目的探讨应用3.0 T心脏磁共振(CMR)体素内不相干运动(IVIM)技术评估肥厚型心肌病(HCM)患者微血管功能障碍的价值。方法纳入2016年4月至2017年10月在兰州大学第一医院行CMR检查的26例HCM患者及12名健康对照,所有纳入对象均接受短轴心脏...目的探讨应用3.0 T心脏磁共振(CMR)体素内不相干运动(IVIM)技术评估肥厚型心肌病(HCM)患者微血管功能障碍的价值。方法纳入2016年4月至2017年10月在兰州大学第一医院行CMR检查的26例HCM患者及12名健康对照,所有纳入对象均接受短轴心脏电影及IVIM扫描,HCM患者还接受钆造影剂延迟增强(LGE)扫描。应用MITK-Diffusion后处理软件测量各心肌节段快速扩散成分所占比例(f)、快速表观扩散系数(ADCfast)、慢速表观扩散系数(ADCslow),于短轴电影图像上测量舒张末期心室壁厚度(EDTH)。依据左心室壁肥厚程度及有无LGE将HCM患者进行分组,分别比较HCM患者与健康对照之间、HCM患者中非肥厚节段与肥厚节段之间和有无LGE心肌节段之间,以及肥厚节段组中不同肥厚程度亚组之间f值、ADCfast、ADCslow的差异。采用Spearman相关分析探究各节段IVIM参数f值、ADCfast、ADCslow与EDTH的相关性。结果 HCM患者ADCslow及ADCfast均低于健康对照[ADCslow分别为0.003(0.002,0.005)、0.004(0.002,0.007)mm2/s,ADCfast分别为0.046(0.025,0.074)、0.069(0.052,0.086)mm2/s],差异均有统计学意义(Z=-2.434、-7.268,P均<0.05),而f值在HCM患者和健康对照之间差异无统计学意义(P>0.05)。HCM患者非肥厚节段组及肥厚节段组的ADCfast分别为0.051(0.029,0.077)、0.027(0.019,0.052)mm2/s,均低于健康对照,差异均有统计学意义(Z=-5.505、-8.144,P均<0.01)。肥厚节段组f值及ADCfast均低于非肥厚节段组[0.444(0.080,0.834) vs 0.735(0.302,0.877)、0.027(0.019,0.052)mm2/s vs 0.051(0.029,0.077)mm2/s],差异均有统计学意义(Z=-3.527、-4.722,P均<0.01)。轻度、中度、重度、极重度肥厚节段亚组之间仅ADCfast的差异有统计学意义[分别为0.035(0.021,0.061)、0.023(0.015,0.038)、0.018(0.013,0.025)、0.012(0.005,0.055)mm2/s,H=9.769,P=0.021],但两两比较差异均无统计学意义(P均>0.05)。HCM患者有LGE心肌节段的f值及ADCfast均低于无LGE心肌节段(Z=-2.704、-2.143,P=0.007、0.032)。Spearman相关分析结果示EDTH与f值及ADCfast均呈负相关(r=-0.195、-0.282,P均<0.01)。结论 CMR IVIM技术可无创、定量地反映HCM患者心脏微血管功能障碍。微血管功能障碍的严重程度与心肌肥厚程度有关,非肥厚及无LGE心肌节段亦存在微血管功能障碍。展开更多
Targeted delivery of anti-tumor drugs and overcoming drug resistance in malig-nant tumor cells remain significant clinical challenges.However,there are only few effective methods to address these issues.Extracellular ...Targeted delivery of anti-tumor drugs and overcoming drug resistance in malig-nant tumor cells remain significant clinical challenges.However,there are only few effective methods to address these issues.Extracellular vesicles(EVs),actively secreted by cells,play a crucial role in intercellular information transmis-sion and cargo transportation.Recent studies have demonstrated that engineered EVs can serve as drug delivery carriers and showed promising application prospects.Nevertheless,there is an urgent need for further improvements in the isolation and purification of EVs,surface modification techniques,drug assem-bly processes,and precise recognition of tumor cells for targeted drug delivery purposes.In this review,we summarize the applications of engineered EVs in cancer treatment and overcoming drug resistance,and current challenges asso-ciated with engineered EVs are also discussed.This review aims to provide new insights and potential directions for utilizing engineered EVs as targeted delivery systems for anti-tumor drugs and overcoming drug resistance in the near future.展开更多
文摘目的探讨应用3.0 T心脏磁共振(CMR)体素内不相干运动(IVIM)技术评估肥厚型心肌病(HCM)患者微血管功能障碍的价值。方法纳入2016年4月至2017年10月在兰州大学第一医院行CMR检查的26例HCM患者及12名健康对照,所有纳入对象均接受短轴心脏电影及IVIM扫描,HCM患者还接受钆造影剂延迟增强(LGE)扫描。应用MITK-Diffusion后处理软件测量各心肌节段快速扩散成分所占比例(f)、快速表观扩散系数(ADCfast)、慢速表观扩散系数(ADCslow),于短轴电影图像上测量舒张末期心室壁厚度(EDTH)。依据左心室壁肥厚程度及有无LGE将HCM患者进行分组,分别比较HCM患者与健康对照之间、HCM患者中非肥厚节段与肥厚节段之间和有无LGE心肌节段之间,以及肥厚节段组中不同肥厚程度亚组之间f值、ADCfast、ADCslow的差异。采用Spearman相关分析探究各节段IVIM参数f值、ADCfast、ADCslow与EDTH的相关性。结果 HCM患者ADCslow及ADCfast均低于健康对照[ADCslow分别为0.003(0.002,0.005)、0.004(0.002,0.007)mm2/s,ADCfast分别为0.046(0.025,0.074)、0.069(0.052,0.086)mm2/s],差异均有统计学意义(Z=-2.434、-7.268,P均<0.05),而f值在HCM患者和健康对照之间差异无统计学意义(P>0.05)。HCM患者非肥厚节段组及肥厚节段组的ADCfast分别为0.051(0.029,0.077)、0.027(0.019,0.052)mm2/s,均低于健康对照,差异均有统计学意义(Z=-5.505、-8.144,P均<0.01)。肥厚节段组f值及ADCfast均低于非肥厚节段组[0.444(0.080,0.834) vs 0.735(0.302,0.877)、0.027(0.019,0.052)mm2/s vs 0.051(0.029,0.077)mm2/s],差异均有统计学意义(Z=-3.527、-4.722,P均<0.01)。轻度、中度、重度、极重度肥厚节段亚组之间仅ADCfast的差异有统计学意义[分别为0.035(0.021,0.061)、0.023(0.015,0.038)、0.018(0.013,0.025)、0.012(0.005,0.055)mm2/s,H=9.769,P=0.021],但两两比较差异均无统计学意义(P均>0.05)。HCM患者有LGE心肌节段的f值及ADCfast均低于无LGE心肌节段(Z=-2.704、-2.143,P=0.007、0.032)。Spearman相关分析结果示EDTH与f值及ADCfast均呈负相关(r=-0.195、-0.282,P均<0.01)。结论 CMR IVIM技术可无创、定量地反映HCM患者心脏微血管功能障碍。微血管功能障碍的严重程度与心肌肥厚程度有关,非肥厚及无LGE心肌节段亦存在微血管功能障碍。
基金This work was supported by grants from the National Natural Science Foundation of China(No.81972394 and 82272856)the Guang Dong Basic and Applied Basic Research Foundation(No.2022A1515010437)+1 种基金the President Foundation of The Third Affiliated Hospital of Southern Medical University(No.YM2021010,No.YM2021011)the Scientific and Technological Support Project of Guizhou Province(Qian Ke He Zhi Cheng 2023]Yi Ban 262)。
文摘Targeted delivery of anti-tumor drugs and overcoming drug resistance in malig-nant tumor cells remain significant clinical challenges.However,there are only few effective methods to address these issues.Extracellular vesicles(EVs),actively secreted by cells,play a crucial role in intercellular information transmis-sion and cargo transportation.Recent studies have demonstrated that engineered EVs can serve as drug delivery carriers and showed promising application prospects.Nevertheless,there is an urgent need for further improvements in the isolation and purification of EVs,surface modification techniques,drug assem-bly processes,and precise recognition of tumor cells for targeted drug delivery purposes.In this review,we summarize the applications of engineered EVs in cancer treatment and overcoming drug resistance,and current challenges asso-ciated with engineered EVs are also discussed.This review aims to provide new insights and potential directions for utilizing engineered EVs as targeted delivery systems for anti-tumor drugs and overcoming drug resistance in the near future.