Objective To compare the value of contrast-enhanced ultrasound(CEUS)and conventional ultrasound(US)during radiofrequency ablation(RFA)for the treatment of hepatocellular carcinoma(HCC)≥3.0 cm in diameter.Methods A to...Objective To compare the value of contrast-enhanced ultrasound(CEUS)and conventional ultrasound(US)during radiofrequency ablation(RFA)for the treatment of hepatocellular carcinoma(HCC)≥3.0 cm in diameter.Methods A total of 149 HCC patients treated with RFA guided by either CEUS or conventional US between January 2012 and June 2013 were retrospectively analyzed.Patients were divided into different groups based on the type of ultrasound guidance(CEUS or conventional US)and tumor volume(diameter<3.0 or≥3.0 cm).The progressionfree survival(PFS)and complete ablation rates were compared between groups,and risk factors for the PFS were investigated.Results Seventy four patients received CEUS-guided RFA,and conventional US was performed in 75 patients.Among patients with a tumor<3.0 cm,the PFS and complete ablation rates were similar.However,for patients with a tumor≥3.0 cm,those treated with CEUS had a significantly longer PFS(17.3 vs.3.1 months,HR=2.73;95%CI,1.28~5.81;P=0.007)and higher complete ablation rates at 6-and 12-month post-treatment(87.5%vs.57.7%,P=0.042;75.0%vs.38.5%,P=0.009,respectively)than those treated with conventional US-guided RFA.The type of treatment(P=0.024)and maximum tumour size(P=0.011)were both found to be independent factors associated with the PFS.Conclusion Compared with conventional US,CEUS is more effective for guiding RFA in patients with HCC≥3.0 cm.CEUS-guided RFA could target HCC more accurately,and its ability to immediately detect any residual tumor during RFA might contribute to an increase in complete ablation rates and reduced progression.展开更多
Adult stem cells or progenitors are essential for maintaining the normal structure and function of adult tissues （i.e., ho- meostasis）. One of the best examples is the adult intestinal epithelium which is constantly...Adult stem cells or progenitors are essential for maintaining the normal structure and function of adult tissues （i.e., ho- meostasis）. One of the best examples is the adult intestinal epithelium which is constantly renewed by the progeny of intestinal stem cells （ISCs）. The proliferation and differentiation of adult stem cells must be tightly controlled in order to maintain resident tissue homeostasis. Mis-regulation of stem cell proliferation and differentiation leads to depletion or excessive proliferation of stem cells, eventually resulting in severe diseases such as cancer （Radtke and Clevers, 2005; Morrison and Spradling, 2008）. Understanding the detailed regulatory mechanisms of stem cell proliferation and differ- entiation will shed insights into the causes of related human diseases.展开更多
目的采用meta分析方法评价超声造影引导射频消融治疗肝癌的疗效及安全性。方法检索收集Pubmed、Embase、Web of Science、Cochrane Library、中国知网(CNKI)、维普、万方数据库建库至2023年7月20日发表的有关应用超声造影引导射频消融(...目的采用meta分析方法评价超声造影引导射频消融治疗肝癌的疗效及安全性。方法检索收集Pubmed、Embase、Web of Science、Cochrane Library、中国知网(CNKI)、维普、万方数据库建库至2023年7月20日发表的有关应用超声造影引导射频消融(试验组)与常规超声或增强CT引导射频消融(对照组)治疗肝癌的临床对照试验研究,将纳入的数据进行meta分析。结果共纳入文献8篇,共879例患者。meta分析显示,两组肿瘤完全消融率(OR=2.96,95%CI:2.13~4.11,P<0.01)、复发率(OR=0.35,95%CI:0.22~0.55,P<0.01)、术后并发症发生率(OR=0.49,95%CI:0.32~0.76,P<0.01)差异有统计学意义。结论超声造影引导射频消融治疗肝癌较常规超声或增强CT疗效更明显。展开更多
Objective To determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.Methods Since 1996 to 2002, 30 consecutive patients underwent ablation proced...Objective To determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.Methods Since 1996 to 2002, 30 consecutive patients underwent ablation procedures for isthmus-dependent atrial flutter. There were 23 males and 7 females [ mean age (47. 85 ±9. 35) years]. With the use of fluoroscopic view of anatomy, radiofrequency ablation was performed during coronary sinus pacing at a cycle length of 600 ms.Results Bidirectional block was achieved with ablation in 29 (97%) of 30 patients. The transisthmus intervals before ablation and after complete transisthmus block were (73.82±13. 01 ) ms and (140. 47±20. 48) ms, respectively, in the clockwise direction (P<0. 0001), and (77. 63±8. 36) ms and (138. 17 ±15. 55) ms, respectively, in the counterclockwise direction (P<0. 0001). A period of incomplete isthmus block was observed during 17 (58%) of the 29 ablation procedures. The clockwise transisthmus intervals during incomplete block [(107. 65 ±21. 33) ms] were (45.5 ± 8. 7)% longer than the baseline transisthmus intervals. An increase in the transisthmus interval by ≥50% in both directions after ablation predicted complete bidirectional block with 100.0% sensitivity and 83. 3% specificity. The positive and negative predictive values were 90. 6% and 100.0% , repectively. The diagnostic accuracy of a≥50% prolongation in the transisthmus interval was 83. 3%.Conclusion The analysis of transisthmus interval is a valuable method for determining complete bidirectional isthmus block.展开更多
基金the Training Plan for Outstanding Young Teachers of Jilin University(No.419080500356).
文摘Objective To compare the value of contrast-enhanced ultrasound(CEUS)and conventional ultrasound(US)during radiofrequency ablation(RFA)for the treatment of hepatocellular carcinoma(HCC)≥3.0 cm in diameter.Methods A total of 149 HCC patients treated with RFA guided by either CEUS or conventional US between January 2012 and June 2013 were retrospectively analyzed.Patients were divided into different groups based on the type of ultrasound guidance(CEUS or conventional US)and tumor volume(diameter<3.0 or≥3.0 cm).The progressionfree survival(PFS)and complete ablation rates were compared between groups,and risk factors for the PFS were investigated.Results Seventy four patients received CEUS-guided RFA,and conventional US was performed in 75 patients.Among patients with a tumor<3.0 cm,the PFS and complete ablation rates were similar.However,for patients with a tumor≥3.0 cm,those treated with CEUS had a significantly longer PFS(17.3 vs.3.1 months,HR=2.73;95%CI,1.28~5.81;P=0.007)and higher complete ablation rates at 6-and 12-month post-treatment(87.5%vs.57.7%,P=0.042;75.0%vs.38.5%,P=0.009,respectively)than those treated with conventional US-guided RFA.The type of treatment(P=0.024)and maximum tumour size(P=0.011)were both found to be independent factors associated with the PFS.Conclusion Compared with conventional US,CEUS is more effective for guiding RFA in patients with HCC≥3.0 cm.CEUS-guided RFA could target HCC more accurately,and its ability to immediately detect any residual tumor during RFA might contribute to an increase in complete ablation rates and reduced progression.
基金supported by the grants from the National Natural Science Foundation of China (Nos.31271582 and 31200213)China Postdoctoral Science Foundation (No.2012M510410)Beijing Scientific Research Foundation for Scholars Returned from Overseas,and Beijing Municipal Commission of Education (No.010135336400)
文摘Adult stem cells or progenitors are essential for maintaining the normal structure and function of adult tissues （i.e., ho- meostasis）. One of the best examples is the adult intestinal epithelium which is constantly renewed by the progeny of intestinal stem cells （ISCs）. The proliferation and differentiation of adult stem cells must be tightly controlled in order to maintain resident tissue homeostasis. Mis-regulation of stem cell proliferation and differentiation leads to depletion or excessive proliferation of stem cells, eventually resulting in severe diseases such as cancer （Radtke and Clevers, 2005; Morrison and Spradling, 2008）. Understanding the detailed regulatory mechanisms of stem cell proliferation and differ- entiation will shed insights into the causes of related human diseases.
文摘目的采用meta分析方法评价超声造影引导射频消融治疗肝癌的疗效及安全性。方法检索收集Pubmed、Embase、Web of Science、Cochrane Library、中国知网(CNKI)、维普、万方数据库建库至2023年7月20日发表的有关应用超声造影引导射频消融(试验组)与常规超声或增强CT引导射频消融(对照组)治疗肝癌的临床对照试验研究,将纳入的数据进行meta分析。结果共纳入文献8篇,共879例患者。meta分析显示,两组肿瘤完全消融率(OR=2.96,95%CI:2.13~4.11,P<0.01)、复发率(OR=0.35,95%CI:0.22~0.55,P<0.01)、术后并发症发生率(OR=0.49,95%CI:0.32~0.76,P<0.01)差异有统计学意义。结论超声造影引导射频消融治疗肝癌较常规超声或增强CT疗效更明显。
文摘目的开发一种名为上下文注意力网络(Context Attention Network,CA-Net)的新方法,基于深度学习利用超声(Ultrasound,US)图像来早期预测局部晚期乳腺癌患者的新辅助化疗(Neoadjuvant Chemotherapy,NAC)疗效。方法选取101例女性为研究对象,在NAC前和NAC的6~8个周期后接受US监测。CA-Net中的嵌入式特征集成模块与多尺度的空洞卷积和通道注意力机制相结合,利用空间注意力模块特征图的空间关系生成空间注意力图。这种组合架构可以增加感受野,也能够更加准确地关注重要的目标区域,提高网络性能。通过消融实验和基本网络对比实验确定CA-Net的最优模型结构。将CA-Net预测病理完全缓解(Pathologic Complete Response,pCR)的性能与最新研究的3种方法进行比较,并通过受试者工作特征曲线下面积(Area Under the Curve,AUC)评估模型的预测性能。结果CA-Net训练集的AUC值为0.950(95%CI:0.870~0.960),准确度为92.3%,敏感度为89.5%,特异性为94.7%;测试集的AUC值为0.920(95%CI:0.850~0.930),准确度为90.7%,敏感度为88.2%,特异性为94.4%,表明模型具有较高的性能和潜在的临床应用价值,且比其他现存模型性能有所提高。结论基于超声的乳腺癌NAC疗效预测的深度学习模型预测效能较好,可作为预测NAC能否达到pCR的新方法。
文摘Objective To determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.Methods Since 1996 to 2002, 30 consecutive patients underwent ablation procedures for isthmus-dependent atrial flutter. There were 23 males and 7 females [ mean age (47. 85 ±9. 35) years]. With the use of fluoroscopic view of anatomy, radiofrequency ablation was performed during coronary sinus pacing at a cycle length of 600 ms.Results Bidirectional block was achieved with ablation in 29 (97%) of 30 patients. The transisthmus intervals before ablation and after complete transisthmus block were (73.82±13. 01 ) ms and (140. 47±20. 48) ms, respectively, in the clockwise direction (P<0. 0001), and (77. 63±8. 36) ms and (138. 17 ±15. 55) ms, respectively, in the counterclockwise direction (P<0. 0001). A period of incomplete isthmus block was observed during 17 (58%) of the 29 ablation procedures. The clockwise transisthmus intervals during incomplete block [(107. 65 ±21. 33) ms] were (45.5 ± 8. 7)% longer than the baseline transisthmus intervals. An increase in the transisthmus interval by ≥50% in both directions after ablation predicted complete bidirectional block with 100.0% sensitivity and 83. 3% specificity. The positive and negative predictive values were 90. 6% and 100.0% , repectively. The diagnostic accuracy of a≥50% prolongation in the transisthmus interval was 83. 3%.Conclusion The analysis of transisthmus interval is a valuable method for determining complete bidirectional isthmus block.
