Surgery combined with photodynamic therapy for early-stage endometrial carcinoma, a report of two cases.

BACKGROUND: Endometrial carcinoma (EC) is one of the most prevalent gynecological malignancies and the onset age of EC tends to be younger. This case report explored the feasibility of surgery combined with photodynamic therapy (PDT) in two young patients with early-stage EC. METHODS: A 31 years old patient and a 24 years old patient were treated with surgery and PDT, respectively. The intraoperative PDT was performed 3 h after oral administration of 5-aminolevulinic acid (ALA) with intrauterine light irradiation of 630 nm laser light. RESULTS: The patients were followed up for 3 years and 4 months, respectively. There were no signs of recurrence. CONCLUSION: Intraoperative and intrauterine PDT was feasible and might be used for EC patients who attempt to preserve fertility.

Comparative study of topical 5-aminolevulinic acid photodynamic therapy and surgery for recurrent cervical high-grade squamous intraepithelial lesions following surgery.

OBJECTIVE: The study aimed to compare the clinical efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and surgery in treating recurrent cervical high-grade squamous intraepithelial lesions (HSIL) after surgery due to precancerous lesions. METHODS: A total of 41 patients with recurrent cervical HSIL after surgery for precancerous lesions were studied retrospectively. Patients underwent ALA-PDT or surgery and were followed up at 3, 6, 9 and 12 months and then every six months after that. Clinical data were collected and the efficacy and safety of the two treatment methods were compared. RESULTS: Of the 41 patients with recurrent cervical HSIL after conization, 15 cases received ALA-PDT and 26 received surgery. At the six-month follow-up, the lesions' complete remission (CR) rate was 93.33 % in ALA-PDT group and 88.46 % in the surgery group. The human papillomavirus (HPV) clearance rates were 66.67 % and 73.08 %, respectively. No significant differences concerning the lesions' CR rate and the HPV clearance rate were observed between the two groups (P>0.05). At the twelve-month follow-up, the HPV clearance rates were 80.00 % and 91.67 %. No significant differences concerning the HPV clearance rate were observed between the two groups (P>0.05). In the surgery group, the HPV clearance rate and the lesions' CR rate were lower in patients over 45 years of age (25.00% vs. 81.82 %, P = 0.031; 50.00% vs. 95.45 %, P = 0.052). During the follow-up, there was no significant difference in the recurrence rate between the two groups (P>0.05). In addition, none of the patients progressed. In women treated with ALA-PDT, there was no vaginal bleeding, and no harmful effects on the cervical organizational structure or functions compared to the surgery group, and two women delivered successfully after ALA-PDT treatment. CONCLUSIONS: The efficacy of ALA-PDT was similar to that of surgery in treating recurrent cervical HSIL following surgery, with fewer side effects.

Comparative study of topical 5-aminolevulinic acid photodynamic therapy and surgery in treating vaginal high-grade squamous intraepithelial lesions following hysterectomy.

OBJECTIVE: To compare the clinical efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and surgery in treating vaginal high-grade squamous intraepithelial lesions (HSIL) after hysterectomy due to cervical cancer (CC) or precancerous lesions. METHODS: A retrospective study was performed comprising 41 women with histologically confirmed vaginal HSIL after hysterectomy for CC or cervical HSIL. Patients were treated with surgery or ALA-PDT and were followed up at 3, 6 and 12 months and then every six months afterwards. Clinical data were collected and the efficacy and safety of the two groups were analyzed. RESULTS: Of the 41 patients with vaginal HSIL after hysterectomy, 18 were treated with ALA-PDT and 23 underwent surgery. There was no significant difference in the lesions' complete remission (CR) rate or the human papillomavirus (HPV) clearance rate between the ALA-PDT group and the surgery group (P > 0.05). In the surgery group, the clearance rate of HPV16/18 was higher than that of other high-risk HPV (HR-HPV) and HPV16/18 combined with other HR-HPV (87.50 % vs. 45.45 % vs. 0.00 %, P = 0.014). No significant difference in the recurrence rate between the two groups was noted (P > 0.05). And none of the patients progressed. In the surgery group, one patient developed significant thickening of the vaginal stump, and one patient had increased vaginal discharge. In women treated with ALA-PDT, there was no vaginal bleeding or harmful effects on the organizational structure or functions compared to the surgery group. CONCLUSIONS: The efficacy of ALA-PDT was comparable to that of surgery in treating vaginal HSIL following hysterectomy due to CC or cervical HSIL, with fewer side effects.

Comparative study of topical 5-aminolevulinic acid photodynamic therapy and surgery for the treatment of vulvar squamous intraepithelial lesion.

BACKGROUND: Vulvar squamous intraepithelial lesion (SIL) is a precursor lesion of vulvar squamous cell carcinoma. The current clinical treatments for vulvar SIL cause damage to the vulvar structure, chronic pain and psychological distress. Topical 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is a novel, non-invasive therapy for intraepithelial lesions. The objective of this study was to compare the clinical efficacy and safety of ALA-PDT with local surgical resection for vulvar SIL. METHODS: A total of 56 patients with vulvar SIL were enrolled in this retrospective study. Among them, 16 patients received local resection and 40 patients received ALA-PDT. HPV genotyping and ThinPrep cytologic test (TCT) were used to evaluate treatment efficacy. In addition, colposcopy-directed biopsy was performed in all patients at 3-month follow-up and in patients with positive high-risk human papillomavirus (HR-HPV) and/or abnormal TCT results during the follow-up. RESULTS: At 3-month follow-up and in HSIL group the complete remission (CR) rate of the ALA-PDT group and surgery group was 90.6% (29/32) and 87.5% (14/16) (P = 1.000), respectively. The HPV clearance rate of the ALA-PDT group and surgery group was 45.2% (14/31) and 43.8% (7/16) (P = 0.927), respectively. The average numbers of ALA-PDT treatments were 5.34 for HSIL patients and 4.88 for LSIL patients, respectively. The CR rate of HSIL patients and LSIL patients was 90.6% (29/32) and 75.0% (6/8) (P = 0.550), respectively. The HPV clearance rate of HSIL patients and LSIL patients was 45.2% (14/31) and 37.5% (3/8) (P = 1.000), respectively. The ALA-PDT group showed similar clinical efficacy and milder adverse effects compared with the surgical group. CONCLUSION: ALA-PDT showed similar clinical efficacy as surgery in the treatment of vulvar SIL, but with milder adverse effects and maintaining the integrity of the vulvar structure.

Responses of photosynthetic characteristics of Phragmites australis to simulated warming in salt marshes of the Yellow Sea and Bohai Sea, China.

Coastal wetlands are highly efficient in blue carbon sequestration. The impacts of climate warming on photosynthetic rates and light response characteristics of wetland plants would change the magnitude of carbon sequestration in coastal wetlands. We constructed warming observation stations in Phragmites australis (Phragmites) wetlands located in the Yellow River Delta in Dongying with dry climate, and in Yancheng by the Yellow Sea with wet climate. By using a Li-6800 photosynthesis system, we investigated the responses of simulated warming on photosynthetic characteristics of Phragmites in both wetlands, and compared the difference between months (June and August) in Dongying wetland. The results showed the photosynthetic rates of Phragmites were higher in June than in August. Warming increased net photosynthetic rate (Pn), transpiration rate (Tr), stomatal conductance (gs) and intercellular carbon dioxide concentration (Ci) in the two months, but the variability of Pn to warming was lower in August. The Pn and water use efficiency (WUE) of Phragmites in the Yancheng wetland were higher than Dongying wetland, and the maximum net photosynthetic rate (Pn max), light saturation point (LSP), apparent quantum efficiency (AQY), and dark respiration rate (Rd) of the former responded more positively to warming. The values of AQY, LSP and Pn max of Phragmites in the Yancheng wetlands were increased by 16.7%, 53.6% and 30.3%, respectively, in the warming plots. Our results suggested that warming could improve the utilization efficiency of weak light, the adaptability to strong light and photosynthetic potential of Phragmites under rainy and humid conditions. This study is of importance for accurately quantifying carbon sequestration of coastal wetlands at the regional and seasonal scales in the context of climate warming.

Genetic alterations in juvenile cervical clear cell adenocarcinoma unrelated to human papillomavirus.

Clear cell adenocarcinoma of the cervix (CCAC) is a special type of HPV-independent cervical cancer. It has a low incidence rate, can be difficult to diagnose early, has a poor prognosis. Its peak incidence is in adolescence, which poses a great threat to women's health. Therefore, it is very important to explore the pathogenesis of cervical clear cell adenocarcinoma to guide subsequent treatment and prevention. This study analyzed 3 juvenile patients with CCAC diagnosed at the First Affiliated Hospital of Zhengzhou University. Using next-generation sequencing methods, we analyzed the pathogenesis of the patients and their close relatives by analyzing the genetic alterations of patients. CMTM5 was identified as the only shared mutated gene. Using published literature and comparative analyses of related disease-causing genes, 6 of the 19 genes (ALKBH7, MYCBP, MZF1, RNF207, RRS1, and TUSC2) were screened as genes with mutations in patients and had higher mutation rates in reproductive cancers. Pathway analysis showed that downregulated genes in non-HPV cervical cancer were mainly related to the immune system response, suggesting that non-HPV cervical cancer differs from HPV-infected cervical cancer in that the immune response is weaker, which is consistent with the weak correlation with viral infection.

The effect of local photodynamic therapy with 5-aminolevulinic acid in treating different grades of cervical intraepithelial neoplasia.

BACKGROUND: Cervical intraepithelial neoplasia (CIN) is a precursor lesion of cervical cancer. Traditional treatments for CIN might have negative effects on cervical anatomical structure and physiological function. Topical 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) is a novel, non-invasive targeted therapy for intraepithelial lesions. This study aims to evaluate and compare the efficacy and safety of 5-ALA PDT for different grades of CIN. METHODS: A retrospective study of 183 patients aged 19-50 with histologically confirmed CIN and receiving ALA-PDT was conducted. ALA-PDT was performed with 20% ALA thermosensitive gel and irradiation at a wavelength of 635 nm and density of 80-100 J/cm2. ALA-PDT was conducted every 7-10 days for 4-6 times. Patients were followed up three, six, nine, and twelve months after treatment. The effect was evaluated through HPV genotyping, ThinPrep cytology test (TCT), and colposcopy-directed biopsy. RESULTS: The HPV clearance rate was 71.0% (130/183) at the six-month follow-up and 84.5% (147/174) at the 12-month follow-up. The complete lesion remission (CR) rate was 90.2% (165/183). No statistically significant differences concerning the CR rate (P>0.05) or HPV clearance rates (P>0.05) were observed in CIN I, CIN II, and CIN III. In women with CIN III, gland involvement was revealed to be associated with a significantly lower HPV clearance rate (63.16% vs. 92.60%, P= 0.036) at the 12-month follow-up. Our study showed that the atypical vessels seemed to be a risk factor for HPV clearance rate in the CIN II group at six-month follow-up, although the difference was not statistically significant (P= 0.089). During the follow-up, 13 cases had persistent lesions (7.1%), four cases recurred (2.3%), and none of the patients progressed. The study also showed that the efficacy of PDT in the treatment of patients with CIN III involving glands was comparable to that of CKC (P>0.05). CONCLUSIONS: ALA-PDT is an effective andsafe treatment for CIN, and responseis unaffected by the grade of lesions. However, for patients with atypical vessels and glandular involvement, the effect of PDT seems to be poorer.

Fabry-Perot interferometric sensor demodulation system utilizing multi-peak wavelength tracking and neural network algorithm.

For FPI sensor demodulation systems to be used in actual engineering measurement, they must have high performance, low cost, stability, and scalability. Excellent performance, however, necessitates expensive equipment and advanced algorithms. This research provides a new absolute demodulation system for FPI sensors that is high-performance and cost-effective. The reflected light from the sensor was demultiplexed into distinct channels using an array waveguide grating (AWG), with the interference spectrum features change translated as the variation of the transmitted intensity in each AWG channel. This data was fed into an end-to-end neural network model, which was utilized to interrogate multiple interference peaks' absolute peak wavelengths simultaneously. This architecturally simple network model can achieve remarkable generalization capabilities without training large-scale datasets using an appropriate data augmentation strategy. Experiments show that in simultaneous multi-wavelength and cavity length interrogations, the proposed system has the precision of up to ± 14 pm and ± 0.07 µm, respectively. The interrogation resolution can theoretically reach the pm level benefit from the neural network method. Furthermore, the system's outstanding demodulation repeatability and suitability were demonstrated. The system is expected to provide a high-performance and cost-effective, reliable solution for practical engineering applications.

Efficient calculation of optical properties of suspended-core fiber via a machine learning algorithm.

Growing nonlinearity demands in mid-infrared applications place more outstanding requirements on fiber structure design. Chalcogenide suspended-core fibers (SCFs) are considered excellent candidates for mid-infrared applications due to their significant advantages in nonlinearity and dispersion management. However, traditional numerical methods for accurate modeling and optimization of SCFs often rely on the performance of computing devices and have many limitations when dealing with complex models. A machine learning algorithm is applied to calculate the optical properties of chalcogenide SCFs, including effective mode area, nonlinear coefficient, and dispersion. The established artificial neural network (ANN) model enables accurate prediction of the above optical properties of As2S3 SCF, for which in the wavelength range of 1.0 to 4.0 µm, the radius of the fiber core is 0.4 to 0.6 µm, and width of the cantilever is 0.06 to 0.09 µm. We demonstrate that this simple ANN model has considerable advantages over the traditional numerical calculation model in computational speed and resource utilization. In summary, the proposed model can quickly provide more accurate optical property predictions, providing a cost-effective solution for precise modeling and optimization of chalcogenide SCFs.

Computational Investigation of Two-Dimensional Vanadium Boride Compounds for Na-Ion Batteries.

Sodium (Na)-ion batteries have received widespread attention due to their low cost and good safety. The possibility of two-dimensional vanadium boride (V2B2, MBene) as the anode material for Na-ion batteries is explored by first principles. It is found that V2B2 has good dynamic stability, thermodynamic stability, and conductivity. V2B2 has a good performance as anode material: it can adsorb nearly 3 layers of Na ions, and the maximum capacity reaches 814 mAhg-1. It is found that V2B2 has a very low Na ion diffusion barrier, about 0.011 eV, which represents the ultrahigh ion diffusion rate of Na ions on the surface of V2B2. The average open circuit voltage of V2B2 is 0.65 V, and good metallicity is maintained during the entire Na ion adsorption process. The results indicate that two-dimensional V2B2 has a low diffusion barrier, low open circuit voltage, and high theoretical capacity and is a potential anode material for Na-ion batteries.

Assessment of the hydrochemistry, water quality, and human health risk of groundwater in the northwest of Nansi Lake Catchment, north China.

In this study, the formation mechanism and water quality of groundwater in the northwest of Nansi Lake Catchment (NNLC) were analyzed through mathematical statistics, hydrochemical analysis and entropy weighted water quality index (EWQI), and the human health risk of nitrate was also evaluated. To this end, 89 wells in the NNLC were sampled, and the groundwater samples were divided into three groups (I, II, and III) according to cluster analysis results and spatial distribution. The main results are as follows: Topographically, Groups I, II, and III correspond to the alluvial plains, apron plain, and low hills and its front margin, respectively. According to the Piper diagram, the hydrochemical types of Groups I and II groundwater are Na-SO4·Cl and Ca·Mg-HCO3, respectively, and that of Group III is more concentrated, mostly corresponding to the Ca-HCO3 type. Hydrochemical analysis indicated that the development of groundwater hydrochemistry is mainly attributable to water-rock interactions, with the primary process being the dissolution of minerals such as calcite, dolomite, gypsum, and albite. Evaporation exhibited an increasing trend from the northeast to the southwest. Groups I and III presented obvious effects of human activities, with Group I showing sulfate pollution and Group III mainly showing nitrate pollution. Analysis of the characteristics and causes of the groundwater hydrochemistry revealed the proposed approach has excellent performance for classification in areas with complex hydrogeological conditions. The results of EWQI showed that the overall water quality was good, following the order Group III > Group II > Group I. The overall human health risk of nitrate in groundwater was low, but the risk was slightly higher for children than for adults. Therefore, the effects of nitrate contamination should be considered when exploiting hilly and peri-urban groundwater for drinking water.

Enhanced dewaterability of waste activated sludge by a combined use of permanganate and peroxymonosulfate.

Ever-increasing efforts have been made to develop rapid and practical conditioning methods of sludge dewatering. This study demonstrated an innovative combination of potassium permanganate (KMnO4) and peroxymonosulfate (PMS) for sludge dewatering. The combined use of KMnO4 and PMS (KMnO4/PMS) showed its superiority in improving sludge dewaterability over the separate use of KMnO4 or PMS. By dosing 4 mmol g-1 VSS KMnO4 and 3 mmol g-1 VSS PMS, the dewaterability of waste activated sludge (WAS) significantly enhanced as capillary suction time (CST) decreased from 73.65 s to 24.65 s while the water content of dewatered sludge cake (W C) decreased from 78.96% to 70.47%. Apart from CST and W C, the KMnO4/PMS process could also affect negative zeta potential, sludge flocs size and the concentrations of protein and polysaccharide in extracellular polymeric substances (EPS). The enhanced sludge dewaterability and changes of the physicochemical characteristics of the WAS samples during the KMnO4/PMS process were actually ascribed to sulfate radicals (SO4˙-) and hydroxyl radicals (HO˙) in situ generated via PMS activation by manganese oxides (MnO x ) in the states of MnO2 and Mn3O4 transferred from KMnO4 oxidation, which was verified by transmission electron microscopy (TEM), energy dispersive X-ray spectroscopy (EDX) techniques and radical scavenging experiments. Moreover, the Fourier transform infrared spectroscopy (FTIR) analysis further confirmed that the in situ generated SO4˙- and HO˙ could improve sludge dewaterability. Thus, the KMnO4/PMS process could be considered as a promising conditioning method of sludge dewatering.

A study of experimental measurements of dosimetric parameters in HDR IR-192 source.

Thermoluminescent dosimeters have been used to perform dosimetry measurements for the widely used Ir-192 microSelectron-HDR source with an improved polystyrene phantom. Radial dose functions and anisotropy functions, main parameters of 2D dose-rate formalism from the TG-43U1 protocol, have been obtained experimentally. Measurement results are compared with that of the Monte Carlo calculations reported, and no difference has been found between them.

[Effect on dose owing to source displacement in coronary endovascular brachytherapy].

OBJECTIVE: To investigate the effect on the dose distribution of source position displacement with the target region margin in catheter-based 192Ir line source endovascular brachytherapy. METHOD: Dose rate distribution along longitudinal axes was estimated by the formula recommended by AAPM No.60 and No. 43. RESULTS: In the two cases of source displacement (1.1 and 5 mm) doses of target region margin was decreased dramatically (at most 53.9% and 565.8% respectively) were compared to that of no source displacement, and the affected range was 6 mm and 9 mm respectively. CONCLUSION: Source displacement will lead to the decrease of dose in target region margin.

Study on the mechanism of epidermal growth factor-induced proliferation of hepatoma cells.

AIM: Many growth factors, such as epidermal growth factor (EGF), are associated with the carcinogenesis. EGF plays its role in the proliferation of hepatoma cells through binding with EGF receptor (EGFR) and a series of signal transduction. But the postreceptor pathway is still not clear. In the present experiment, we studied the effect of tyrosine kinase, protein kinase C, Na(+)/H(+) exchange, calmodulin and voltage-dependent Ca(2+) channel on EGF-induced hepatoma cell proliferation. METHODS: Hepatoma cell line SMMC7721 was cultured in RPMI1640 serum-free medium. In order to study the effect of thyrosine kinase, protein kinase C, Na(+)/H(+) exchange, calmodulin and voltage-dependent Ca(2+) channel on human heptoma cell proliferation induced by epidermal growth factor (EGF), DNA synthesis rate of hepatoma cells was measured by the method of (3)H-TdR incorporation. RESULTS: EGF (10(-9) M) stimulated the proliferation of heptoma cells significantly ((3)H-TdR incorporation was 1 880+/-281 cpm/well, P<0.05), and this effect was significantly inhibited by tyrosine kinase inhibitor genistein ((3)H-TdR incorporation was 808+/-209 cpm/well, P<0.001). Calmodulin inhibitor W-7, protein kinase C inhibitor H-7 and Na(+)/H(+) exchange inhibitor amiloride individually had significant inhibiting effect on EGF-induced proliferation of hepatoma cells ((3)H-TdR incorporation was 978+/-87.3 cpm/well, 1 241+/-147 cpm/well, 1 380+/-189 cpm/well, respectively, P<0.001, P<0.01, P<0.05), but they all had no effect on the basal level proliferation of cultured hepatoma cells ((3)H-TdR incorporation was 1 284+/-260 cpm/well, 1 179+/-150 cpm/well, 1 392+/-152 cpm/well, respectively, (3)H-TdR incorporation of the control was 1 353+/-175 cpm/well, P>0.05). Voltage-dependent Ca(2+) channel inhibitor verapamil had no inhibition on EGF-induced proliferation of hepatoma cells ((3)H-TdR incorporation was 1 637+/-133 cpm/well, P>0.05), it also had no effect on the basal level proliferation of cultured hepatoma cells ((3)H-TdR incorporation was 1 196+/-112 cpm/well, P>0.05). CONCLUSION: Our data suggest that tyrosine kinase, Ca(2+)-calmodulin-dependent pathway, protein kinase C and Na(+)/H(+) exchange play a critical role in EGF-induced proliferation of hepatoma cells and that the effect of EGF is independent of voltage-dependent Ca(2+) channel.

[Effect of common ions in water on water association by 17O-NMR].

There are various kinds of trace ions in water supply, such as Na+, K+, Ca2+, Mg2+ and Cl-, SO(4)2-, CO(3)2- etc. 17O-NMR chemical shift and line-width of water were measured under different temperature and different concentrations of various salts in aqueous solutions containing those ions. The relationship of 17O-NMR chemical shift and line-width of water to water association and the effect of ions on water association were analyzed. Cations promoted water association and anions destroyed water association. Generally, the more the ionic charge and the larger the ionic radius, the larger was the effect of those ions on water association. Besides, the effect of ionic charge on water association was more significant than that of ionic radius.