The psychotherapeutic technique plays an important role in acupuncture therapy. In the present paper, the authors explain the relevance of psychotherapeutic technique and curative effect of acupuncture from (1)conne...The psychotherapeutic technique plays an important role in acupuncture therapy. In the present paper, the authors explain the relevance of psychotherapeutic technique and curative effect of acupuncture from (1)connection between psychologic factors and curing disease, (2)specialty of acupuncture therapy, and (3)influence of psychologic factors on acupuncture therapy, etc. Finally bring forward how to make good use of the technique during the course of acupuncture.展开更多
BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroa...BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.展开更多
Manual Therapy is a rehabilitative approach based on the use of therapeutic procedures that includes several techniques, but this paper focuses on what is known as Positional Release (PR), a therapeutic model that inc...Manual Therapy is a rehabilitative approach based on the use of therapeutic procedures that includes several techniques, but this paper focuses on what is known as Positional Release (PR), a therapeutic model that includes a series of manoeuvres that are mainly used for the treatment of soft tissue. A deeper understanding of this type of therapeutic approach, especially its well known and widespread variant, Strain-Counterstrain, could, through controlled trials and systematic reviews, confirm its effectiveness, definitively explain the neurophysiological mechanism, and therefore make Positional Release another indispensable option in the professional expertise of the physiotherapist.展开更多
Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as d...Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as difficulty of sinus electrode implantation,coronary sinus injury and bleeding,still one third展开更多
Objective To discuss the therapeutic effect and mechanism of warming needling technique for the treatment of depression. Methods A total of 60 patients with depression were randomly divided into treatment group and co...Objective To discuss the therapeutic effect and mechanism of warming needling technique for the treatment of depression. Methods A total of 60 patients with depression were randomly divided into treatment group and control group with 30 cases each. The treatment group was treated with warming needle technique on the Jiaji points of the heart, lung, liver, spleen and kidney, control group with Amitriptyline, HAMD scale and the qualitative change of EEG-α wave were observed before and after the treatment. Results The total effective rate of treatment group was 100%, much better than that of the control group with 80% (P<0.05); the HAMD scale of treatment group was better than that of control group (P<0.05); the comparison of the improvement of somatic symptoms between treatment group and control group was significant (P<0.05); the comparison of frequency and amplitude of EEG-α wave was significant (P<0.05), there was no toxic and side effect in the treatment group. Conclusion Warming needling technique for depression has better effect than Amitriptyline, and there was no toxic and side effect in the treatment group. Warming needle technique can effectively regulate the frequency and amplitude EEG-α wave, and acts to improve depressive condition.展开更多
Although the number of hospitalizations for non-variceal gastrointestinal bleeding has decreased inrecent years,acute upper gastrointestinalhemorrhage continues to be a common reason forhospital admission,and peptic u...Although the number of hospitalizations for non-variceal gastrointestinal bleeding has decreased inrecent years,acute upper gastrointestinalhemorrhage continues to be a common reason forhospital admission,and peptic ulcers account for atleast fifty percent of all cases.Despite the fact thatbleeding from ulcers ceases spontaneously inapproximately 80% of patients,it is still a展开更多
The volumetric modulated arc therapy(VMAT)technique,in the form of RapidArc,is widely used to treat prostate cancer.The full-single arc(f-SA)technique in RapidArc planning for prostate cancer treatment provides effici...The volumetric modulated arc therapy(VMAT)technique,in the form of RapidArc,is widely used to treat prostate cancer.The full-single arc(f-SA)technique in RapidArc planning for prostate cancer treatment provides efficient treatment,but it also delivers a higher radiation dose to the rectum.This study aimed to compare the dosimetric results from the new partial-single arc(p-SA)technique with those from the f-SA technique in RapidArc planning for prostate cancer treatment.In this study,10 patients with lowrisk prostate cancer were selected.For each patient,two sets of RapidArc plans(f-SA and p-SA)were created in the Eclipse treatment planning system.The f-SA plan was created using one full arc,and the p-SA plan was created using planning parameters identical to those of the f-SA plan but with anterior and posterior avoidance sectors.Various dosimetric parameters of the f-SA and p-SA plans were evaluated and compared for the same target coverage and identical plan optimization parameters.The f-SA and p-SA plans showed an average difference of±1%for the doses to the planning target volume(PTV),and there were no clear differences in dose homogeneity or plan conformity.In comparison to the f-SA technique,the p-SA technique reduced the doses to the rectum by approximately 6.1%to 21.2%,to the bladder by approximately 10.3%to 29.5%,and to the penile bulb by approximately 2.2%.In contrast,the dose to the femoral heads,the integral dose,and the number of monitor units were higher in the p-SA plans by approximately 34.4%,7.7%,and 9.2%,respectively.In conclusion,it is feasible to use the p-SA technique for RapidArc planning for prostate cancer treatment.For the same PTV coverage and identical plan optimization parameters,the p-SA technique is better in sparing the rectum and bladder without compromising plan conformity or target homogeneity when compared to the f-SA technique.展开更多
Lung cancer represents the leading cause of cancer mortality worldwide. Despite improvements in preoperative staging, surgical techniques, neoadjuvant/adjuvant options and postoperative care, there are still major dif...Lung cancer represents the leading cause of cancer mortality worldwide. Despite improvements in preoperative staging, surgical techniques, neoadjuvant/adjuvant options and postoperative care, there are still major difficulties in significantly improving survival, especially in locally advanced non-small cell lung cancer(NSCLC). To date, surgical resection is the primary mode of treatment for stage?Ⅰ?and Ⅱ NSCLC and has become an important component of the multimodality therapy of even more advanced disease with a curative intention. In fact, in NSCLC patients with solitary distant metastases, surgical interventions have been discussed in the last years. Accordingly, this review displays the recent surgical strategies implemented in the therapy of NSCLC patients.展开更多
Gastric cancer is common in China [1-42],and its early diagnosis and treatment in advanced stage are difficult [31-50].In recent years ,gene study in cancer is a hotspot ,and great progress has been achieved [41-80] ....Gastric cancer is common in China [1-42],and its early diagnosis and treatment in advanced stage are difficult [31-50].In recent years ,gene study in cancer is a hotspot ,and great progress has been achieved [41-80] .Cancer gene therapy has shifted from the imagination into the laboratory and clinical trials.展开更多
Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way an...Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible recurrence.Even if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver disease.Different medical treatments are now approved,and others are under investigation.On this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for RHCC.This review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.展开更多
Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases(LM)from neuroendocrine neoplasms(NEN),and minimally invasive,liver-directed therapies are gaining increasing interest.Cathet...Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases(LM)from neuroendocrine neoplasms(NEN),and minimally invasive,liver-directed therapies are gaining increasing interest.Catheter-based treatments are used in disseminated disease,whereas ablation techniques are usually indicated when the number of LM is limited.Although radiofrequency ablation(RFA)is by far the most used ablative technique,the goal of this opinion review is to explore the potential role of laser ablation(LA)in the treatment of LM from NEN.LA uses thinner needles than RFA,and this is an advantage when the tumors are in at-risk locations.Moreover,the multi-fiber technique enables the use of one to four laser fibers at once,and each fiber provides an almost spherical thermal lesion of 12-15 mm in diameter.Such a characteristic enables to tailor the size of each thermal lesion to the size of each tumor,sparing the liver parenchyma more than any other liver-directed therapy,and allowing for repeated treatments with low risk of liver failure.A recent retrospective study reporting the largest series of LM treated with LA documents both safety and effectiveness of LA,that can play a useful role in the multimodality approach to LM from NEN.展开更多
Recent and advanced protocols are now available to derive human induced pluripotent stem cells (hiPSCs) from patients affected by genetic diseases. No curative treatments are available for many of these diseases; thus...Recent and advanced protocols are now available to derive human induced pluripotent stem cells (hiPSCs) from patients affected by genetic diseases. No curative treatments are available for many of these diseases; thus, hiPSCs represent a major impact on patient’ health. hiPSCs represent a valid model for the in vitro study of monogenic diseases, together with a better comprehension of the pathogenic mechanisms of the pathology, for both cell and gene therapy protocol applications. Moreover, these pluripotent cells represent a good opportunity to test innovative pharmacological treatments focused on evaluating the efficacy and toxicity of novel drugs. Today, innovative gene therapy protocols, especially gene editing-based, are being developed, allowing the use of these cells not only as in vitro disease models but also as an unlimited source of cells useful for tissue regeneration and regenerative medicine, eluding ethical and immune rejection problems. In this review, we will provide an up-to-date of modelling monogenic disease by using hiPSCs and the ultimate applications of these in vitro models for cell therapy. We consider and summarize some peculiar aspects such as the type of parental cells used for reprogramming, the methods currently used to induce the transcription of the reprogramming factors, and the type of iPSC-derived differentiated cells, relating them to the genetic basis of diseases and to their inheritance model.展开更多
The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of patients.An effective therapeutic option is crucial for achieving long-term survival in patients wit...The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of patients.An effective therapeutic option is crucial for achieving long-term survival in patients with postoperative recurrences.Local ablative therapy has been established as a treatment option for resectable and unresectable HCCs,and it is also a feasible approach for recurrent HCC(RHCC)due to less trauma,shorter operation times,fewer complications,and faster recovery.This review focused on ablation techniques,description of potential candidates,and therapeutic and prognostic implications of ablation for guiding its application in treating intrahepatic RHCC.展开更多
Mental disorders are considerate "the evil of the century" by renowned researchers, because a large part of the population in many countries is a diagnosticated, and currently afect youth and children. Among...Mental disorders are considerate "the evil of the century" by renowned researchers, because a large part of the population in many countries is a diagnosticated, and currently afect youth and children. Among the numerous therapeutic interventions, the music therapy is a non-invasive approach. However, there are very few people who are professionally engaged in research and studies on the subject. Therefore, this article is a literature to talk about the benefits of music therapy sessions for people with stress, depression and anxiety disorders.展开更多
Radiotherapy(RT)is one of the important modalities for cancer treatments.Mounting evidence suggests that the host immune system is involved in the tumor cell killing during RT,and future RT technology development shou...Radiotherapy(RT)is one of the important modalities for cancer treatments.Mounting evidence suggests that the host immune system is involved in the tumor cell killing during RT,and future RT technology development should aim to minimize radiation dose to the immune system while maintaining a sufficient dose to the tumor.A brief history of RT technology development is first summarized.Three RT technologies,namely FLASH RT,proton therapy,and spatially fractionated RT(SFRT),are singled out for the era of immunotherapy.Besides the technical aspects,the mechanism of FLASH effect is discussed,which is likely the combined results of the recombination effect,oxygen depletion effect and immune sparing effect.The proton therapy should have the advantage of causing much less immune damage in comparison to X-ray based RT due to the Bragg peak.However,the relative biological effectiveness(RBE)uncertainty and range uncertainty may hinder the translation of this advantage into clinical benefit.Research approaches to overcome these two technical hurdles are discussed.Various SFRT approaches and their application are reviewed.These approaches are categorized as single-field 1D/2D SFRT,multi-field 3D SFRT and quasi-3D SFRT techniques.A 3D SFRT approach,which is achieved by placing the Bragg peak of a proton 2D SFRT field in discrete depths,may have special potential because all 3 technologies(FLASH RT,proton therapy and SFRT)may be used in this approach.展开更多
Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy(...Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy(SCT) could be a solution for prompting cardiac regeneration. Multiple studies have been published from the beginning of SCT until now, but overall no unanimous conclusion could be drawn in part due to the lack of appropriate endpoints. In order to appreciate the impact of SCT, multiple markers from different categories should be considered: Structural, biological, functional, physiological, but also major adverse cardiac events or quality of life. Imaging end-points are among the most used-especially left ventricle ejection fraction(LVEF) measured through different methods. Other imaging parameters are infarct size, myocardial viability and perfusion. The impact of SCT on all of the aforementioned end-points is controversial and debatable. 2 D-echocardiography is widely exploited, but new approaches such as tissue Doppler, strain/strain rate or 3 D-echocardiography are more accurate, especially since the latter one is comparable with the MRI gold standard estimation of LVEF. Apart from the objective parameters, there are also patient-centered evaluations to reveal the benefits of SCT, such as quality of life and performance status, the most valuable from the patient point of view. Emerging parameters investigating molecular pathways such as non-coding RNAs or inflammation cytokines have a high potential as prognostic factors. Due to the disadvantages of current techniques, new imaging methods with labelled cells tracked along their lifetime seem promising, but until now only pre-clinical trials have been conducted in humans. Overall, SCT is characterized by high heterogeneity not only in preparation, administration and type of cells, but also in quantification of therapy effects.展开更多
The purpose of this study was to investigate the prediction of mechanical error using DICOM-RT plan parameters for volumetric modulated arc therapy (VMAT). We created plans for gantry rotation arcs of 360° and 18...The purpose of this study was to investigate the prediction of mechanical error using DICOM-RT plan parameters for volumetric modulated arc therapy (VMAT). We created plans for gantry rotation arcs of 360° and 180° (full-arc and half-arc VMAT) for six maxillary sinus cancer cases using a Monaco treatment planning system, and delivered the doses with a linear accelerator. We calculated DICOM-RT plan parameters, including gantry, multileaf collimator (MLC) positions and Monitor Units (MU). We compared plans with regard to gantry angle per MU (degrees/MU) and MLC travel per MU (mm/MU) for each segment. Calculated gantry angle/MLC position speeds and errors were evaluated by comparison with the log file. On average, the half-arc VMAT plan resulted in 47% and 35% fewer degrees/MU and mm/MU than the full-arc VMAT plan, respectively. The root mean square (r.m.s.) gantry and MLC speeds showed a linear relationship with calculated degrees/MU and mm/MU, with coefficients of determination (R2) of 0.86 and 0.72, respectively. The r.m.s. gantry angle and MLC position errors showed a linear relationship with calculated degrees/MU and mm/MU with R2 of 0.63 and 0.76, respectively. Deviations from plan parameters were related to mechanical error for VMAT, and provided quantitative information without the need for VMAT delivery. These parameters can be used in the selection of treatment planning.展开更多
BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vei...BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy(CRT)upgrade.CASE SUMMARY We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously.We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques.The patient recovered uneventfully during the follow-up period.CONCLUSION CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation.展开更多
文摘The psychotherapeutic technique plays an important role in acupuncture therapy. In the present paper, the authors explain the relevance of psychotherapeutic technique and curative effect of acupuncture from (1)connection between psychologic factors and curing disease, (2)specialty of acupuncture therapy, and (3)influence of psychologic factors on acupuncture therapy, etc. Finally bring forward how to make good use of the technique during the course of acupuncture.
文摘BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.
文摘Manual Therapy is a rehabilitative approach based on the use of therapeutic procedures that includes several techniques, but this paper focuses on what is known as Positional Release (PR), a therapeutic model that includes a series of manoeuvres that are mainly used for the treatment of soft tissue. A deeper understanding of this type of therapeutic approach, especially its well known and widespread variant, Strain-Counterstrain, could, through controlled trials and systematic reviews, confirm its effectiveness, definitively explain the neurophysiological mechanism, and therefore make Positional Release another indispensable option in the professional expertise of the physiotherapist.
文摘Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as difficulty of sinus electrode implantation,coronary sinus injury and bleeding,still one third
文摘Objective To discuss the therapeutic effect and mechanism of warming needling technique for the treatment of depression. Methods A total of 60 patients with depression were randomly divided into treatment group and control group with 30 cases each. The treatment group was treated with warming needle technique on the Jiaji points of the heart, lung, liver, spleen and kidney, control group with Amitriptyline, HAMD scale and the qualitative change of EEG-α wave were observed before and after the treatment. Results The total effective rate of treatment group was 100%, much better than that of the control group with 80% (P<0.05); the HAMD scale of treatment group was better than that of control group (P<0.05); the comparison of the improvement of somatic symptoms between treatment group and control group was significant (P<0.05); the comparison of frequency and amplitude of EEG-α wave was significant (P<0.05), there was no toxic and side effect in the treatment group. Conclusion Warming needling technique for depression has better effect than Amitriptyline, and there was no toxic and side effect in the treatment group. Warming needle technique can effectively regulate the frequency and amplitude EEG-α wave, and acts to improve depressive condition.
文摘Although the number of hospitalizations for non-variceal gastrointestinal bleeding has decreased inrecent years,acute upper gastrointestinalhemorrhage continues to be a common reason forhospital admission,and peptic ulcers account for atleast fifty percent of all cases.Despite the fact thatbleeding from ulcers ceases spontaneously inapproximately 80% of patients,it is still a
文摘The volumetric modulated arc therapy(VMAT)technique,in the form of RapidArc,is widely used to treat prostate cancer.The full-single arc(f-SA)technique in RapidArc planning for prostate cancer treatment provides efficient treatment,but it also delivers a higher radiation dose to the rectum.This study aimed to compare the dosimetric results from the new partial-single arc(p-SA)technique with those from the f-SA technique in RapidArc planning for prostate cancer treatment.In this study,10 patients with lowrisk prostate cancer were selected.For each patient,two sets of RapidArc plans(f-SA and p-SA)were created in the Eclipse treatment planning system.The f-SA plan was created using one full arc,and the p-SA plan was created using planning parameters identical to those of the f-SA plan but with anterior and posterior avoidance sectors.Various dosimetric parameters of the f-SA and p-SA plans were evaluated and compared for the same target coverage and identical plan optimization parameters.The f-SA and p-SA plans showed an average difference of±1%for the doses to the planning target volume(PTV),and there were no clear differences in dose homogeneity or plan conformity.In comparison to the f-SA technique,the p-SA technique reduced the doses to the rectum by approximately 6.1%to 21.2%,to the bladder by approximately 10.3%to 29.5%,and to the penile bulb by approximately 2.2%.In contrast,the dose to the femoral heads,the integral dose,and the number of monitor units were higher in the p-SA plans by approximately 34.4%,7.7%,and 9.2%,respectively.In conclusion,it is feasible to use the p-SA technique for RapidArc planning for prostate cancer treatment.For the same PTV coverage and identical plan optimization parameters,the p-SA technique is better in sparing the rectum and bladder without compromising plan conformity or target homogeneity when compared to the f-SA technique.
文摘Lung cancer represents the leading cause of cancer mortality worldwide. Despite improvements in preoperative staging, surgical techniques, neoadjuvant/adjuvant options and postoperative care, there are still major difficulties in significantly improving survival, especially in locally advanced non-small cell lung cancer(NSCLC). To date, surgical resection is the primary mode of treatment for stage?Ⅰ?and Ⅱ NSCLC and has become an important component of the multimodality therapy of even more advanced disease with a curative intention. In fact, in NSCLC patients with solitary distant metastases, surgical interventions have been discussed in the last years. Accordingly, this review displays the recent surgical strategies implemented in the therapy of NSCLC patients.
文摘Gastric cancer is common in China [1-42],and its early diagnosis and treatment in advanced stage are difficult [31-50].In recent years ,gene study in cancer is a hotspot ,and great progress has been achieved [41-80] .Cancer gene therapy has shifted from the imagination into the laboratory and clinical trials.
文摘Since hepatocellular carcinoma(HCC)represents an important cause of mortality and morbidity all over the world.Currently,it is fundamental not only to achieve a curative treatment but also to manage in the best way any possible recurrence.Even if the latest update of the Barcelona Clinic Liver Cancer guidelines for HCC treatment has introduced new locoregional techniques and confirmed others as well-established clinical practices,there is still no consensus about the treatment of recurrent HCC(RHCC).Locoregional treatments and medical therapy represent two of the most widely accepted approaches for disease control,especially in the advanced stage of liver disease.Different medical treatments are now approved,and others are under investigation.On this basis,radiology plays a central role in the diagnosis of RHCC and the assessment of response to locoregional treatments and medical therapy for RHCC.This review summarized the actual clinical practice by underlining the importance of the radiological approach both in the diagnosis and treatment of RHCC.
文摘Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases(LM)from neuroendocrine neoplasms(NEN),and minimally invasive,liver-directed therapies are gaining increasing interest.Catheter-based treatments are used in disseminated disease,whereas ablation techniques are usually indicated when the number of LM is limited.Although radiofrequency ablation(RFA)is by far the most used ablative technique,the goal of this opinion review is to explore the potential role of laser ablation(LA)in the treatment of LM from NEN.LA uses thinner needles than RFA,and this is an advantage when the tumors are in at-risk locations.Moreover,the multi-fiber technique enables the use of one to four laser fibers at once,and each fiber provides an almost spherical thermal lesion of 12-15 mm in diameter.Such a characteristic enables to tailor the size of each thermal lesion to the size of each tumor,sparing the liver parenchyma more than any other liver-directed therapy,and allowing for repeated treatments with low risk of liver failure.A recent retrospective study reporting the largest series of LM treated with LA documents both safety and effectiveness of LA,that can play a useful role in the multimodality approach to LM from NEN.
基金Supported by Agenzia Spaziale Italiana(ASI),CoReA,No2013-084-R.0
文摘Recent and advanced protocols are now available to derive human induced pluripotent stem cells (hiPSCs) from patients affected by genetic diseases. No curative treatments are available for many of these diseases; thus, hiPSCs represent a major impact on patient’ health. hiPSCs represent a valid model for the in vitro study of monogenic diseases, together with a better comprehension of the pathogenic mechanisms of the pathology, for both cell and gene therapy protocol applications. Moreover, these pluripotent cells represent a good opportunity to test innovative pharmacological treatments focused on evaluating the efficacy and toxicity of novel drugs. Today, innovative gene therapy protocols, especially gene editing-based, are being developed, allowing the use of these cells not only as in vitro disease models but also as an unlimited source of cells useful for tissue regeneration and regenerative medicine, eluding ethical and immune rejection problems. In this review, we will provide an up-to-date of modelling monogenic disease by using hiPSCs and the ultimate applications of these in vitro models for cell therapy. We consider and summarize some peculiar aspects such as the type of parental cells used for reprogramming, the methods currently used to induce the transcription of the reprogramming factors, and the type of iPSC-derived differentiated cells, relating them to the genetic basis of diseases and to their inheritance model.
基金Supported by the National Key Research and Development Program of China,No.2020AAA0109503.
文摘The post-hepatectomy recurrence rate of hepatocellular carcinoma(HCC)is persistently high,affecting the prognosis of patients.An effective therapeutic option is crucial for achieving long-term survival in patients with postoperative recurrences.Local ablative therapy has been established as a treatment option for resectable and unresectable HCCs,and it is also a feasible approach for recurrent HCC(RHCC)due to less trauma,shorter operation times,fewer complications,and faster recovery.This review focused on ablation techniques,description of potential candidates,and therapeutic and prognostic implications of ablation for guiding its application in treating intrahepatic RHCC.
文摘Mental disorders are considerate "the evil of the century" by renowned researchers, because a large part of the population in many countries is a diagnosticated, and currently afect youth and children. Among the numerous therapeutic interventions, the music therapy is a non-invasive approach. However, there are very few people who are professionally engaged in research and studies on the subject. Therefore, this article is a literature to talk about the benefits of music therapy sessions for people with stress, depression and anxiety disorders.
文摘Radiotherapy(RT)is one of the important modalities for cancer treatments.Mounting evidence suggests that the host immune system is involved in the tumor cell killing during RT,and future RT technology development should aim to minimize radiation dose to the immune system while maintaining a sufficient dose to the tumor.A brief history of RT technology development is first summarized.Three RT technologies,namely FLASH RT,proton therapy,and spatially fractionated RT(SFRT),are singled out for the era of immunotherapy.Besides the technical aspects,the mechanism of FLASH effect is discussed,which is likely the combined results of the recombination effect,oxygen depletion effect and immune sparing effect.The proton therapy should have the advantage of causing much less immune damage in comparison to X-ray based RT due to the Bragg peak.However,the relative biological effectiveness(RBE)uncertainty and range uncertainty may hinder the translation of this advantage into clinical benefit.Research approaches to overcome these two technical hurdles are discussed.Various SFRT approaches and their application are reviewed.These approaches are categorized as single-field 1D/2D SFRT,multi-field 3D SFRT and quasi-3D SFRT techniques.A 3D SFRT approach,which is achieved by placing the Bragg peak of a proton 2D SFRT field in discrete depths,may have special potential because all 3 technologies(FLASH RT,proton therapy and SFRT)may be used in this approach.
文摘Despite optimal interventional and medical therapy, ischemic heart disease is still an important cause of morbidity and mortality worldwide. Although not included in standard of care rehabilitation, stem cell therapy(SCT) could be a solution for prompting cardiac regeneration. Multiple studies have been published from the beginning of SCT until now, but overall no unanimous conclusion could be drawn in part due to the lack of appropriate endpoints. In order to appreciate the impact of SCT, multiple markers from different categories should be considered: Structural, biological, functional, physiological, but also major adverse cardiac events or quality of life. Imaging end-points are among the most used-especially left ventricle ejection fraction(LVEF) measured through different methods. Other imaging parameters are infarct size, myocardial viability and perfusion. The impact of SCT on all of the aforementioned end-points is controversial and debatable. 2 D-echocardiography is widely exploited, but new approaches such as tissue Doppler, strain/strain rate or 3 D-echocardiography are more accurate, especially since the latter one is comparable with the MRI gold standard estimation of LVEF. Apart from the objective parameters, there are also patient-centered evaluations to reveal the benefits of SCT, such as quality of life and performance status, the most valuable from the patient point of view. Emerging parameters investigating molecular pathways such as non-coding RNAs or inflammation cytokines have a high potential as prognostic factors. Due to the disadvantages of current techniques, new imaging methods with labelled cells tracked along their lifetime seem promising, but until now only pre-clinical trials have been conducted in humans. Overall, SCT is characterized by high heterogeneity not only in preparation, administration and type of cells, but also in quantification of therapy effects.
文摘The purpose of this study was to investigate the prediction of mechanical error using DICOM-RT plan parameters for volumetric modulated arc therapy (VMAT). We created plans for gantry rotation arcs of 360° and 180° (full-arc and half-arc VMAT) for six maxillary sinus cancer cases using a Monaco treatment planning system, and delivered the doses with a linear accelerator. We calculated DICOM-RT plan parameters, including gantry, multileaf collimator (MLC) positions and Monitor Units (MU). We compared plans with regard to gantry angle per MU (degrees/MU) and MLC travel per MU (mm/MU) for each segment. Calculated gantry angle/MLC position speeds and errors were evaluated by comparison with the log file. On average, the half-arc VMAT plan resulted in 47% and 35% fewer degrees/MU and mm/MU than the full-arc VMAT plan, respectively. The root mean square (r.m.s.) gantry and MLC speeds showed a linear relationship with calculated degrees/MU and mm/MU, with coefficients of determination (R2) of 0.86 and 0.72, respectively. The r.m.s. gantry angle and MLC position errors showed a linear relationship with calculated degrees/MU and mm/MU with R2 of 0.63 and 0.76, respectively. Deviations from plan parameters were related to mechanical error for VMAT, and provided quantitative information without the need for VMAT delivery. These parameters can be used in the selection of treatment planning.
基金The Ningbo Natural Science Foundation of China,No.2019A610342the Ningbo Health Branding Subject Fund,No.PPXK2018-01.
文摘BACKGROUND Subclavian vein stenosis or occlusion may be caused by a transvenous pacemaker,which makes the reimplantation of a new pacemaker lead difficult.Transvenous pacemaker lead implantation-related subclavian vein occlusion may present difficulty with regard to cardiac resynchronization therapy(CRT)upgrade.CASE SUMMARY We report the case of a 46-year-old man who was admitted with total subclavian vein occlusion caused by a permanent pacemaker that had been implanted 2 years previously.We successfully treated this patient with an upgrade to a CRT pacemaker by utilizing transferable interventional coronary and radiological techniques.The patient recovered uneventfully during the follow-up period.CONCLUSION CRT upgrade is still a viable technique for the treatment of subclavian vein obstruction caused by previous pacemaker implantation.