Unilateral acute cataract after facial aesthetic procedure: a case report

ABSTRACT Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound.

Efficacy and safety of ultrasound cycloplasty in the treatment of refractory glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate clinical efficacy and safety of ultrasound cycloplasty(UCP)in the treatment of refractory glaucoma.METHODS:From June 2021 to October 2022, a total of 17 patients(17 eyes)with refractory glaucoma were enrolled in this prospective study, and they all underwent UCP. The patients underwent 6 mo followed-up post-treatment, and the intraocular pressure(IOP), pain grade score, IOP lowering drugs, success rate and occurrence of complications were documented.RESULTS:The IOP was significantly decreased from 51.98±7.80 mmHg before UCP to 32.54±13.21 mmHg at 1 d, 22.38±11.98 mmHg at 1 wk, 22.63±10.78 mmHg at 1 mo, 26.05±9.17 mmHg at 3 mo, and 23.73±9.60 mmHg at 6 mo postoperatively(all P<0.01). The percentage of IOP reduction after treatment was 36.25%, 57.10%, 56.35%, 49.16% and 54.09% at 1 d, 1 wk, 1, 3, and 6 mo, respectively. The pain grade scores were decreased(P<0.01). There was a statistically significant reduction in the use of IOP lowering medications(P=0.008). At 6 mo postoperatively, 2 eyes(12%)were complete success, 11 eyes(65%)were qualified success, and 4 eyes(24%)were failure. The main complication observed was anterior chamber inflammation in 1 eye(6%), foreign body sensation in 2 eyes(12%), subconjunctival hemorrhage in 2 eyes(12%), and conjunctival congestion in 6 eyes(35%). All symptoms spontaneously resolved within 1 wk without requiring any specific treatment. One case of choroidal detachment(6%)occurred on 10 d postoperatively, but recovered after orally treated by prednisone acetate for 1 mo. No other serious complications, such as hyphema, corectopia, synechia or macular edema were reported.CONCLUSION:UCP is safe and efficacious in treating refractory glaucoma, reducing IOP and alleviating ocular pain symptoms, while maintaining a favorable safety profile.

Efficacy of high-intensity focused ultrasound cycloplasty in glaucoma and its influencing factor / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of high-intensity focused ultrasound cyclo plasty(UCP)in the treatment of glaucoma and to investigate related influencing factors.METHODS: The study involved a total of 110 patients(134 eyes)who received UCP treatment between January 2019 and January 2022 at three medical centers: Tianjin Eye Aier Eye Hospital, Chongqing Aier Eye Hospital, and Chongqing Nanping Aier Eye Hospital. Patients were classified into three categories: primary angle-closure glaucoma, primary open-angle glaucoma, and secondary glaucoma. Best corrected visual acuity, intraocular pressure, and the usage of anti-glaucoma medications, etc., were recorded at 6 and 12 mo postoperatively.RESULTS: After 6 months of the UCP procedure, statistically significant differences in intraocular pressure were observed across all groups(all P<0.05). At 12 mo postoperatively, intraocular pressure of the primary angle-closure and primary open-angle glaucoma groups showed differences(all P<0.05). Notably, there were no significant changes in visual acuity at either the 6 or 12 mo compared to preoperative values across all patient groups(all P>0.05). Furthermore, the study identified a statistically significant correlation between the changes in intraocular pressure at 6 mo and factors such as age, history of previous glaucoma surgery, baseline white-to-white(corneal diameter), and the extent of UCP treatment(all P<0.05).CONCLUSION: The UCP procedure has been demonstrated to effectively lower intraocular pressure in patients with glaucoma. The efficacy appears to be influenced by variables including patient age, previous glaucoma surgery history, baseline white-to-white(corneal diameter), and the scope of UCP treatment. Importantly, UCP treatment did not adversely affect visual acuity, underscoring its favorable safety profile.

Research advances of focal therapy for prostate cancer / 现代泌尿外科杂志

Prostate cancer is now the second most common malignancy in men worldwide, with an increasing incidence in China. Most prostate cancer patients receive whole-gland therapy after diagnosis, but patients with localized prostate cancer may not benefit from the treatment due to side effects. With the development of imaging technology and the theory of "index lesion," focal therapy has been greatly developed, which includs high intensity focused ultrasound, focal laser ablation, cryotherapy, irreversible electroporation and photodynamic therapy. This study reviews the clinical trials in recent years and reveals that high intensity focused ultrasound and focal laser ablation have better failure-free survival and postoperative functional control compared with other focal therapy techniques.

Preoperative MR T2WI signal characteristics of adenomyosis are closely related with the outcome of high-intensity focused ultrasound ablation: a propensity score-matched cohort study / 南方医科大学学报

OBJECTIVE@#To evaluate the correlation of magnetic resonance (MR) T2-weighted image (T2WI) signal characteristics of adenomyosis and the efficacy of high-intensity focused ultrasound (HIFU) ablation.@*METHODS@#Based on the presence or absence of patchy hyperintense foci on preoperative MR T2WI, the patients with adenomyosis undergoing HIFU treatment were divided into homogeneous signal group and heterogeneous signal group, and the heterogeneous group was further divided into heterogeneous hypointense group and heterogeneous isointense group according to signal intensity of the lesions. The patients in heterogeneous signal group were matched with the patients in the homogeneous group at a 1:1 ratio using the propensity score matching, and similarly, the patients in the heterogeneous hypointense group were matched with those in the heterogeneous isointense group at a 1:1 ratio. The non-perfused volume ratio (NPVR) and relief of dysmenorrhea were used to assess the therapeutic efficacy in the 4 groups.@*RESULTS@#A total of 299 patients were enrolled, who had a median preoperative dysmenorrhea score of 7.0 (6.0, 8.0) and a median NPVR of 53.5% (35.4, 70.1)%. After propensity score matching, the NPVR in homogeneous signal group was significantly higher than that in heterogeneous signal group [(60.3 ± 21.8)% vs (44.6±21.6)%, P < 0.05]. At 3, 6 and 12 months after HIFU, dysmenorrhea relief rates were higher in homogeneous signal group than in heterogeneous signal group, and the difference was statistically significant at 12 months (91.1% vs 76.8%, P < 0.05). The NPVR of heterogeneous hypointense group was higher than that of heterogeneous isointense group [(54.0±22.0) % vs (47.3± 22.9) %, P < 0.05]. At 6 months after HIFU, dysmenorrhea relief rate was significantly higher in heterogeneous hypointense group than in heterogeneous isointense group (91.5% vs 80.9%, P < 0.05).@*CONCLUSION@#The signal characteristics of adenomyosis on T2WI are closely related with the outcome of HIFU ablation, and its efficacy is better for homogeneous than for heterogeneous adenomyosis, and better for heterogeneous hypointense adenomyosis than for heterogeneous isointense adenomyosis.

Evaluation of the Clinical Effect of High-Intensity Focused Ultrasound and Drug Conservative on the Treatment of Cesarean Scar Pregnancy / 实用妇产科杂志

Objective:To evaluate the clinical effect of high-intensity focused ultrasound(HIFU)and drug con-servative treatment on the treatment of type Ⅰ and type Ⅱ cesarean scar pregnancy(CSP).Methods:A retrospec-tive analysis was performed on 191 patients diagnosed with type Ⅰ and type Ⅱ CSP by ultrasonography and trea-ted in Mianyang Central Hospital from January 2018 to December 2021,and they were divided into drug group(n=67)and HIFU group(n=124)according to different treatment methods before curettage surgery.After receiv-ing conservative drug treatment or HIFU treatment,preformnegative pressure suction curettage under ultrasound monitoring to evaluate the effectiveness and safety of the two pretreatment methods.Results:There were no sig-nificant differences in age,number of cesarean sections,gestational age,the maximum diameter of the gestational sac,number of incision pregnancies,the β-hCG level before pretreatment,the heart tube pulse in the gestational sac,size of fetal bud,and fertility requirements between the medication group and HIFU group(P＞0.05).The proportion of type Ⅱ incision in HIFU group was higher than that in drug group(P＜Q.05).There were no signifi-cant differences between the two groups in intraoperative bleeding,treatment outcome effective rate after pretreat-ment,postoperative vaginal bleeding duration,postoperative uterine cavity residual,rate of reoperation and rate of repregnancy(P＞0.05).There were statistical differences between the two groups in the operation time of curet-tage surgery,whether the operation method was changed after pre-treatment,total hospital stay,β-hCG recovery time and hospitalization cost(P＜0.05).Following up to November 2022,there were 12 cases re-pregnancies in the drug group and 16 cases re-pregnancies in the HIFU group.Conclusions:For type Ⅰ and type Ⅱ CSP,HIFU pretreatment before negative pressure suction curettage under ultrasound monitoring is a safe and effective treat-ment,which improves the treatment effect and reduces the hospitalization time of patients.It may be an effective clinical therapy for type Ⅰ and type Ⅱ CSP treatment.

Efficacy and safety of HIFU lesion combined with endometrial ablation in treatment of adenomyosis with excessive menstruation / 实用医学杂志

Objective To evaluate the efficacy and safety of high intensity focused ultrasound(HFIU)combined with endometrial ablation in the treatment of adenomyosis(AM)patients with heavy menstrual bleeding(HMB).Method A total of 199 patients with AM combined with HMB who underwent HIFU treatment at the Obstetrics and Gynecology Center of Affiliated Hospital of Chengdu University of TCM from July 2020 to September 2022 were selected and divided into two groups according to the ablation range.The combined ablation group included 80 cases with lesion and endometrial ablation(endometrial ablation rate≥30%),while the lesion ablation group 119 cases with simple lesion ablation.A 1∶1 propensity score matching was performed on the two groups,resulting in 59 patients in each group.A 6-month follow-up was conducted.The clinical manifestations(menstrual volume,degree of dysmenorrhea,uterine and lesion volume),quality of life(MS-QOL,UFS-QOL),and postoperative adverse reactions between the two groups before and 6 months after surgery was compared.Results Menstrual volume,degree of dysmenorrhea,uterine and lesion volume,MS-QOL score,and UFS-QOL score of the both groups were improved 6 months after surgery,when compared to those before surgery(P<0.05).Significantly reduced menstrual volume,degree of dysmenorrhea,and lower MS-QOL score were observed in the combined ablation group when compared with the lesion ablation group(P<0.05),but there was no statistical significance in uterine and lesion volume and UFS-QOL score(P>0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05),but the combined ablation group had longer vaginal bleeding and fluid flow time(P<0.05).Conclusion The combined HIFU and endometrial ablation can effectively reduce menstrual flow,alleviate dysmenorrhea,and improve quality of life in patients with AM combined with HMB.Although it increases vaginal bleeding and fluid flow time,reasonable symptomatic management can effectively prevent the occurrence of adverse consequences such as infection.

High intensity focused ultrasound in the treatment of advanced pancreatic cancer / 肿瘤

Objective:To evaluate the efficacy and safety of ultrasound-guided high intensity focused ultrasound(HIFU)on pain intensity,pain sensation and overall survival in patients with advanced pancreatic cancer. Methods:Clinical data of advanced pancreatic cancer patients treated by HIFU were collected from the patients enrolled during August 2020 to September 2022 at the second department for oncology of Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine.In this study,SPSS 26.0 software was used for the statistical analysis of NRS score and BPI score.The Kaplan-Meier survival analysis method was applied to calculate the median overall survival(OS)and then the survival curve was drawn.At the same time,the incidence of related adverse reactions during and after HIFU treatment was counted. Results:(1)Among the 45 patients,30 patients received HIFU combined with chemotherapy,and the other 15 patients only received HIFU.(2)Among the 45 patients,32 patients had pain relief after HIFU treatment,and the NRS score kept decreased across 1 week,2 weeks,3 weeks and 1 month after HIFU treatment(P＜0.05).The pain sensation score of BPI scale also decreased correspondingly,and the difference was statistically significant(P＜0.05).(3)The median OS of 45 patients was 11.1 months(95％Cl:9.30-1 2.90),of which 30 patients treated with HIFU combined chemotherapy had a median OS of 12.4 months(95％Cl:9.1 8-15.62),and 15 patients treated with HIFU only had a median OS of 4.6 months(95％Cl:1.11-8.10).(4)No serious adverse events were observed in all patients during and after HIFU treatment.Only 5 patients had asymptomatic mild elevation of blood amylase,and the incidence of mild adverse reactions was 11.1％. Conclusion:HIFU can effectively relieve pain and prolong the median survival time in patients with advanced pancreatic cancer.

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.

Impact factors of sonication dose of high-intensity focused ultrasound ablation for treating cesarean scar pregnancy / 中国介入影像与治疗学

Objective To observe the impact factors of the total sonication dose of high-intensity focused ultrasound(HIFU)ablation in patients with cesarean scar pregnancy(CSP)using optimal scale regression analysis.Methods A total of 131 patients with CSP who underwent HIFU ablation combined with ultrasound-guided suction curettage were enrolled.The correlations of clinical and ultrasonic data with the total sonication dose were evaluated.The optimal scale regression analysis was used to explore the impact factors of the total sonication dose,also to establish a prediction model of the latter.Results The total success rate of HIFU treatment of CSP was 96.95%(127/131).The total sonication dose was significantly correlated with patient's body mass index(BMI,X1),menopause time(X2),serum β-human chorionic gonadotropin level(X3),myometrium thickness between gestational sac and bladder(X4),as well as the maximum meridian of the gestational sac(X5)(all P＜0.05),and the model was as follow:Total sonication dose=0.273×X1+0.044×X2+0.113×X3-0.033×X4+0.327×X5.The Optimal scale regression analysis showed that BMI and the maximum meridian of the gestational sac were both important impact factors of the total sonication dose(r=0.295,0.448,both P＜0.05),with an importance of 0.294 and 0.535,respectively.Conclusion BMI(17.9-29.3 kg/m2)and the maximum meridian of gestational sac were both the most important impact factors of the total sonication dose in HIFU ablation of CSP.

Available evidence on HIFU for focal treatment of prostate cancer: a systematic review

ABSTRACT Purpose: Prostate cancer (PCa) is the second most common oncologic disease among men. Radical treatment with curative intent provides good oncological results for PCa survivors, although definitive therapy is associated with significant number of serious side-effects. In modern-era of medicine tissue-sparing techniques, such as focal HIFU, have been proposed for PCa patients in order to provide cancer control equivalent to the standard-of-care procedures while reducing morbidities and complications. The aim of this systematic review was to summarise the available evidence about focal HIFU therapy as a primary treatment for localized PCa. Material and methods: We conducted a comprehensive literature review of focal HIFU therapy in the MEDLINE database (PROSPERO: CRD42021235581). Articles published in the English language between 2010 and 2020 with more than 50 patients were included. Results: Clinically significant in-field recurrence and out-of-field progression were detected to 22% and 29% PCa patients, respectively. Higher ISUP grade group, more positive cores at biopsy and bilateral disease were identified as the main risk factors for disease recurrence. The most common strategy for recurrence management was definitive therapy. Six months after focal HIFU therapy 98% of patients were totally continent and 80% of patients retained sufficient erections for sexual intercourse. The majority of complications presented in the early postoperative period and were classified as low-grade. Conclusions: This review highlights that focal HIFU therapy appears to be a safe procedure, while short-term cancer control rate is encouraging. Though, second-line treatment or active surveillance seems to be necessary in a significant number of patients.

Perfluorooctyl bromide nanoemulsions holding MnO2 nanoparticles with dual-modality imaging and glutathione depletion enhanced HIFU-eliciting tumor immunogenic cell death

Tumor-targeted immunotherapy is a remarkable breakthrough, offering the inimitable advantage of specific tumoricidal effects with reduced immune-associated cytotoxicity. However, existing platforms suffer from low efficacy, inability to induce strong immunogenic cell death (ICD), and restrained capacity of transforming immune-deserted tumors into immune-cultivated ones. Here, an innovative platform, perfluorooctyl bromide (PFOB) nanoemulsions holding MnO2 nanoparticles (MBP), was developed to orchestrate cancer immunotherapy, serving as a theranostic nanoagent for MRI/CT dual-modality imaging and advanced ICD. By simultaneously depleting the GSH and eliciting the ICD effect via high-intensity focused ultrasound (HIFU) therapy, the MBP nanomedicine can regulate the tumor immune microenvironment by inducing maturation of dendritic cells (DCs) and facilitating the activation of CD8+ and CD4+ T cells. The synergistic GSH depletion and HIFU ablation also amplify the inhibition of tumor growth and lung metastasis. Together, these findings inaugurate a new strategy of tumor-targeted immunotherapy, realizing a novel therapeutics paradigm with great clinical significance.

Comparison of the long-term outcomes of focused ultrasound ablation surgery for uterine fibroids and myomectomy / 中华妇产科杂志

Objective:To compare the long-term outcomes after focused ultrasound ablation surgery (FUAS) versus myomectomy for uterine fibroids.Methods:A retrospective study was conducted on women who were treated by FUAS or myomectomy for uterine fibroids at First Medical Center of Chinese PLA General Hospital from January 2007 to January 2015. Regular follow-up was conducted to evaluate the symptoms relief, symptoms recurrence, the need for re-interventions and complications of the two groups.Results:The effective rates were 95.7% (730/763) and 95.5% (1 151/1 205) in women who were treated by FUAS and myomectomy, no statistical difference was seen between the two groups ( χ2 =0.027, P=0.869). The cumulative rates of symptoms recurrence at 1 year, 3 years, 5 years, 8 years and 10 years of follow-up in FUAS group were 1.8%, 6.8%, 11.9%, 15.2% and 15.9%, respectively; and the cumulative re-intervention rates were 0.7%, 4.1%, 6.8%, 9.9% and 11.0%, respectively. The cumulative rates of symptoms recurrence at 1 year, 3 years, 5 years, 8 years and 10 years of follow-up in myomectomy group were 1.8%, 5.9%, 10.6%, 14.2% and 14.9%, respectively; and the cumulative re-intervention rates were 0.9%, 4.5%, 7.8%, 10.3% and 11.4%, respectively. No statistical differences were seen between the two groups (all P>0.05). There were no significant differences in the effective rate, symptoms recurrence rate and re-intervention rate between the two groups in patients with intermural fibroids; but the effective rate of FUAS (95.9%, 235/245) was higher than that of myomectomy (89.1%, 115/129), the symptoms recurrence rate (11.9%, 28/235) was lower than that of myomectomy (27.8%, 32/115), and the re-intervention rate (7.7%, 18/235) was lower than that of myomectomy (17.4%, 20/115) in patients with submucosal fibroids, there were significant different (all P<0.05). The effective rate of FUAS (91.0%, 132/145) was lower than that of myomectomy (97.0%, 322/332), the symptoms recurrence rate (32.6%, 43/132) was higher than that of myomectomy (9.9%, 32/322), and the re-intervention rate (22.0%, 29/132) was higher than that of myomectomy group (6.2%, 20/132) in patients with subserosal fibroids, there were significant different (all P<0.01). The incidences of total [1.8% (14/763) vs 21.9% (264/1 205)], minor and moderate adverse events were lower in FUAS group than myomectomy group (all P<0.001). Conclusion:Satisfaction with long-term outcomes after FUAS treatment or myomectomy for uterine fibroids is comparable.

Clinical effect and influencing factors of focused ultrasound ablation surgery combined with suction curettage for the treatment of mass-type cesarean scar pregnancy / 中华妇产科杂志

Objective:To investigate the clinical effect of focused ultrasound ablation surgery (FUAS) combined with suction curettage for mass-type cesarean scar pregnancy (CSP) and to analyze the influencing factors of vaginal bleeding and readmission.Methods:From January 2014 to December 2020, 88 patients with mass-type CSP were treated by FUAS combined with suction curettage in the Third Xiangya Hospital of Central South University. The clinical results and the influencing factors of bleeding and readmission for mass-type CSP were analyzed.Results:All the patients underwent one time FUAS treatment successfully. Immediately after FUAS treatment, color Doppler ultrasound showed obvious necrosis and no perfusion area in all lesions, and the blood flow in the mass-type CSP tissue significantly decreased. The median volume of blood loss in the procedure was 20 ml (range: 5-950 ml). Thirteen patients (15%, 13/88) had vaginal bleeding≥200 ml, and 15 patients (17%, 15/88) were hospitalized again. The average time for menstruation recovery was (28±8) days (range: 18-66 days). The average time needed for serum human chorionic gonadotropin-beta subunit to return to normal levels was (22±6) days (range: 7-59 days). The risk of large vaginal bleeding of patients were related to the blood supply of the mass ( OR=5.280, 95% CI: 1.335-20.858, P=0.018) and the largest diameter of the mass ( OR=1.060, 95% CI: 1.010-1.120, P=0.030). The risk of readmission were related to the largest diameter of the mass ( OR=1.055, 95% CI: 1.005-1.108, P=0.030) and the depth of the uterus cavity ( OR=1.583, 95% CI: 1.015-2.471, P=0.043). No serious complications such as intestinal and nerve injury occurred during and after FUAS treatment. Conclusions:FUAS combined with suction curettage is safe and effective in treating patients with mass-type CSP through this preliminary study. The volume of vaginal bleeding are associated with the blood supply of the mass and the largest diameter of the mass, the risk of readmission are related to the largest diameter of the mass and the depth of the uterus cavity.

Clinical efficacy of focused ultrasound ablation surgery in the treatment of internal adenomyosis / 中华妇产科杂志

Objective:To investigate the relationship between the clinical efficacy and the ablated area of endometrium in patients with internal adenomyosis treated with focused ultrasound ablation surgery (FUAS).Methods:From January 2015 to December 2018, 122 patients in Chongqing Haifu Hospital who were diagnosed as internal adenomyosis through history, clinical symptoms and enhanced magnetic resonance imaging (MRI) and treated with FUAS were enrolled in this study. According to the patient′s wishes, patients were given whether to ablate the adenomyotic lesion alone or ablate the adenomyotic lesion and the endometrium that involved in adenomyotic lesions together. The ablated area of adenomyotic lesions and endomitrium were evaluated by post-FUAS enhanced MRI. The adverse events and the changes of dysmenorrhea and menstrual volume at different follow-up points within 24 months were recorded.Results:Among the 122 patients, 32 patients chose to ablate adenomyotic lesion alone, and 90 patients chose to ablate the adenomyotic lesion and the endometrium during FUAS. No major complications such as bowel injury and nerve injury occurred after FUAS. The median non-perfused volume ratio of adenomyotic lesions was 31.7% in the group without endometrial ablation and it was 60.0% in the group with endometrium ablation ( P<0.01). The improvement of dysmenorrhea in the group with endometrium ablation was significantly better than the group without endometrial ablation ( P<0.01). The average menstrual volume score (3.4±0.9) before FUAS in the group with endometrial ablation was higher than that in the group without endometrial ablation (2.5±0.6; P<0.01), but it decreased significantly after FUAS treatment, reaching the similar menstrual volume score of the group without endometrial ablation ( P>0.05). The proportions of abnormal vaginal discharge (34.4%, 31/90) and bleeding (16.7%, 15/90) were significantly higher in the group with endometrium ablation than those in the group without endometrial ablation (all P<0.01). Conclusions:FUAS could be safely and effectively used in the treatment of patients with internal adenomyosis. It seems that ablation of adenomyotic lesion and endometrium together could obtain better therapeutic effects.

Effects of sevoflurane inhalation anesthesia on intraoperative hepatic blood flow in infants with hepatoblastoma / 肿瘤研究与临床

Objective:To evaluate the effect of different concentrations of sevoflurane inhalation anesthesia on hepatic blood flow in children with hepatoblastoma (HB).Methods:A total of 22 children who underwent radical resection of HB in Shanxi Children's Hospital from January 2019 to August 2021 were perspectively enrolled, including 15 males and 7 females, with an average age of 17±7 months. There were 19 normal children undergoing ultrasound examination without other systemic diseases who received hernia, cryptorchidism, hydrocele of tunica vaginalis surgery during the same period, including 11 males and 8 females, with an average age of 18±5 months. After inhaling different concentrations of sevoflurane preoperatively and intraoperatively, ultrasound apparatus was used to detect the hepatic blood flow (HBF) in HB children. The portal blood flow (PBF), hepatic artery blood flow (HABF), PBF/HABF and HBF were compared between HB children and non-HB children before operation and after inhalation of 1% sevoflurane, 2% sevoflurane.Results:Compared with non-HB children, children with HB had lower PBF [41.9 ml/min (26.8 ml/min, 63.1 ml/min) vs. 66.7 ml/min (41.4 ml/min, 137.2 ml/min), Z = -2.62, P = 0.008], increased HABF [31.2 ml/min (20.4 ml/min, 50.3 ml/min) vs. 12.9 ml/min (5.5 ml/min, 25.0 ml/min), Z = -3.59, P < 0.001], decreased PBF/HABF [1.3 (1.2, 1.4) vs. 6.1 (5.0, 7.5), Z = -5.68, P < 0.001], and the difference in HBF between the both groups was statistically significant ( P>0.05). Compared with the 2% sevoflurane HB group, PBF was reduced [41.1 ml/min (25.0 ml/min, 62.0 ml/min) vs. 63.0 ml/min (40.5 ml/min, 78.3 ml/min), Z = -2.09, P = 0.036] and PBF/HABF was reduced [1.3 (1.1,1.5) vs. 1.8 (1.6, 1.9), Z = -4.01, P<0.001] in the 1% sevoflurane group, and the differences in HABF and HBF were statistically significant (all P>0.05). Conclusion:Relatively low concentration of sevoflurane reduces HBF by reducing PBF for HB children after radical surgery.

Comparison of the therapeutic effects of high-intensity focused ultrasound cycloplasty and cyclocryotherapy on refractory glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the therapeutic effects of high-intensity focused ultrasound cycloplasty(UCP)and cyclocryotherapy on refractory glaucoma.<p>METHODS:This retrospective study included 45 patients(81 eyes)with refractory glaucoma admitted to the hospital between January 2017 and December 2020. According to the treatment method, patients enrolled were divided into cyclocryotherapy group(22 patients, 40 eyes)and high-intensity UCP group(23 patients, 41 eyes). Changes in intraocular pressure at 1d, 1wk, 1 and 3mo after operation were compared between the two groups. The Numerical Rating Scale(NRS)was used to evaluate eyeball pain. Surgical results and complications in the two groups were compared. <p>RESULTS:The total effective rate of operation in the high-intensity UCP group was significantly higher than that in the control group(<i>P</i><0.05). Generalized estimation equation analysis showed that there were statistically significant differences in intraocular pressure and eyeball pain between the two groups before and after operation(all <i>P</i><0.05). There were statistically significant differences in intraocular pressure and eyeball pain between the two groups at different time points after operation(all <i>P</i><0.05). The incidence rates of complications such as conjunctival hyperemia, corneal edema, anterior chamber inflammatory exudation, reactive intraocular hypertension and hyphema in the high-intensity UCP group were significantly lower than those in the cyclocryotherapy group(<i>P</i><0.05).<p>CONCLUSION: High-intensity UCP is effective in the treatment of refractory glaucoma, with obvious advantages in reducing intraocular pressure, eyeball pain and complications as compared with cyclocryotherapy.

Does mpMRI guidance improve HIFU partial gland ablation compared to conventional ultrasound guidance? Early functional outcomes and complications from a single center

ABSTRACT Background Focal therapy (FT) for localized prostate cancer (PCa) treatment is raising interest. New technological mpMRI-US guided FT devices have never been compared with the previous generation of ultrasound-only guided devices. Materials and Methods We retrospectively analyzed prospectively recorded data of men undergoing FT for localized low- or intermediate-risk PCa with US- (Ablatherm®-2009 to 2014) or mpMRI-US (Focal One®-from 2014) guided HIFU. Follow-up visits and data were collected using internationally validated questionnaires at 1, 2, 3, 6 and 12 months. Results We included n=88 US-guided FT HIFU and n=52 mpMRI-US guided FT HIFU respectively. No major baseline differences were present except higher rates of Gleason 3+4 for the mpMRI-US group. No major differences were present in hospital stay (p=0.1), catheterization time (p=0.5) and complications (p=0.2) although these tended to be lower in the mpMRI-US group (6.8% versus 13.2% US FT group). At 3 months mpMRI-US guided HIFU had significantly lower urine leak (5.1% vs. 15.9%, p=0.04) and a lower drop in IIEF scores (2 vs. 4.2, p=0.07). Of those undergoing 12-months control biopsy in the mpMRI-US-guided HIFU group, 26% had residual cancer in the treated lobe. Conclusion HIFU FT guided by MRI-US fusion may allow improved functional outcomes and fewer complications compared to US- guided HIFU FT alone. Further analysis is needed to confirm benefits of mpMRI implementation at a longer follow-up and on a larger cohort of patients.

In vitro recognition of HIFU-induced biological tissue degeneration based on ultrasound / 中国医学影像技术

Objective: To explore a method to improve the identification rate of tissue degeneration caused by high intensity focused ultrasound (HIFU) based on ultrasound combining with generalized regression neural network (GRNN). Methods: Totally 300 fresh isolated pork tissue samples were selected and irradiated at different HIFU doses, then 150 denatured and 150 undenatured samples were obtained. Ultrasonic images of the samples were collected before and after irradiation, then ultrasonic subtraction images were obtained. A total of 18 characteristic parameters of ultrasonic subtractive images were extracted using gray-gradient co-occurrence matrix and gray difference statistical methods, and the best characteristic vectors were obtained with P-value significance detection method and Euclidean distance method. Among 300 samples, 198 were taken as training samples and 102 as test samples. After recognition of training samples, the feature vectors eliminated with P-value significance detection method and 2 feature vectors with the smallest Euclidean distance were taken as control group of the best feature vectors, and then were input into GRNN respectively for recognition of tissue denaturation. Correct recognition rate and total recognition rate of test samples were calculated using combining feature vectors with GRNN. Results: The best feature vectors were non-uniformity of gray distribution and non-uniformity of gradient distribution, and the total recognition rate was 90.20% and 91.18% combining with GRNN, respectively, which increased to 98.04% when both 2 best characteristic parameters combined GRNN. The feature vectors eliminated using P-value significance detection method were average value and contrast, and the total recognition rate combining with GRNN was 48.04% and 75.49%, respectively, which became 79.41% when both 2 best characteristic parameters combined GRNN. The feature vectors with the smallest euclide distance were energy and small gradient, and the total recognition rate combining with GRNN was 88.24% and 89.22%, respectively, which remained 89.22% when both 2 of them combined with GRNN. The recognition rate of the optimal feature vectors combined with GRNN for tissue denaturation was significantly higher than that of control group. Conclusion: Based on ultrasonic subtraction images, of pork tissue irradiated with HIFU, non-uniformity of gray distribution and non-uniformity of gradient distribution combined with GRNN can both improve the recognition rate of tissue denaturation, while the combination of them and GRNN is more effective in identifying tissue denaturation induced by HIFU.

Clinical effect and safety of ultrasound cyclo-plasty in the treatment of neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy and safety of ultrasound cycloplasty(UCP)in the treatment of neovascular glaucoma(NVG).<p>METHODS: Thirty patients(30 eyes)with NVG who were treated with UCP at our hospital from January 2018 to December 2018 were collected. All patients received comprehensive ophthalmic examination. Visual acuity, best corrected visual acuity(BCVA), intraocular pressure(IOP), pain grade score, ocular surface, number of glaucoma drugs and complications were recorded before and 1, 3d, 1wk and 1, 2, 3, 6mo after operation, and the efficacy and safety were evaluated.<p>RESULTS: The postoperative visual acuity was improved, the pain score was decreased, and the use of intraocular pressure-lowering drugs was decreased and the IOP decreased significantly(<i>P<0.01). </i>The preoperation visual acuity, pain score, use of intraocular pressure-lowering drugs and IOP was \〖1.63±0.59(LogMAR)\〗, \〖2(1,4)\〗, \〖4(4,4)\〗 and(44.19±13.72)mmHg. The postoperative IOP were decreased at different observation time within 6mo, and the differences with preoperative IOP were statistically significant(all <i>P</i><0.01). The IOP decrease rates were 57.32%, 56.45%, 56.82%, 55.64%, 52.37%, 50.20% and 49.18% on 1d, 3d, 1wk, 1mo, 2mo, 3mo and 6mo after surgery respectively. On 6mo after treatment, 8 eyes(31%)IOP were complete controlled, 7 eyes(27%)were partially controlled, 11 eyes(42%)cannot be controlled, and 4 eyes were lost to follow-up. The IOP reduction on 6mo of postoperation was significantly correlated with that of preoperation(<i>r=0.928, P<0.001)</i>. The number of glaucoma drugs and pain scores were decreased, and the differences with that of preoperation were statistically significant(<i>P</i><0.01), and the BCVA were improved, the differences were statistically significant(<i>P</i><0.01). There was no serious complications were occurred in all patients after operation. <p>CONCLUSION: UCP is high safety and few complications for NVG treatment. It has significant effect on reducing IOP, relieving ocular pain. The higher the preoperation IOP, the greater the IOP reduction after surgery. It was a promising anti-glaucoma method.