Microbubbles carrying resiquimod enhance HIFU ablation and co-stimulate tumor immune response / 中华超声影像学杂志

Objective:To prepare the resiquimod-loaded lipid microbubbles R848-MBs, evaluate their enhanced ultrasound imaging and high intensity focused ultrasound (HIFU) ablation effects, and explore their ability to improve tumor immune microenvironment synergize with HIFU.Methods:R848-MBs were prepared by the thin film hydration-mechanical shock method; The basic characteristics and safety of R848-MBs were detected, the HIFU controlled-release characteristics were verified in vitro and the drug metabolism and biological distribution were investigated in vivo. The ability of enhancing ultrasound imaging was observed in vitro and in vivo. To investigate the enhanced HIFU ablation effect of R848-MBs, six EMT6 tumor-bearing mice were randomly divided into HIFU group and R848-MBs+ HIFU group, three mice in each group, the changes in contrast average sound intensity before and after ablation in mouse tumor areas and the change of ultrasound image gray value in tumor area were evaluated, the tumor were resected to observe the coagulative necresis by TTC staining and HE staining. Forty-five tumor-bearing mice were randomly divided into control group, Free R848 group, HIFU group, Blank-MBs+ HIFU group and R848-MBs+ HIFU group, nine mice in each group. On the third day after treatment, 3 mice in each group were randomly selected and killed, to evaluate the ability of R848-MBs to improve tumor immune microenvironment synergize with HIFU. The expression level of CRT on the surface of tumor cells were detected by immunofluorescence staining, the proportion of mature DC in lymph nodes, spleen, and CD8 + T cells in spleen were detected by flow cytometry. The treatment effectiveness of each group( n=6) were evaluated by measuring tumor volume, observing and drawing survival curves. Results:The R848-MBs lipid microbubbles with good safety were successfully prepared, with a concentration of 2.58×10 9/ml, as spherical bubbles under optical microscope and laser confocal microscopy, in a particle size of (1.72±0.11)μm, at a surface potential of (-10.16±0.73)mV. The cumulative drug release was up to 83.44% after HIFU (90 W, 3 s) in vitro. The concentration of R848 in plasma decreased rapidly, and the drug concentration in tumor tissue of the R848-MBs+ HIFU group was higher than that of the R848 group 24 hours after treatment ( P<0.01). The ultrasound imaging of R848-MBs was significantly enhanced in contrast mode in vitro and in vivo; R848-MBs can significantly enhance the HIFU ablation effect, the contrast average sound intensity change in the tumor area before and after ablation in the R848MBs+ HIFU group was greater than that in the R848 group ( P<0.05), and the immediate ultrasound grayscale value change in the HIFU+ R848-MBs group was 46.34±3.21, which was significantly greater than that in the HIFU group (10.67±1.53), with statistical significance ( P<0.000 1). Coagulation necrosis was observed in tumor HE staining and TTC staining. The results of treatment efficacy in vivo showed that R848-MBs+ HIFU group had the strongest therapeutic effect, and R848-MBs combined with HIFU treatment could significantly prolong the survival period of mice compared with intravenous injection of free R848 ( P<0.01). Immunofluorescence staining and flow cytometry results showed an increase in the expression level of CRT on the surface of tumor tissue in the R848-MBs combined with HIFU group, and the percentage of mature DC in tumor draining lymph nodes (58.53±1.04)% were significantly higher than those in the HIFU group (37.56±2.13)% ( P<0.001), and the percentage of mature DC in the spleen (70.65±1.91)% were significantly higher than those in the HIFU group (36.46±3.89)% ( P<0.001), the percentage of CD8 + T cells in the spleen (27.46±3.04)% was significantly higher than that in the HIFU group (18.69±0.29)% ( P<0.01). Conclusions:The HIFU controlled-release lipid microbubbles R848-MBs can not only enhance the efficiency of HIFU ablation, but also improve the tumor immune microenvironment.

Multimodal imaging and photothermal/chemotherapy in vitro study of peptide-mediated network engineering paclitaxel nanoparticles loaded with metal polyphenols / 中华超声影像学杂志

Objective:To prepare a phase-change lipid nanoparticle modified by tumor homing membrane-penetrating peptide (tLyP-1) and carrying paclitaxel (PTX) engineered by metal polyphenol network (TA-Fe 3+ ), and evaluate the therapeutic effects of tumor targeting, ultrasound/photoacoustic imaging and photothermal combined chemotherapy in vitro. Methods:Phase-change lipid nanoparticles (t-P@TFP) with TA-Fe 3+ engineered PTX mediated by tLyP-1 were prepared by solvent replacement method, thin film hydration method and double emulsification method. Its detection and characterization, in vitro targeting ability, photothermal conversion ability, in vitro photoacoustic and ultrasonic imaging ability, CCK-8 method, cell live and death double staining method and flow cytometry method were used to detect the safety of nanoparticles and the killing effects of different nanoparticles on 4T1 cells. Results:t-P@TFP nanoparticles were successfully prepared. Transmission electron microscopy showed that the nanoparticles were spherical with uniform shape and size, with a particle size of (209.8±1.56)nm and a potential of (-25.9±1.36)mV. Laser confocal scanning microscopy showed that t-P@TFP nanoparticles could gather around 4T1 cells in a targeted manner. It had an efficient photothermal conversion effect, and nanoparticles could quickly become microbubbles after being irradiated by near-infrared laser, which enhanced the in vitro ultrasonic imaging effect; The photoacoustic signal of nanoparticles increased with the increase of concentration. CCK-8 method, double staining of living and dead cells and flow cytometry showed that t-P@TFP combined photothermal chemotherapy had the best anti-tumor effect. Conclusions:t-P@TFP nanoparticles are successfully prepared. The nanoparticles have good targeting ability for photoacoustic and ultrasonic imaging and have good photothermal effect, killing breast cancer cells, which is expected to realize the integration of diagnosis and treatment.

Teaching reform of ultrasound imaging on integrated medical curriculum / 中华医学教育探索杂志

Recently, the integrated medical curriculum with main line of organ system and with core of disease has played an important role in medical educational reform. During the teaching reform of ultrasonic imaging in the First Affiliated Hospital of Chongqing Medical University, there existed some main problems: simply considering the "integration" as "combination"; unreasonable arrangement of ultrasonic courses; different emphasis on teaching goals between the traditional and integrated teaching; deficient ultrasonic knowledge of clinical teachers, etc.. To solve those problems, teachers participated in the reform must take some measures: firstly, totally understand the spirit of integrated medical reform, and the goal of reform which is improving the clinical ability and quality of medical students but not the pure teaching of medical knowledge; secondly , adjust the curriculum establishment and content of ultrasonic imaging;thirdly, fully utilize the Picture Archiving and Communication System (PACS) system to complement the problem of deficient ultrasonic knowledge of clinical teachers.

A universal ultrasound diagnostic system developed to support urology and coloproctological applications

In this study, we sought to describe a novel imaging apparatus that is lightweight, inexpensive, and highly eff ective for use in colorectal diagnostic and treatment settings. Typical probes for use in colorectal ultrasonic imaging applications are developed for surgeons to diagnose and stage rectal tumors and image the rectum and anus. Here we outline a new technique and use it for colorectal imaging in an animal. This technique involves use of an ultrasound array module positioned along the axis of rotation such that improved rotation is possible. This module is in the shape of a linear rod with a rotary linear component that allows for emission of focused ultrasonic echo signals from a linear section of the probe. The usability of the transducer and rectal image quality are satisfactory in a porcine model with the technique proposed here, axial/lateral resolution as 0.96/2.24 mm with 6 dB applied through the contour map using the point spread function. When compared to currently available methods, this technique provides superior diagnostic 3D volumetric image quality with reduced acquisition time. Given this, the ultrasound device proposed here may prove a viable and preferable method to those currently available for urology and colorectal imaging applications.

A pictorial review of signature patterns living in musculoskeletal ultrasonography

The musculoskeletal system is mainly composed of the bones, muscles, tendons, and ligaments, in addition to nerves and blood vessels. The greatest difficulty in an ultrasonographic freeze-frame created by the examiner is recognition of the targeted structures without indicators, since an elephant's trunk may not be easily distinguished from its leg. It is not difficult to find descriptive ultrasonographic terms used for educational purposes, which help in distinguishing features of these structures either in a normal or abnormal anatomic condition. However, the terms sometimes create confusion when describing common objects, for example, in Western countries, pears have a triangular shape, but in Asia they are round. Skilled experts in musculoskeletal ultrasound have tried to express certain distinguishing features of anatomic landmarks using terms taken from everyday objects which may be reminiscent of that particular feature. This pictorial review introduces known signature patterns of distinguishing features in musculoskeletal ultrasound in a normal or abnormal condition, and may stir the beginners' interest to play a treasure-hunt game among unfamiliar images within a boundless ocean.

A pictorial review of signature patterns living in musculoskeletal ultrasonography

The musculoskeletal system is mainly composed of the bones, muscles, tendons, and ligaments, in addition to nerves and blood vessels. The greatest difficulty in an ultrasonographic freeze-frame created by the examiner is recognition of the targeted structures without indicators, since an elephant's trunk may not be easily distinguished from its leg. It is not difficult to find descriptive ultrasonographic terms used for educational purposes, which help in distinguishing features of these structures either in a normal or abnormal anatomic condition. However, the terms sometimes create confusion when describing common objects, for example, in Western countries, pears have a triangular shape, but in Asia they are round. Skilled experts in musculoskeletal ultrasound have tried to express certain distinguishing features of anatomic landmarks using terms taken from everyday objects which may be reminiscent of that particular feature. This pictorial review introduces known signature patterns of distinguishing features in musculoskeletal ultrasound in a normal or abnormal condition, and may stir the beginners' interest to play a treasure-hunt game among unfamiliar images within a boundless ocean.

Valuea of contrast-enhanced imaging and enhanced CT in diagnosis of traumatic spleen rupture / 实用医学杂志

Objective To explore the value of contrast-enhanced ultrasound in the diagnosis and classification of traumatic spleen rupture , as compared with enhanced CT. Methods The manifestations of contrast-enhanced ultrasound on surgically or clinically confirmed spleen rupture in 40 patients were retrospectively analyzed. The performance of contrast-enhanced ultrasound on diagnosis and classification was compared with that of enhanced CT. Results For 40 patients with traumatic spleen rupture , the of accuracy of enhanced CT and contrast-enhanced imaging in the diagnosis of traumatic spleen rupture was 97.5%, with no significant statistical differences (chi-square = 0, P = 1). On contrast-enhanced ultrasound examination, 14 patients were diagnosed as true splenic rupture , 9 as subcapsular spleen rupture , and 16 as central splenicrupture, with a accuracy rate of 92.5% (37/40); and accuracy rate for enhanced CT was 90.0% (36/40), there was no significant statistical difference (chi-square = 1.97, P > 0.05). Conclusions Contrast-enhanced and enhanced CT have good consistency in the diagnosis and classification of traumatic spleen rupture. Contrast-enhanced ultrasound can accurately determine the scope and degree of spleen damage , resulting in more accurate classification; and it has values in the diagnosis of traumatic spleen rupture and choice of therapies.

Application of ultrasonic tomography imaging in staging cervical cancers / 中华超声影像学杂志

Objective To evaluate the clinical value of tomography ultrasonic imaging (TUI) in staging carcinomas of the cervix.Methods Eighty-seven patients with biopsy proven cervical cancer who underwent transvaginal TUI examination were enrolled.Clinical and ultrasonic staging were based on the FIGO staging system.Surgical-pathological or MR results was taken as golden standard.Ultrasonic staging were compared with clinical staging.Tumor sizes of 38 cases of cervical cancers measured by TUI were recorded and compared with the pathological results.Results The overall accuracy of preoperative TUI staging was higher than that of preoperative clinical staging (91.95 ％ vs 81.60 ％,P ＜0.01).Mean size of the 38 malignant tumors was 2.5 cm×2.1 cm×2.2 cm by TUI and 2.6 cm×2.1 cm×2.3 cm by pathological samples (P ＞ 0.05).Conclusions TUI technology may be useful in the noninvasive examination of preoperative staging of carcinoma cervix.

Real-time three plane ultrasonic imaging for evaluation of left atrial function in the general population / 中国医学装备

Objective:To evaluate the clinical efficacy of left left atrial function for the healthy by using real-time three plane ultrasonic imaging in.Methods: The three plane real-time ultrasound imaging was used for evaluation healthy people of left atrial function in 32 adults (including storage volume of left atrium, left atrial pipeline volume, left ventricular ejection fraction). At the same time, the two-dimensional echocardiography was also used to detect the parameters which were to compare two methods of correlation and consistency.Results:Two methods of ultrasonic examination in LARV, LACV and LVEF indicators have no obvious difference; LARV, LACV and LAEF in three plane image and two-dimensional ultrasound images show good correlation, the correlation coefficient rLARV=0.82, rLACV=0.85, rLVEF=0.88,P<0.05).Conclusion:Real-time three plane ultrasound imaging and two-dimensional echocardiography in the assessment of left atrial function of normal people have a good correlation.

Architectural Changes of the Gastrocnemius Muscle after Botulinum Toxin Type A Injection in Children with Cerebral Palsy

PURPOSE: This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP). MATERIALS AND METHODS: Thirteen children with CP who received a BoNT-A injection into their GCM to treat equinus were recruited (9 males and 4 females). Architectural changes in both the medial and lateral heads of the GCM from a total of 20 legs were assessed using B-mode, real-time US. Muscle thickness (MT), fascicle length (FL), and fascicle angle (FA) were measured over the middle of the muscle belly in both a resting and neutral ankle position. Measures at 1 and 3 months after the injection were compared with baseline data taken before the injection. RESULTS: The mean age of the subjects was 5.8 (+/-1.6) years. Spasticity was significantly reduced when measured by both the modified Tardieu scale and the modified Ashworth scale at 1 and 3 months after injection (p<0.05). The MT and FA of both the medial and lateral heads of the GCM were significantly reduced for both neutral and resting ankle positions at 1 and 3 months after the injection. The FL of both the medial and lateral heads of the GCM were significantly increased in a resting position (p<0.05), but not in a neutral position. CONCLUSION: Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.

Characteristics of metabolic syndrome associated with hepatic steatosis / Características da síndrome metabólica associados à esteatose hepática

Design of the study: a cross-sectional population-based study performed at clinics and healthy units at Curitiba - Paraná - Brazil. Objectives: to evidence which are the major cardiovascular risk factors of MS related with the hepatic steatosis (HS). Methodology: 75 patients with metabolic syndrome (MS), in treatment or not for this condition, after meeting the criteria of inclusion or exclusion for the research, were submitted to ultrasound exam of the liver to quantify the degree of HS. Then, the relationship between HS and cardiovascular risk factors of MS was evaluated.Results: regardless of age, gender and hypertension, patients with glucose intolerance or diabetes mellitus have a higher risk for HS than patients with normal serum glucose (p<0,05). Less relevant, hypertension also demonstrated association with HS. Conclusions: Cardiovascular risk factors of MS may be associated with HS. The alteration of glucose metabolism appears to be the main risk factor of MS associated with HS.

Modelo do estudo: estudo transversal de base populacional realizado em ambulatórios e unidades de saúde em Curitiba - Paraná - Brasil. Objetivo: evidenciar quais são os principais fatores de risco cardiovascular da síndrome metabólica (SM) associados à esteatose hepática (EH). Metodologia: 75 pacientes com SM, sob tratamento ou não, após preencher os critérios de inclusão ou exclusão da pesquisa, foram submetidos à ultrassonografia hepática para investigar a presença de EH. Em seguida, foi avaliada a relação entre EH e fatores de risco cardiovasculares da SM. Resultados: independente da idade, gênero e hipertensão arterial, pacientes com intolerância à glicose ou diabetes mellitus têm maior risco de EH que os pacientes com glicose sérica normal (p<0,05). Menos relevante, hipertensão também demonstrou associação com EH. Conclusão: fatores de risco cardiovasculares da SM podem estar associados à EH. A alteração no metabolismo da glicose parece ser o fator fisiopatológico mais importante associado ao dano hepático

Development of ultrasonic imaging transducer / 国际生物医学工程杂志

Transducer,which acts as both ultrasound emitter and echo receiver,is the most important acoustics part in medical ultrasonic imaging system.The development of ultrasonic imaging technology makes ultrasound image clearer and more intuitionistic.This paper mainly introduces the technical development and the prospects of piezocomposite transducer,piezoelectric single crystal transducer,wide-band transducer,3D imaging transducer and capacitive micromachined ultrasonic transducer(cMUT).

Development and application status of ultrasonic imaging diagnostic technique / 医疗卫生装备

Ultrasonic imaging diagnostic technique is one of the most widely used imaging diagnostic techniques,whose fast development has greatly raised the level of clinical diagnosis.The development of ultrasonic imaging diagnostic technique is mainly introduced and various kinds of ultrasonic imaging diagnostic techniques are mentioned including A-mode,M-mode and B-mode ultrasonic diagnostic techniques,Doppler imaging technique,3D imaging technique and harmonic imaging technique.

Measurement of human tongue by ultrasonic imaging / 实用口腔医学杂志

0.05). Conclusion: The tongue measurement with ultrasonic imaging is reproducible.