| 6 | Magnetic resonance imaging biomarkers for pulsed focused ultrasound treatment of pancreatic ductal adenocarcinoma显示文摘BACKGROUND The robust fibroinflammatory stroma characteristic of pancreatic ductal adenocarcinoma(PDA)impedes effective drug delivery.Pulsed focused ultrasound(pFUS)can disrupt this stroma and has improved survival in an early clinical trial.Non-invasive methods to characterize pFUS treatment effects are desirable for advancement of this promising treatment modality in larger clinical trials.AIM To identify promising,non-invasive pre-clinical imaging methods to characterize acute pFUS treatment effects for in vivo models of PDA.METHODS We utilized quantitative magnetic resonance imaging methods at 14 tesla in three mouse models of PDA(subcutaneous,orthotopic and transgenic-KrasLSLG12D/+,Trp53LSL-R172H/+,Cre or“KPC”)to assess immediate tumor response to pFUS treatment(VIFU 2000 Alpinion Medical Systems;475 W peak electric power,1 ms pulse duration,1 Hz,duty cycle 0.1%)vs sham therapy,and correlated our results with histochemical data.These pFUS treatment parameters were previously shown to enhance tumor permeability to chemotherapeutics.T1 and T2 relaxation maps,high(126,180,234,340,549)vs low(7,47,81)b-value apparent diffusion coefficient(ADC)maps,magnetization transfer ratio(MTR)maps,and chemical exchange saturation transfer(CEST)maps for the amide proton spectrum(3.5 parts per million or“ppm”)and the glycosaminoglycan spectrum(0.5-1.5 ppm)were generated and analyzed pre-treatment,and immediately post-treatment,using ImageJ.Animals were sacrificed immediately following post-treatment imaging.The whole-tumor was selected as the region of interest for data analysis and subsequent statistical analysis.T-tests and Pearson correlation were used for statistical inference.RESULTS Mean high-b value ADC measurements increased significantly with pFUS treatment for all models.Mean glycosaminoglycan CEST and T2 measurements decreased significantly post-treatment for the KPC group.Mean MTR and amide CEST values increased significantly for the KPC group.Hyaluronic acid focal intensities in the treated regions were significantly lower following pFUS treatment for all animal models.The magnetic resonance imaging changes observed acutely following pFUS therapy likely reflect:(1)Sequelae of variable degrees of microcapillary hemorrhage(T1,MTR and amide CEST);(2)Lower PDA glycosaminoglycan content and associated water content(glycosaminoglycan CEST,T2 and hyaluronic acid focal intensity);and(3)Improved tumor diffusivity(ADC)post pFUS treatment.CONCLUSION T2,glycosaminoglycan CEST,and ADC maps may provide reliable quantitation of acute pFUS treatment effects for patients with PDA. | Ezekiel Maloney Yak-Nam Wang Ravneet Vohra Helena Son Stella Whang Tatiana Khokhlova Joshua Park Kayla Gravelle Stephanie Totten Joo Ha Hwang Donghoon Lee | 2020 | World Journal of Gastroenterology2020，26，9： | 0 |
| 7 | 香港脑损伤患者的出院后服务(英文)显示文摘目的:建立针对脑损伤患者及其看护者的可负担、易获取的出院后电话跟进服务,并为发展区域内有成本效益的连续监护体制提供实证基础。方法:本研究从香港大学玛丽医院脑外科招募35名成年脑损伤患者和26名看护者。参与者在出院后第4周和第12周各接受一次结构化的电话访谈。有调整能力不足风险的患者与看护者将被送交进一步的医疗咨询或心理干预。患者的生理和认知功能,以及患者与看护者的情感功能、知觉到的社会支持和对当前所提供的服务的满意程度都被列入调查。结果:大部分患者报告他们的生理状况有明显改善。相当多的患者在出院后经历过认知困难并报告所接受到的社会心理支持不足。大多数看护者报告在看护期间健康、情感功能和社会生活受损。患者与看护者都对服务表示满意,看护者的满意程度更高。结论:脑损伤患者及其看护者都受益于出院后电话跟进服务。两者都同意该项服务有助于识别有调整能力不足风险的个体,并提供及时的建议和情感支持。看护工作会明显损害看护者的生理、情感功能和社会生活,提示需要为他们提供关于看护技巧、生活调整和压力管理的意见与建议。 | Helena MK Tam Tatia MC Lee | 2011 | 中国康复医学杂志2011，26，12： | 0 |
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