)。大多数患者报告尿失禁(54.0%)和尿流(93.4%)有所改善,但勃起功能无差异(81.6%)。无持续性排尿困难报告。患者对手术结果的满意度很高(96.1%)。
    结论:新型脉冲固体Tm:YAG激光内镜下前列腺摘除术是一种安全有效的前列腺增生症手术治疗方法。
    背景:德国临床试验登记号:DRKS00031676。注册日期:2023年5月10日,追溯注册。
    OBJECTIVE: The solid-state Thulium laser (Tm: YAG) is a novel alternative to the widely used Holmium laser for endoscopic enucleation of the prostate (EEP) due to its relatively high peak power. The aim of this study was to examine the efficacy and safety of a new pulsed Tm: YAG laser in its first application in humans.
    METHODS: Data were retrospectively collected for the first 103 patients who underwent EEP with a new pulsed solid-state Tm: YAG laser (Thulio®, Dornier MedTech Systems GmbH, Weßling, Germany). Peri- and postoperative data were assessed. Procedure-specific complications were graded using Clavien-Dindo Classifications (CDC). Patients were interviewed 15 months after the surgery to evaluate functional and long-term outcomes. Statistical analysis was performed with Statistical Package for the Social Sciences (SPSS®).
    RESULTS: The mean preoperative prostate volume was 105.6 ± 55.0 ml. Median enucleation speed was 4.1 g per minute (range 1.1-9.7). Short-term postoperative complications occurred in 21 patients (20.4%), but no high-grade complications (CDC ≥ IV) were observed. Five patients suffered gross haematuria and required reintervention (CDC IIIb; 4.9%). After 15 months, 76 patients (73.8%) participated in the follow-up interview, where seven patients (9.2%) reported complications, including two reinterventions for urethral strictures (CDC IIIb; 2.6%). Most patients reported an improvement in continence (54.0%) and urine stream (93.4%), but no difference in erectile function (81.6%). No persistent dysuria was reported. Patient satisfaction with the surgery results was very high (96.1%).
    CONCLUSIONS: Endoscopic enucleation of the prostate with the new pulsed solid-state Tm: YAG laser is a safe and effective option for surgical BPH treatment.
    BACKGROUND: German Clinical Trials Register number: DRKS00031676. Registration date: 10 May 2023, retrospectively registered.
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  • 文章类型: Journal Article
    目的:评估一位在激光内镜下前列腺摘除术(EEP)中没有经验的外科医师的thulium光纤前列腺摘除术(ThuFLEP)学习曲线。
    方法:我们回顾性分析了2022年1月至2023年8月在我们中心由一名外科医生进行ThuFLEP的所有良性前列腺增生患者。纳入标准为国际前列腺症状评分>7,前列腺体积<200g,最大尿流率<15mL/s。外科医生对激光EEP缺乏经验,并在前4例病例中开始在指导下进行手术之前,通过观看ThuFLEP的教育视频进行了培训。程序数据(摘除和粉碎效率,并发症)和长达3个月的功能结果进行评估。将患者分为4组,每组20例,以评估整个时间的结果演变。
    结果:患者的平均年龄为69.9岁(SD7.8),平均前列腺体积为89.9g(SD25.8)。两组之间的术前功能参数具有可比性。平均摘除效率(EE)比率和碎裂效率(ME)比率分别达到0.78g/min(SD0.55)和2.49g/min(SD1.03),并且两个变量从组1到组3显着增加(p<0.001)。在整个病例中,围手术期并发症仍然很低,所有组之间3个月的功能改善相似。
    结论:这是第一项评估ThuFLEP学习曲线的研究,该研究是针对没有激光EEP经验且指导有限的单一外科医生。在这些现实世界的条件下,完成学习曲线需要近60例病例,在整个训练过程中并发症发生率保持较低.
    OBJECTIVE: To assess the learning curve of Thulium Fiber Laser Enucleation of prostate (ThuFLEP) of a single surgeon inexperienced in laser endoscopic enucleation of prostate (EEP).
    METHODS: We retrospectively analyzed all patients with benign prostate hyperplasia undergoing ThuFLEP at our center between January 2022 and August 2023 by one surgeon. Inclusion criteria were International Prostate Symptom Score > 7, prostate volume < 200 g, and maximal urinary flow rate < 15 mL/s. The surgeon was inexperienced in laser EEP and trained by watching educational videos of ThuFLEP before starting to perform the procedure under mentoring during the first 4 cases. Procedural data (enucleation and morcellation efficiency, complications) and functional results up to 3 months were evaluated. Patients were divided into 4 cohorts of 20 consecutive cases to evaluate outcomes evolution throughout time.
    RESULTS: The mean age of the patients was 69.9 years (SD 7.8) and mean prostate volume was 89.9 g (SD 25.8). Preoperative functional parameters were comparable between the groups. Mean enucleation efficiency (EE) ratio and morcellation efficiency (ME) ratio reached respectively 0.78 g/min (SD 0.55) and 2.49 g/min (SD 1.03) and both variables significantly increased from group 1 to group 3 (p < 0,001). Perioperative complications remained low throughout the caseload with similar significant 3-month functional improvements between all groups.
    CONCLUSIONS: This is the first study to evaluate ThuFLEP learning curve for a single surgeon inexperienced in laser EEP with limited mentoring. Under these real-world conditions, nearly 60 cases were needed to complete the learning curve with a complications rate remaining low throughout the training process.
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  • 文章类型: Journal Article
    背景:良性前列腺增生(BPH)通常会导致男性下尿路症状(LUTS)。钬(HoLEP)和cliium(ThuLEP)激光摘除是BPH治疗的既定技术。Thulium光纤激光(TFL)用于前列腺摘除(ThuFLEP)显示出有希望的结果。
    方法:进行前瞻性随机多中心研究。纳入对药物治疗无反应的BPH和LUTS患者。术前,外科,记录围手术期及术后3个月和6个月的随访数据。主要结果是功能改善,次要结局是并发症的安全性.
    结果:纳入200名患者(HoLEP100,ThuFLEP100)。组间没有发现显著的基线差异。在3个月和6个月时,我们发现HoLEP和ThuFLEP的疗效与基线相比有统计学上的显着改善:国际前列腺症状评分(IPSS),IPSS-生活质量(QoL),最大尿流率(Qmax),和后空隙残余体积(PVR;P<0.05)。6个月时,平均值±SDIPSS,IPSS-QoL,Qmax,和PVRforHoLEPvs.ThuFLEP为5.8±4.9vs.4.8±5.0分(P=0.57),1.6±1.4vs.0.7±1.1分(P=0.09),29.9±12.5vs.29.6±8.0mL/s(P=0.8),和16.3±17.7vs.15.5±13.4mL(P=0.92),分别。术中无并发症记录。住院期间无Clavien-Dindo≥III并发症发生。六个月后,在HoLEP和ThuFLEP组中,有8例(8%)和6例(6%)患者报告轻度压力性尿失禁,分别为(P=0.24)。在HoLEP组中3例男性(3%)和ThuFLEP组中1例受试者(1%)观察到尿道狭窄(P=0.72)。
    结论:HoLEP和ThuFLEP对于BPH治疗是有效和安全的,6个月时具有相当的功能结局和并发症发生率。需要进一步的研究来证实这些发现。
    BACKGROUND: Benign prostatic hyperplasia (BPH) commonly causes lower urinary tract symptoms (LUTS) in men. Holmium (HoLEP) and thulium (ThuLEP) laser enucleation are established techniques for BPH treatment. Thulium fiber laser (TFL) for prostate enucleation (ThuFLEP) shows promising outcomes.
    METHODS: A prospective randomized multicenter study was conducted. Patients with BPH and LUTS unresponsive to medical therapy were enrolled. Preoperative, surgical, perioperative and postoperative data were recorded with follow-up at 3 and 6 months. The primary outcome was functional improvement, and the secondary outcome was safety in terms of complications.
    RESULTS: Two hundred patients were included (HoLEP 100, ThuFLEP 100). No significant baseline difference was found between groups. At 3 and 6 months we found statistically significant improvements from baseline for both HoLEP and ThuFLEP in efficacy: International Prostatic Symptoms Score (IPSS), IPSS-Quality of Life (QoL), maximum urinary flow rate (Qmax), and post-void residual volume (PVR; P<0.05). At 6 months, mean±SD IPSS, IPSS-QoL, Qmax, and PVR for HoLEP vs. ThuFLEP were 5.8±4.9 vs. 4.8±5.0 points (P=0.57), 1.6±1.4 vs. 0.7±1.1 points (P=0.09), 29.9±12.5 vs. 29.6±8.0 mL/s (P=0.8), and 16.3±17.7 vs. 15.5±13.4 mL (P=0.92), respectively. No intraoperative complication was recorded. No Clavien-Dindo ≥III complications occurred during hospitalization. After 6 months, 8 (8%) and 6 (6%) patients reported mild stress urinary incontinence in HoLEP and ThuFLEP groups, respectively (P=0.24). Urethral stenosis was observed in 3 men (3%) in the HoLEP group and 1 subject (1%) in the ThuFLEP group (P=0.72).
    CONCLUSIONS: HoLEP and ThuFLEP are effective and safe for BPH treatment, with comparable functional outcomes and complication rates at 6 months. Further research is needed to confirm these findings.
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  • 文章类型: Journal Article
    这项荟萃分析评估了绿光(PVP)和thu激光汽化术(ThuVAP)在良性前列腺增生(BPH)治疗中的有效性和安全性。在包括PubMed在内的数据库中进行了系统的文献检索,科克伦图书馆,EMBASE,CNKI,王芳,和VIP在2023年11月。按照PRISMA准则,我们对感兴趣的主要结局进行了系统评价和荟萃分析.该审查已在PROSPERO上注册,注册号为CRD42023491316。共纳入13项研究。荟萃分析的结果表明,与PVP相比,ThuVAP手术时间较短(MD:8.56,95%CI:4.10~13.03,p=0.0002),术后输血量较高(OR:0.26,95%CI:0.10~0.64,p=0.004)。然而,两组间住院时间无显著差异(MD:-0.32,95%CI:-0.78~0.14,p=0.17),诱导时间(MD:0.03,95%CI:-0.13~0.19,p=0.73),国际前列腺症状评分改善(MD:0.23,95%CI:-0.36〜0.81,p=0.45),生活质量改善(MD:0.04,95%CI:-0.04~0.12,p=0.29),最大尿流率改善(MD:-0.59,95%CI:-1.42~0.24,p=0.16),残余尿量改善(MD:1.04,95%CI:-6.63~8.71,p=0.79),术后总并发症(OR:1.15,95%CI:0.65~2.03,p=0.63),术后出血(OR:1.18,95%CI:0.67~2.07,p=0.56),结果(OR:0.55,95%CI:0.16~1.95,p=0.35),尿道狭窄(OR:0.90,95%CI:0.46~1.75,p=0.75),尿失禁(OR:1.07,95%CI:0.64~1.78,p=0.80)。亚组分析的结果显示,与PVP比较the的结果与合并分析的结果一致。绿光和thulium激光汽化都是有效和安全的,具有可比的手术和功能结果。这些方法之间的选择应基于患者特异性因素。
    This meta-analysis evaluates the efficacy and safety of greenlight (PVP) and thulium laser vaporization (ThuVAP) in Benign Prostatic Hyperplasia (BPH) treatment. A systematic literature search was conducted in databases including PubMed, Cochrane Library, EMBASE, CNKI, Wangfang, and VIP in November 2023. Following the PRISMA guidelines, a systematic review and meta-analysis of the primary outcomes of interest were performed. The review was prospectively registered on PROSPERO under the registration number CRD42023491316. A total of 13 studies were included. The results of the meta-analysis showed that compared to PVP, ThuVAP had a shorter operation time (MD: 8.56, 95% CI: 4.10 ~ 13.03, p = 0.0002), and higher postoperative transfusion (OR:0.26, 95% CI: 0.10 ~ 0.64, p = 0.004). However, no significant differences were observed between the two groups in terms of length of stay (MD: -0.32, 95% CI: -0.78 ~ 0.14, p = 0.17), catherization time (MD: 0.03, 95% CI: -0.13 ~ 0.19, p = 0.73), international prostate symptom score improvement (MD: 0.23, 95% CI: -0.36 ~ 0.81, p = 0.45), quality of life improvement (MD: 0.04, 95% CI: -0.04 ~ 0.12, p = 0.29), maximum urinary flow rate improvement (MD: -0.59, 95% CI: -1.42 ~ 0.24, p = 0.16), postvoid residual urine volume improvement (MD: 1.04, 95% CI: -6.63 ~ 8.71, p = 0.79), overall postoperative complications (OR:1.15, 95% CI: 0.65 ~ 2.03, p = 0.63), postoperative bleeding (OR:1.18, 95%  CI: 0.67 ~ 2.07, p = 0.56), re-peration (OR:0.55, 95% CI: 0.16 ~ 1.95, p = 0.35), urethral stricture (OR:0.90, 95% CI: 0.46 ~ 1.75, p = 0.75), and urinary incontinence (OR:1.07, 95% CI: 0.64 ~ 1.78, p = 0.80). The results of subgroup analysis showed that the results of comparing thulium vaporesection or vapoenucleation with PVP were consistent with the results of the pooled analysis. Both greenlight and thulium laser vaporization are effective and safe, with comparable surgical and functional outcomes. The choice between these methods should be based on patient-specific factors.
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  • 文章类型: Journal Article
    目的:本研究比较了三种不同的前列腺激光摘除术(ThuLEP)治疗良性前列腺增生(BPH)的围手术期和功能结局。主要目的是评估欧盟是否,三叶,和双叶技术对手术疗效和患者预后有不同的影响。
    方法:对2019年1月至2024年1月在两个三级中心接受ThuLEP治疗BPH的患者进行了回顾性分析。倾向评分匹配用于平衡接受不同技术的患者之间的基线特征。手术参数,包括手术时间,摘除时间,分折时间,能源消耗,和术后结果,在各组之间进行了比较。
    结果:在倾向得分匹配之后,213名患者被纳入分析。术中分析显示摘除术明显缩短,激光摘除,与三叶组相比,En-bloc和两叶组的分块和手术时间以及总能量。在术中和术后并发症方面,各组之间没有显着差异。在3个月的随访中,两组之间的功能结局没有显着差异。
    结论:这项研究的结果表明,尽管En-bloc和Two-lobe技术可以提供效率优势,并且可以被认为是ThuLEP手术中的安全替代品,激光摘除时间和能量的减少并不一定转化为患者术后储存症状或其他功能结局的改善.外科医生的偏好和熟练程度可能在为个体患者选择最合适的技术中起着至关重要的作用。未来的研究应集中在更大规模的前瞻性研究,以进一步验证这些发现并探索影响手术结局的潜在因素。
    OBJECTIVE: This study compares the peri-operative and functional outcomes of three distinct surgical techniques in Thulium Laser Enucleation of the Prostate (ThuLEP) for benign prostatic hyperplasia (BPH). The main aim is to assess whether the En-bloc, Three-lobe, and Two-lobe techniques have differential effects on surgical efficacy and patient outcomes.
    METHODS: A retrospective analysis was conducted on patients undergoing ThuLEP for BPH between January 2019 and January 2024 at two tertiary centers. Propensity score matching was utilized to balance baseline characteristics among patients undergoing the different techniques. Surgical parameters, including operative time, enucleation time, morcellation time, energy consumption, and postoperative outcomes, were compared among the groups.
    RESULTS: Following propensity score matching, 213 patients were included in the analysis. Intraoperative analysis revealed significantly shorter enucleation, laser enucleation, morcellation and operative times and total energy delivered in the En-bloc and Two-lobe groups compared to the Three-lobe group. No significant differences were observed among the groups in terms of intraoperative and postoperative complications. There were no significant differences in functional outcomes at the 3-month follow-up among the groups.
    CONCLUSIONS: The findings of this study suggest that while the En-bloc and Two-lobe techniques may offer efficiency benefits and could be considered safe alternatives in ThuLEP procedures, the reduction in laser enucleation time and energy delivered did not necessarily translate into improvements in post operative storage symptoms or other functional outcomes for the patients. Surgeon preference and proficiency may play a crucial role in selecting the most suitable technique for individual patients. Future research should focus on larger-scale prospective studies to further validate these findings and explore potential factors influencing surgical outcomes.
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  • 文章类型: Journal Article
    通过离体实验研究,我们旨在比较Ho:YAG激光虚拟篮(VB™)调制和Thulium光纤激光器(TFL)在不同环境和使用激光配置对肾脏组织的影响.100WHo:YAG(CyberHo,Quanta系统,意大利)和60WTFL(纤维粉尘,Quanta系统,意大利)使用了激光设备。选择了以下激光器设置:功率在10-60W范围内,频率为20-40Hz,能量为0.5-1-1.5J。VB™使用600微秒的中等脉冲持续时间,而短(spdTFL;50µsec)和长(lpdTFL;15,000µsec)用于TFL。组织的切口深度(ID),汽化面积(VA),凝血面积(CA),激光总面积(TLA=VA+CA),表面截面(SS),测量横向效应(LE)。总的来说,进行了108次实验。平均VA无统计学差异,TLA,ID,LE,或SS在VB™之间观察到,spdTFL,低功率输出组在生理盐水中的lpdTFL(p>0.05)。然而,VB™的平均CA在统计学上显著较高(p=0.005).在盐水和高功率输出组中,平均VA,CA,TLA,LE,使用lpdTFL时,和ID高于其他脉冲持续时间(分别为p=0.001,p=0.001,p=0.001,p=0.006和p=0.001)。类似于lpdTFL,VB™可以提供受控的解剖和切口以及止血。在不同的激光设置下,激光特性的个别影响(如脉冲长度,能量和频率)对组织的影响可能更显著。
    Through an ex vivo experimental study, we aimed to compare the effects of the Ho: YAG laser Virtual Basket (VB™) modulation and a Thulium fiber laser (TFL) on kidney tissue in different environments and using laser configurations. The 100 W Ho: YAG (Cyber Ho, Quanta System, Italy) and 60 W TFL (Fiber Dust, Quanta System, Italy) laser devices were used. The following laser settings were selected: power in the range of 10-60 W, frequency of 20-40 Hz, and energy of 0.5-1-1.5 J. A medium pulse duration of 600 µsec was used for VB™, while short (spdTFL; 50 µsec) and long (lpdTFL; 15,000 µsec) were used for TFL. The tissue\'s incision depth (ID), vaporization area (VA), coagulation area (CA), total laser area (TLA = VA + CA), surface section (SS), and lateral effect (LE) were measured. In total, 108 experiments were conducted. No statistically significant difference in mean VA, TLA, ID, LE, or SS was observed between VB™, spdTFL, and lpdTFL in the low-power output group in saline (p > 0.05). However, the mean CA was statistically significantly higher for VB™ (p = 0.005). In saline and high-power output group, the mean VA, CA, TLA, LE, and ID were higher when using lpdTFL than other pulse durations (p = 0.001, p = 0.001, p = 0.001, p = 0.006, and p = 0.001, respectively). Similar to lpdTFL, VB™ may provide controlled dissection and incision as well as haemostasis. At different laser settings, the individual effects of laser properties (such as pulse length, energy and frequency) on tissue may be more significant.
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  • 文章类型: Journal Article
    开发用于准确检测生物标志物的高效便携式传感器对于早期疾病诊断至关重要,但仍然是一个重大挑战。为了满足这一需求,我们介绍了增强发光侧流测定,它利用高度发光的上转换纳米粒子(UCNPs)以及便携式阅读器和智能手机应用程序。传感器的效率和多功能性被证明用于肾脏健康监测,作为概念的证明。我们设计了涂有多层的Er3+和Tm3+掺杂的UCNPs,包括未掺杂的惰性基质外壳,介孔二氧化硅壳,和金外层(UCNP@mSiO2@Au)。这些涂层协同增强发射超过40倍,并促进生物分子缀合,使UCNP@mSiO2@Au易于使用,适用于广泛的生物应用。在侧流分析中使用这些优化的纳米粒子,我们成功地在尿液样本中检测到两种急性肾损伤相关生物标志物-肾损伤分子-1(KIM-1)和中性粒细胞明胶酶相关脂质运载蛋白(NGAL).使用我们的传感器平台,KIM-1和NGAL可以在0.1至20ng/mL的范围内准确检测和定量,在0.28和0.23ng/mL时具有令人印象深刻的低检测限,分别。验证我们的方法,我们分析了临床尿液样本,实现与通过ELISA获得的结果密切相关的生物标志物浓度。重要的是,我们的系统可以在不到15分钟的时间内对生物标志物进行定量,强调了我们新颖的基于UCNP的方法的性能及其潜在的可靠性,快速,和用户友好的诊断。
    Development of efficient portable sensors for accurately detecting biomarkers is crucial for early disease diagnosis, yet remains a significant challenge. To address this need, we introduce the enhanced luminescence lateral-flow assay, which leverages highly luminescent upconverting nanoparticles (UCNPs) alongside a portable reader and a smartphone app. The sensor\'s efficiency and versatility were shown for kidney health monitoring as a proof of concept. We engineered Er3+- and Tm3+-doped UCNPs coated with multiple layers, including an undoped inert matrix shell, a mesoporous silica shell, and an outer layer of gold (UCNP@mSiO2@Au). These coatings synergistically enhance emission by over 40-fold and facilitate biomolecule conjugation, rendering UCNP@mSiO2@Au easy to use and suitable for a broad range of bioapplications. Employing these optimized nanoparticles in lateral-flow assays, we successfully detected two acute kidney injury-related biomarkers─kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL)─in urine samples. Using our sensor platform, KIM-1 and NGAL can be accurately detected and quantified within the range of 0.1 to 20 ng/mL, boasting impressively low limits of detection at 0.28 and 0.23 ng/mL, respectively. Validating our approach, we analyzed clinical urine samples, achieving biomarker concentrations that closely correlated with results obtained via ELISA. Importantly, our system enables biomarker quantification in less than 15 min, underscoring the performance of our novel UCNP-based approach and its potential as reliable, rapid, and user-friendly diagnostics.
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  • 文章类型: Journal Article
    目的:确定皮秒KTP在减少主要由过度色素沉着引起的眼周黑眼圈中的有效性,并比较皮秒KTP与Thulium激光在减少眼周黑眼圈的强度和程度方面的能力。
    方法:这项分脸前瞻性研究包括12名眶周黑眼圈(色素沉着型或混合色素沉着型)的女性。使用PicoHi机器(HIRONICLtd)治疗左下眼睑,由KTP晶体(523nm)提供的全光束调QNd-YAG,设置为0.3J/cm2,5mm,5Hz,300ps而右下眼睑是使用Laveen机器治疗的(WONTECHCo.,Ltd),设置为1320mJ/cm2,30×15mm的分数Thulium激光(1927nm),1500微秒。患者接受了一系列3次治疗,每隔4周给予一次。
    结果:532nm全光束Q开关KTP和分数激光更有可能诱发炎症后色素沉着过度,而不是减少色素沉着。Q开关KTP激光器的风险更高,这可能归因于参与者的肤色。尽管如此,色素沉着型PDC的一些改进,虽然临床上没有发现,由VISIA软件记录。
    结论:从研究结果中无法得出可靠的结论。皮秒KTP和Thulium激光器可能在减少PDC中起作用,但应进行更多研究以确定这些激光器的确切影响。
    OBJECTIVE: To determine the effectiveness of picosecond KTP in reducing peri-ocular dark circles caused mainly by excessive pigmentation and to compare Picosecond KTP with Thulium laser ability in reducing the intensity and extent of peri-ocular dark circles.
    METHODS: This split-face prospective study included twelve women with periorbital dark circles (pigmented or mixed-pigmented type). The left lower eyelid was treated using the PicoHi machine (HIRONIC Ltd), a full beam Q-switched Nd-YAG provided by KTP crystal (523 nm) at settings of 0.3 J/cm2, 5 mm, 5 Hz, and 300 Ps. Whereas the right lower eyelid was treated using the Lavieen machine (WON TECH Co., Ltd), a fractional Thulium laser (1927 nm) at setting 1320 mJ/cm2, 30 × 15 mm, 1500 microseconds. Patients received a series of 3 treatment sessions, given at 4-week intervals.
    RESULTS: The 532-nm full beam Q-switched KTP and fractional Thulium lasers were more likely to induce post-inflammatory hyperpigmentation rather than decrease the pigmentation. The risk is higher with a Q-switched KTP laser, which may be attributed to the skin tone of the participants. Nonetheless, some improvement in the pigmented type of PDCs, although not detected clinically, was documented by the VISIA software.
    CONCLUSIONS: No solid conclusion can be drawn from the results of the study. Picosecond KTP and Thulium lasers may have a role in reducing PDCs yet more studies should be performed in order to determine the exact impact these lasers have.
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