ABSTRACT
Objective:To investigate the efficacy and safety of radium-223 in combination with new-generation hormonal agents in patients with bone metastases of prostate cancer.Methods:The clinical data of 17 patients (12 from the First Affiliated Hospital of Airforce Military Medical University and 5 from Xi'an International Medical Center Hospital) with metastatic castration-resistant prostate cancer(mCRPC) treated by radium-223 combined with new-generation hormonal agents from January 2021 to June 2022 were retrospectively analyzed. In all cases, the average age was (73.3±8.5) years old. Before treatment, the median prostate-specific antigen (PSA) was 15.7 (3.2, 36.5) ng/ml, the median alkaline phosphatase (ALP) was 131.5 (79.0, 430.7) U/L. All patients had ≥ 2 bone metastases but no visceral or lymph node metastases. The median number of bone scan lesions was 10(8, 15). Bone pain symptom was present in 16(94.1%) patients. There were 9 cases (52.9%) with Eastern Cooperative Oncology Group (ECOG) score of ≥2, 1 case (5.9%) with ECOG score of 1 and 6 cases (35.2%) with ECOG score of 0. All patients were treated with radium-223 (55 kBq/kg, injected every 4 weeks for a maximum of 6 cycles), of which 5 patients were combined with enzalutamide, 8 patients combined with apatamide and 4 patients combined with bicalutamide. PSA response (PSA decreased by ≥30% from baseline and maintained for at least 1 month), ALP response (ALP decreased by ≥30% from baseline and maintained for at least 1 month) and pain relief rates were analyzed. Imaging evaluation was performed before and after treatment to calculate the objective response rate of metastases. The incidence of treatment-related adverse effects and skeletal related event (SRE) were also recorded.Results:Eleven patients completed 6 courses, 3 patients completed 5 courses and 3 patients completed ≥4 courses. The median ALP after 1 month of last treatment was 83.2 (51.5, 126.5) U/L, which was significantly decreased than baseline. 12 patients (70.6%) showed an ALP response and the other 5 (29.4%) showed varying degrees of ALP elevation. PSA response was observed in 4 patients (23.5%), of which 2 (11.8%) had a continuous decrease and 2 (11.8%) had a late-stage increase in PSA. Pain relief was relieved in 15 cases (88.2%) during treatment, 1 case (5.9%) had worsening pain due to disease progression and 1 case (5.9%) had no change during treatment. The ECOG score decreased in 15 (88.2%) patients. The median number of bone metastases in patients decreased to 5 (4, 9). One patient (5.9%) had complete remission during treatment, 11 patients (64.7%) had a partial response, 4 patients (23.5%) were stable, and 1 (5.9%) showed imaging progression after 4 months of treatment. The overall objective remission response rate was 70.5% (12/17). Treatment-related hematologic adverse effects included anemia (1 case, 5.9%, grade 3), thrombocytopenia (1 case, 5.9%, grade 3) and leukopenia (1 case, 5.9%, grade 2). Non-hematologic adverse effects included fatigue (3 cases, 17.6%, 2 cases in grade 1, 1 case in grade 2), gastrointestinal bleeding (1 case, 5.9%, grade 3), diarrhea (1 case, 5.9%, grade 2) and fever (1 case, 5.9%, grade 1). Patients with grades 1 to 2 relieved with symptomatic management. Three cases (17.6%) were discontinued due to intolerance of grade 3 adverse reactions and 1 case (5.9%) terminated on its own. There was no SRE during treatment and follow-up.Conclusions:Radium-223 combined with New-generation hormonal agents has a high objective remission rate in patients with mCRPC, which could provide pain relief and improve quality of life. The incidence of adverse reactions was low and well tolerated.
ABSTRACT
Objective:To explore the preoperative 68Ga-PSMA PET/CT examination on the guidance of surgical strategies for high-risk prostate cancer patients and the influence of positive surgical margins after surgery. Methods:The clinical data of 118 patients with high-risk prostate cancer who underwent robot-assisted laparoscopic radical prostatectomy from June 2019 to December 2020 in Xijing Hospital of Air Force Military Medical University was retrospectively analyzed. 47 patients received 68Ga-PSMA PET/CT examination before surgery (study group), and 71 cases without 68Ga-PSMA PET/CT examination before operation ( control group). There was no statistically significant difference in the age [69 (63, 76) vs. 67 (64, 74) years], PSA [PSA≤20ng/ml: 9.91 (6.00, 13.67) vs. 11.64 (8.15, 15.44) ng/ ml, PSA> 20ng/ml: 66.53 (53.66, 195.30) vs. 63.18 (30.08, 148.05) ng/ml], preoperative clinical staging (T 2/≥T 3: 21/26 cases vs. 34/37 cases), and Gleason score [8 (7, 9) vs. 8 (7, 9) points] (all P>0.05) between study group and control group. Both groups underwent robot-assisted laparoscopic radical prostatectomy. The surgical plan was based on the PSMA PET/CT and MRI results in study group and control group respectively. First, ensure that all tumors are removed, and secondly, preserve the patient's urethral length as much as possible to ensure postoperative urinary control.If there is seminal vesicle invasion, expand the scope of resection as needed. If lymph node metastasis is shown, lymph node dissection is performed. For those with negative lymph nodes in imaging studies, if enlarged lymph nodes are found during the operation, lymph node dissection is also performed. After the operation, the perioperative results and surgical margins of the two groups were compared, and the correlation between the PSA value and the SUVmax value of prostate cancer tissue was analyzed. Results:The operations of the two groups were successfully completed, and there was no transfer to open surgery. The operation time of the study group was shorter than that of the control group [175 (155, 205) min vs. 205 (155, 235) min, P=0.003], and the positive rate of resection margin was significantly lower than that of the control group [23.40% (11/47) vs. 45.07%(32/71), P=0.017]. For patients with pathological stage ≥pT 3, the positive rate of surgical margins in the study group was significantly lower than that in the control group [30.77%(8/26) vs. 62.16%(23/37), P=0.014]. In the study group, 11 cases of PSMA-PET showed positive lymph nodes before operation, 10 cases were pathologically positive after operation (90.91%). PSMA-PET showed negative lymph nodes in 1 case, which was pathologically positive after operation. In the control group, 26 cases underwent lymph node dissection, and 16 cases (61.54%) were pathologically positive after operation. The preoperative PSA value of 47 cases in the study group was positively correlated with the SUVmax value of prostate cancer tissue ( r=0.579, P<0.01). Conclusions:Preoperative 68Ga-PSMA PET/CT for high-risk prostate cancer patients can guide the surgeon to optimize the surgical plan, reduce the positive rate of resection margins, and effectively remove the metastatic lymph nodes, which will benefit the patients.
ABSTRACT
Objective@#To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.@*Methods@#We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019. Among the 150 patients, 118 patients were males and 32 patients were females. The average age was 57 years, ranging 20-93 years. There were 112 cases of single tumor and 38 cases of multiple tumor. All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy, including 61 patients for pirarubicin, 58 patients for gemcitabine, 11 patients for epirubicin, and 11 patients for mitomycin. 14 patients did not receive bladder infusion chemotherapy. In this study, univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.@*Results@#The average follow-up time was 25.6 months, ranging 5.5-122.7 months. Among the patients, 21 patients occurred recurrence. The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months). 12 patients had pathological progression, including 9 patients for low-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade non-invasive papillary urothelial carcinoma, 1 patient for high-grade invasive urothelial carcinoma, 1 patient for squamous cell carcinoma. The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months). Among the 150 patients, 18 patients with inverted growth pattern did not recur. There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups, same as the progression and non-progression groups. The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR=7.884, 95%CI 2.815-22.082, P<0.05)and progression(OR=6.107, 95%CI 1.659-22.473, P=0.006) in patients of bladder PUNLMP. Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression.@*Conclusions@#About 14% (21/150) patients of bladder PUNLMP reoccurred after TURBT. About half of them had pathological progression, and most of them progressed to low-grade non-invasive papillary urothelial carcinoma. Multiple tumors was an independent risk factor for postoperative recurrence and progression. Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP.
ABSTRACT
Objective To investigate the pathological characteristics of bladder low malignant potential papillary urothelial tumors (PUNLMP) and the predic factors of recurrence and pathological progress.Methods We retrospectively analyzed 150 patients of bladder PUNLMP in the Department of Urology of Xijing Hospital from February 2009 to February 2019.Among the 150 patients,118 patients were males and 32 patients were females.The average age was 57 years,ranging 20-93 years.There were 112 cases of single tumor and 38 cases of multiple tumor.All patients received transurethral resection of bladder tumor (TURBT) and 136 patients received bladder infusion chemotherapy,including 61 patients for pirarubicin,58 patients for gemcitabine,11 patients for epirubicin,and 11 patients for mitomycin.14 patients did not receive bladder infusion chemotherapy.In this study,univariate and multivariate logistic regression analysis were used to investigate independent predictors of recurrence and pathological progression in patients of bladder PUNLMP who received TURBT.Results The average follow-up time was 25.6 months,ranging 5.5-122.7 months.Among the patients,21 patients occurred recurrence.The recurrent duration ranged from 2.2 to 108.3 months (mean 23.1 months).12 patients had pathological progression,including 9 patients for low-grade non-invasive papillary urothelial carcinoma,1 patient for high-grade noninvasive papillary urothelial carcinoma,1 patient for high-grade invasive urothelial carcinoma,1 patient for squamous cell carcinoma.The progressive duration ranged from 2.2 to 56.3 months (mean 21.5 months).Among the 150 patients,18 patients with inverted growth pattern did not recur.There were significant differences in the number of tumors and the tumor length between the recurrence and non-recurrence groups,same as the progression and non-progression groups.The univariate and multivariate logistic regression analysis results showed that the number of tumors was an independent predictor of tumor recurrence (OR =7.884,95％ CI 2.815-22.082,P ＜ 0.05) and progression (OR =6.107,95％ CI 1.659-22.473,P =0.006) in patients of bladder PUNLMP.Bladder infusion chemotherapy failed to reduce the risk of recurrence and progression.Conclusions About 14％ (21/150) patients of bladder PUNLMP reoccurred after TURBT.About half of them had pathological progression,and most of them progressed to low-grade noninvasive papillary urothelial carcinoma.Multiple tumors was an independent risk factor for postoperative recurrence and progression.Bladder infusion chemotherapy did not reduce the risk of recurrence and progression in patients of bladder PUNLMP.
ABSTRACT
Objective@#To observe the effect of cinobufacin on the expression of phosphorylated PTEN protein in human breast cancer MCF-7 and MDA-MB-231 cells.@*Methods@#The MCF-7 and MDA-MB-231 cells were divided into control group, high dose group and low dose group according to random number table method. Low and high dose groups were added with 0.5, 5.0 mg/ml cinobufacin, 100 μl/well for intervention, respectively, while the control group was added with equal volume of RPMI-1640 medium. Cell Counting Kit-8 was used to detect cell proliferation assay at 24, 48, and 72 h following intervention. Immunoblotting was used to detect the expression of AKT/mTOR pathway protein expression and p-PTEN.@*Results@#At 24, 48, and 72 h after intervention, the proliferation of MCF-7 and MDA-MB-231 cells in high dose group were significantly decreased (P<0.05). Compared with the control group, the expression of p-AKT (MCF-7: 0.357 ± 0.064, 0.215 ± 0.056 vs. 0.924 ± 0.085; MDA-MB-231: 0.310 ± 0.022, 0.194 ± 0.019 vs. 0.811 ± 0.089), p-mTOR (MCF-7: 0.476 ± 0.039, 0.217 ± 0.038 vs. 0.838 ± 0.058; MDA-MB-231: 0.300 ± 0.031, 0.223 ± 0.025 vs. 0.896 ± 0.096), p-S6 (MCF-7: 0.551 ± 0.068, 0.428 ± 0.041 vs. 1.254 ± 0.264; MDA-MB-231: 0.281 ± 0.014, 0.197 ± 0.012 vs. 0.748 ± 0.022), p-PTEN (MCF-7: 0.487 ± 0.170, 0.184 ± 0.135 vs. 1.003 ± 0.284, P<0.05; MDA-MB-231: 0.261 ± 0.184, 0.170 ± 0.105 vs. 1.014 ± 0.206) in the low and high dose group significantly decreased (P<0.05).@*Conclusions@#Cinobufacin inhibited the proliferation of MCF-7 and MDA-MB-231 cells, which may be mediated by down-regulation of the expression of the upstream of the AKT/mTOR signaling pathway p-PTEN.
ABSTRACT
Objective@#To investigate the independent predictors of inguinal lymph node metastasis (LLM) in patients with penile squamous cell carcinoma (SCCP), and to establish a nomogram for predicting individual LLM risk.@*Methods@#The data of patients with SCCP diagnosed at the department of urology, Xijing Hospital from July 2009 to June 2019 were analyzed retrospectively. A total of 101 patients were included in this study, with age of 55 (26-84) years. There were 25 (24.8%) and 76 (75.2%) patients with and without palpable inguinal lymph node enlargement, respectively. There were 47 cases (46.5%), 40 cases (39.6%) and 14 cases (13.9%) in T1, T2 and T3 stages, respectively; there were 67 cases (66.3%), 21 cases (20.8%) and 13 cases (12.9%) in Broder 1, 2 and 3, respectively. The average value (or median) of fibrinogen was 2.84 (1.72-5.00)g/L; alkaline phosphatase was 80(32±214)U, hemoglobin was 147(81-180)g, platelet count was (193.74±65.68×109/L, absolute value of neutrophils, monocytes and lymphocytes were 3.98(1.19-11.85)×109/L, 0.44(0.17-1.90)×109/L and 1.68(0.58-4.13)×109/L, respectively. The average (or median) value of PLR, NLR and LMR were 113.38(18.80-418.42), 2.42(0.59-10.22) and 3.84 (1.08-9.89), respectively. There were 26 cases (25.7%) with LLM and 75 cases (74.3%) without LLM. The independent predictors of LLM were identified by univariate and multivariate logistic regression analyses. The R software was used to establish the nomogram by integrating all independent predictors, and the bootstrap method was used to internally validated our nomogram, where the value of AUC (area under the ROC curve) was calculated and the calibration plot was drawn.@*Results@#Clinical inguinal lymph node status (P<0.006), T stage (P<0.021), Broder grade (P<0.017) and absolute neutrophil value (P<0.043) were independent predictors of LLM. The accuracy of our nomogram was 0.875 (AUC=0.875, 95%CI 0.859-0.891); Moreover, the risk of LLM predicted by nomogram was in good consistency with the actual LLM rate, and the errors of the nomogram-predicted LLM risks were all within 10%.@*Conclusions@#Clinical inguinal lymph node status, T stage, broder grade and absolute value of neutrophils were identified as independent predictors of LLM in patients with SCCP on the basis of single center data. A generic nomogram predicting LLM risk for Chinese patients was developed, which would be helpful to screen SCCP patients who need prophylactic inguinal lymph node dissection.
ABSTRACT
Objective To investigate the independent predictors of inguinal lymph node metastasis (LLM) in patients with penile squamous cell carcinoma (SCCP),and to establish a nomogram for predicting individual LLM risk.Methods The data of patients with SCCP diagnosed at the department of urology,Xijing Hospital from July 2009 to June 2019 were analyzed retrospectively.A total of 101 patients were included in this study,with age of 55 (26-84) years.There were 25 (24.8％) and 76 (75.2％) patients with and without palpable inguinal lymph node enlargement,respectively.There were 47 cases (46.5 ％),40 cases (39.6％) and 14 cases (13.9％) in T1,T2 and T3 stages,respectively;there were 67 cases (66.3％),21 cases (20.8％) and 13 cases (12.9％) in Broder 1,2 and 3,respectively.The average value (or median) of fibrinogen was 2.84 (1.72-5.00) g/L;alkaline phosphatase was 80 (32 ± 214) U,hemoglobin was 147 (81-180) g,platelet count was (193.74 ± 65.68 × 109/L,absolute value of neutrophils,monocytes and lymphocytes were 3.98(1.19-11.85) × 109/L,0.44(0.17-1.90) × 109/L and 1.68(0.58-4.13) × 109/L,respectively.The average (or median) value of PLR,NLR and LMR were 1 13.38 (18.80-418.42),2.42 (0.59-10.22) and 3.84 (1.08-9.89),respectively.There were 26 cases (25.7％) with LLM and 75 cases (74.3％) without LLM.The independent predictors of LLM were identified by univariate and multivariate logistic regression analyses.The R software was used to establish the nomogram by integrating all independent predictors,and the bootstrap method was used to internally validated our nomogram,where the value of AUC (area under the ROC curve) was calculated and the calibration plot was drawn.Results Clinical inguinal lymph node status (P ＜0.006),T stage (P ＜0.021),Broder grade (P ＜ 0.017) and absolute neutrophil value (P ＜ 0.043) were independent predictors of LLM.The accuracy of our nomogram was 0.875 (AUC =0.875,95％ CI 0.859-0.891);Moreover,the risk of LLM predicted by nomogram was in good consistency with the actual LLM rate,and the errors of the nomogram-predicted LLM risks were all within 10％.Conclusions Clinical inguinal lymph node status,T stage,broder grade and absolute value of neutrophils were identified as independent predictors of LLM in patients with SCCP on the basis of single center data.A generic nomogram predicting LLM risk for Chinese patients was developed,which would be helpful to screen SCCP patients who need prophylactic inguinal lymph node dissection.
ABSTRACT
Objective To observe the effect of cinobufacin on the expression of phosphorylated PTEN protein in human breast cancer MCF-7 and MDA-MB-231 cells. Methods The MCF-7 and MDA-MB-231 cells were divided into control group, high dose group and low dose group according to random number table method. Low and high dose groups were added with 0.5, 5.0 mg/ml cinobufacin, 100 μl/well for intervention, respectively, while the control group was added with equal volume of RPMI-1640 medium. Cell Counting Kit-8 was used to detect cell proliferation assay at 24, 48, and 72 h following intervention. Immunoblotting was used to detect the expression of AKT/mTOR pathway protein expression and p-PTEN. Results At 24, 48, and 72 h after intervention, the proliferation of MCF-7 and MDA-MB-231 cells in high dose group were significantly decreased (P<0.05). Compared with the control group, the expression of p-AKT (MCF-7: 0.357 ± 0.064, 0.215 ± 0.056 vs. 0.924 ± 0.085; MDA-MB-231: 0.310 ± 0.022, 0.194 ± 0.019 vs. 0.811 ± 0.089), p-mTOR (MCF-7:0.476 ±0.039, 0.217 ±0.038 vs. 0.838 ±0.058; MDA-MB-231: 0.300 ±0.031, 0.223 ±0.025 vs. 0.896 ±0.096), p-S6 (MCF-7: 0.551 ±0.068, 0.428 ±0.041 vs. 1.254 ±0.264; MDA-MB-231: 0.281 ±0.014, 0.197 ±0.012 vs. 0.748 ±0.022), p-PTEN (MCF-7: 0.487 ±0.170, 0.184 ±0.135 vs. 1.003 ±0.284, P<0.05; MDA-MB-231: 0.261 ± 0.184, 0.170 ± 0.105 vs. 1.014 ± 0.206) in the low and high dose group significantly decreased (P<0.05). Conclusions Cinobufacin inhibited the proliferation of MCF-7 and MDA-MB-231 cells, which may be mediated by down-regulation of the expression of the upstream of the AKT/mTOR signaling pathway p-PTEN.
ABSTRACT
Objective To investigate the clinical value and experience of transperitoneal and retroperitoneal robot-assisted partial nephrectomy for renal hi1 ar tumors.Methods We evaluated 48 patients who had partial nephrectomy for renal hilar tumor by robotic surgical syestem from January 2013 to March 2017.In those cases,35 were male and 13 were female,with an average age of 57.3 (range from 41 to 75 ),27 cases were ventral tumor and 21 cases were dorsal tumor.3 cases were totally confined to the renal parenchyma,the other 45 cases were partially confined to the renal parenchyma.18 cases were performed surgery by retroperitoneal route,the rest 30 cases were performed by peritoneal route.Results A total of 48 patients underwent successful robotic partial nephrectomy for renal hilar tumors.The mean warm ischemia time was 22 minutes (range from 16 to 33 minutes) and the mean estimated blood loss was 88 md (range from 50 to 350 ml).No bleeding-related complications were found.Histopathology confirmed 39 cases of ccRCC,7 cases of angioleiomyolipoma,2 cases of renal oncocytoma.There was one case in this review was positive surgical margin (2.1％) and found no sign of recurrence during the short term post-operation follow-up.All cases in this review are following up after surgery to date from 2 months to 4 years,no cases of tumor recurrence or metastasis were found.Conclusions The application of transperitoneal and retroperitoneal RAPN is the effective and safe way for renal hilar tumor resection,and it has a clear advantage of renal surgical incision stitching and tumor complete resection.The choice of surgical approaches depends on the size and location of tumor and the clinical experience of the surgeon.
ABSTRACT
Liver cirrhosis is a common chronic progressive liver disease,and at present the most effective treatment for advanced liver cirrhosis is liver transplantation.However,main reasons of limiting the wide application of liver cirrhosis are liver source deficiency,expensive cost,graft rejection reaction,the complications caused by long-term application of immunosuppressant and so on.Stem cell transplantation has become a new method for the treatment of liver diseases due to its beneficial to the damaged liver tissue repair,and it can compensate part of liver function.The basis and clinical research progress,the existing problems and prospects of the bone mesenchymal stem cell transplantation for the treatment of liver cirrhosis are summarized,aiming to provide theoretical basis for the further research.
ABSTRACT
[Abstact] Objective To investigate the efficacy and safety of sunitinib as first line therapy in treating those patients with metastatic renal cell carcinoma ( mRCC ) .Methods A total of 66 patients , including 42 male and 24 female cases ,with metastatic renal cell carcinoma were enrolled from January 2009 to June 2014.The median age was 52 years (range 26-75 years).According to American Joint Committee On Cancer (AJCC) staging,there were 35 cases of T3 stage,31 cases of T4 stage.All patients had distant metastasis ,including single organ metastasis in 52 patients and multiple organ metastasis in 14 cases.Sixty-one patients received prior radical nephrectomy ,5 patients received biopsy .Sixty-two patients were diagnosed as renal clear cell carcinoma and 4 patients were diagnosed as renal papillary cell carcinoma .Sunitinib was administered in standard 4/2 regimens.Briefly, patient takes 50 mg once a day orally for 4 weeks.Then the sunitinib will be stopped for 2 weeks.Six weeks was defined as 1 cycle.It should be continued until disease progression or occurrence of intolerable adverse reactions .The efficacy of sunitinib should be evaluated within 2 cycles.Results The duration of following-up ranged from 5 to 66 months.The efficacy could be evaluated in 63 patients.Two patients ( 3.2%) achieved complete remission .Twelve patients ( 19.0%) achieved partial remission.Forty-five patients (71.4%) demonstrated stable disease and 4 patients (6.3%) developed progressive disease .The disease control rate was 93.7%(59/63) and the objective response rate was 22.2%(14/63).2 (3.2%) patients died due to the progression of disease .The most commonⅠ-Ⅱadverse events included fatigue in 36 cases ( 57.1%) , thrombocytopenia in 36 cases ( 57.1%) , hand-foot syndrome in 32 cases (50.8%),hypertension in 27 cases (42.9%),neutropenia in 15 cases (23.8%), hypothyroidism in 12 cases (19.0%), diarrhea in 6 cases (9.5%) and alopecia in 4 cases (6.3%).Ⅲ-Ⅳ adverse events were hand-foot syndrome in 4 cases ( 6.3%) , hypertension in 2 cases ( 3.2%) , neutropenia in 5 cases (7.9%) and thrombocytopenia in 5 cases (7.9%).Most mild adverse reactions after symptomatic treatment could be alleviated ,did not affect the medication .When the adverse events returned to the Ⅰ-Ⅱdegree, the 37.5 mg sunitinib was resumed once daily by orally.NoⅢ-Ⅳadverse events were reported again.Conclusions Sunitinib was efficacious in the treatment of advanced renal cell carcinoma.Most mild adverse events were tolerable ,and severe adverse events need medical treatment .
ABSTRACT
In order to improve the resolution, contrast and frame rate of ultrasound imaging, it is necessary to design an adaptive beamforming method for plane wave ultrasound imaging. An optimized minimum variance algorithm that suits plane wave ultrasound imaging was proposed, based on the traditional minimum variance algorithm that combines with the subband beamforming as well as the forward-backward spatial smoothing method in the frequency domain. To verify the effectiveness of the improved algorithm, the matlab software was used. Simulation results showed that full width at half maximum and peak side-lobe level of Optimized MV, Conventional MV, DAS boxcar, and Linear scan methods were 0.08, 0.36, 0.92, 1.42 dB, and -41.1, - 37.3, -16.9, - 34.1 dB, respectively. The improved algorithm can significantly improve the image resolution and contrast, particularly applicable to plane wave ultrasound imaging, compared with the conventional minimum variance algorithm and traditional delay-and-sum method.
Subject(s)
Algorithms , Contrast Media , Image Enhancement , Image Processing, Computer-Assisted , Methods , Microbubbles , Phantoms, Imaging , Ultrasonography , MethodsABSTRACT
This investigation was made with regard to the influences of ultrasound combined with hematoporphyrin on the activities of antioxidative enzyme in ascites hepatoma 22 (H-22) tumor cells, and to a better understanding of the potential biological mechanism of sonodynamic therapy which involved the damage to cells. Combined with 100 microg/ml hematoporphyrin, high intensity focused ultrasound sonication at a frequency of 1.43 MHz and an intensity level of 2.0 W/cm2 was delivered to H-22 tumor cells for 1 min. The viability of cells was evaluated by typan-blue blue exclusion test. The intracellular reactive oxygen species (ROS) levels were determined by 2',7'-dichlorofluorescein diacetata (DCFH-DA). Enzymatic chemical methods were used to measure the activities of key antioxidative enzymes. The results indicated that the cell damage rate of ultrasound combined with hematoporphyrin was significantly higher than that of the treatment with ultrasound alone, and hematoporphyrin alone had no killing effect on H-22 cells. The level of ROS in cell suspension was significantly increased, and the key antioxidative enzyme activities were obviously decreased after treatment with the combined use of ultrasound and hematoporphyrin. We speculated that the decreased activities of key antioxidative enzymes in cells might be involved in mediating the killing effect on H22 cells in sonodynamic therapy.