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Профессору Евгению Филипповичу Странадко – 75 лет 叶夫根尼·菲利波维奇·斯特拉纳科教授,75岁
Q3 Medicine Pub Date : 2019-07-11 DOI: 10.24931/2413-9432-2012-1-1-17
Статья Редакционная
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引用次数: 0
Роль и место фотодинамической терапии в мультимодальных программах лечения злокачественных опухолей 光动力疗法在恶性肿瘤多模式治疗方案中的作用和地位
Q3 Medicine Pub Date : 2019-07-11 DOI: 10.24931/2413-9432-2012-1-1-3-5
В. А. Титова
The application of photodynamic therapy combined with local laser hyperthermia in patients with exhausted surgical treatment, radiotherapy and other cancer therapy is reviewed. Pre-requisites and relevancy of concurrent use of these methods in different groups of patients. The experience for this concurrent treatment in 60 patients with malignant tumors of oral, vulvar, rectal and other mucosa is summarized. Indications and eligibility criteria are represented, the efficiency and safety of developed methods are illustrated by case-reports.
综述了光动力疗法联合局部激光热疗在衰竭手术治疗、放疗等肿瘤治疗中的应用。不同患者组同时使用这些方法的前提条件和相关性。总结了60例口腔、外阴、直肠等粘膜恶性肿瘤同时治疗的经验。说明了适应症和合格标准,并通过病例报告说明了所开发方法的有效性和安全性。
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引用次数: 0
Сравнение эффективности фотодинамической терапии при использовании источников излучения с различными длинами волн в лечении синуситов 不同波长辐射源光动力疗法治疗窦炎的疗效比较
Q3 Medicine Pub Date : 2019-07-10 DOI: 10.24931/2413-9432-2019-8-2-14-18
Г. П. Попова, Я. А. Накатис, М. А. Рымша
Inflammatory diseases of the sinuses – one of the most common nosologies in the practice of otorhinolaryngologist; its pathogenesis is well studied, and treatment recommendations are detailed. Following them, however, cannot completely prevent chronic disease or recurrence. Antimicrobial photodynamic therapy is a promising method of treating sinusitis, which has proved its effectiveness, but has not yet been widely used. This work describes our experience in photodynamic therapy with chlorin e6 of chronic sinusitis using a new laser diode-based irradiation source. For patients who had previous sinus surgery an adapter for penetration into the sinus through anastomosis was developed and tested. First group of the patients underwent photodynamic therapy (PDT) according to the conventional scheme, using a laser with a wavelength of 662 nm; while the second one underwent PDT using a 405 nm laser. With daily washing of the nasal sinus, the period of inflammation relief (evaluated by the absence of pathological discharge during washing) amounted to 3.8 full days on average in the first group of patients, compared to 5.4 days on average for the second group. We carried out the comparative analysis of the treatment results based on clinical assessment and radiological evaluation (CT) at the time of discharge from the hospital and 1 month later.
鼻窦炎症性疾病——耳鼻喉科医生实践中最常见的疾病之一;其发病机制研究得很好,治疗建议也很详细。然而,遵循它们并不能完全预防慢性疾病或复发。抗菌光动力疗法是治疗鼻窦炎的一种很有前途的方法,已证明其有效性,但尚未广泛应用。这项工作描述了我们的经验,光动力治疗慢性鼻窦炎氯e6使用新的激光二极管为基础的照射源。对于以前做过鼻窦手术的患者,我们开发并测试了一种通过吻合进入鼻窦的适配器。第一组患者按常规方案进行光动力治疗(PDT),使用波长为662 nm的激光;而另一组则使用405纳米激光进行PDT。在每天清洗鼻窦的情况下,第一组患者的炎症缓解期(通过清洗过程中没有病理性分泌物来评估)平均为3.8天,而第二组患者平均为5.4天。我们根据出院时和1个月后的临床评估和影像学评价(CT)对治疗结果进行对比分析。
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引用次数: 1
Experience of using photodynamic therapy in the treatment of esophageal cancer 光动力疗法治疗食管癌的体会
Q3 Medicine Pub Date : 2019-07-10 DOI: 10.24931/2413-9432-2019-8-2-19-24
A. N. Tumanina, A. Polezhaev, V. Apanasevich, L. Gurina, M. Volkov, A. Y. Tarasenko, E. Filonenko
Photodynamic therapy (PDT) is a worthy alternative to surgical esophageal resection or endoscopic mucosal resection and dissection (EMR, ESD) in patients with superficial esophageal cancer with severe concomitant diseases as well as in patients with a common form of esophageal cancer with severe malignant dysphagia. Patients with superficial (7) and advanced (15) esophageal cancer received PDT as an independent method and as a supplement to complex treatment. Radachlorin was used as a photosensitizer at a dose of 0.6–0.8 mg/kg, administered intravenously 3 hours before irradiation. A PDT session was carried out using a laser with a wavelength of 662 nm. The light dose used was 150–300 J/cm2 . The use of PDT made it possible to achieve the full effect in 7 (100%) patients in the group of superficial (T1a-T1b) esophageal cancer where PDT was either the only method of treatment or in combination with radiation therapy. In the group of patients with stenotic cancer the use of PDT made it possible to achieve full recovery of food intake after recanalization for 20% of patients, and partial – for 66.7%. Thus, complete natural food intake was restored for 86.7% of patients which improved their quality of life. PDT is also a method of choice for cancer of the upper esophagus as esophageal stenting in this situation can cause unwanted subjective sensations. 
光动力疗法(PDT)对于伴有严重伴发疾病的浅表性食管癌患者以及伴有严重恶性吞咽困难的常见食管癌患者来说,是一种值得替代手术食管切除术或内镜粘膜切除与剥离(EMR, ESD)的治疗方法。浅表性食管癌(7例)和晚期食管癌(15例)患者接受PDT作为一种独立的治疗方法,并作为综合治疗的补充。Radachlorin作为光敏剂使用,剂量为0.6-0.8 mg/kg,在照射前3小时静脉注射。使用波长为662 nm的激光器进行PDT会话。使用的光剂量为150 ~ 300 J/cm2。在7例(100%)浅表性(T1a-T1b)食管癌患者中,PDT要么是唯一的治疗方法,要么是与放射治疗联合使用,使用PDT可以达到完全的效果。在狭窄性癌症患者组中,使用PDT使20%的患者在再通后完全恢复进食,66.7%的患者部分恢复进食。因此,86.7%的患者恢复了完全的天然食物摄入,改善了他们的生活质量。PDT也是上食管癌的一种选择方法,因为在这种情况下食管支架置入会引起不必要的主观感觉。
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引用次数: 4
Improving the efficiency of bladder cancer diagnostic cystoscopy with 5-ALA hexyl ester 提高5-ALA己基酯膀胱镜诊断膀胱癌的效率
Q3 Medicine Pub Date : 2019-03-31 DOI: 10.24931/2413-9432-2019-8-1-29-37
A. Kaprin, A. Trushin, M. P. Golovachenko, V. Ivanova-Radkevich, V. Chissov, E. Filonenko
This article presents the results of a clinical study that examined the diagnostic efficacy of fluorescent diagnostics (FD) of non-muscularinvasive bladder cancer using a photosensitizer of FD of malignant neoplasms – 5-aminolevulinic acid hexyl ester (5-ALA HE) compared with standard cystoscopy. The study involved 110 patients. The study began with intravesical administration of 50 ml of 0.2% solution of 5-ALA HE, the exposure time was 1 hour, after which the drug was removed from the organ. During the next hour, the mucous membranes were examined in two cystoscopy modes, followed by a standard transurethral resection of all urothelium sites with suspicion for tumor lesion based on white light and visible red fluorescence, and a control blind biopsy from the visually unchanged and non-fluorescent mucous tissue in each patient. The results of the study indicate the high effectiveness of the developed FD methodology with 5-ALA HE in detecting non-muscularinvasive bladder cancer during intravesical administration of the drug, due to selective accumulation of hexasens-induced PPIX in the tumor tissue compared with healthy mucosa. Compared with the results of standard cystoscopy, fluorescence diagnostics significantly increased diagnostic sensitivity by 24.4% (from 75.1% to 99.5%), diagnostic accuracy – by 15.8% (from 82.4% to 98.2%) and a negative predictive value – by 33.2% (from 65.8% to 99%) (p≤0.05). Additionally, a total of 37 (33.6%) patients was found to have 63 foci of fluorescence with a diameter of 2.5 to 3.0 mm. 59 of these were morphologically confirmed to contain cancer cells.
本文介绍了一项临床研究的结果,该研究使用恶性肿瘤FD光敏剂- 5-氨基乙酰丙酸己基酯(5-ALA HE)荧光诊断(FD)与标准膀胱镜检查比较非肌肉浸润性膀胱癌的诊断效果。这项研究涉及110名患者。研究开始时,膀胱内给药50 ml 0.2%的5-ALA HE溶液,暴露时间为1小时,然后将药物从器官中取出。在接下来的一个小时内,用两种膀胱镜检查粘膜,然后根据白光和可见红色荧光对所有怀疑有肿瘤病变的尿路上皮部位进行标准经尿道切除术,并对每个患者的视觉不变和非荧光粘膜组织进行对照盲活检。该研究结果表明,由于六体素诱导的PPIX在肿瘤组织中选择性积累,与健康粘膜相比,在膀胱内给药期间,开发的FD方法与5-ALA HE在检测非肌肉侵袭性膀胱癌方面具有很高的有效性。与标准膀胱镜检查结果相比,荧光诊断的诊断敏感性提高了24.4%(从75.1%提高到99.5%),诊断准确性提高了15.8%(从82.4%提高到98.2%),阴性预测值提高了33.2%(从65.8%提高到99%)(p≤0.05)。此外,共有37例(33.6%)患者发现63个荧光灶,直径为2.5至3.0 mm,其中59例经形态学证实含有癌细胞。
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引用次数: 3
Solubilization of hydrophobic bacteriochlorin-based photosensitizers in micelles of surfactants 疏水细菌氯基光敏剂在表面活性剂胶束中的增溶作用
Q3 Medicine Pub Date : 2019-03-31 DOI: 10.24931/2413-9432-2019-8-1-18-23
E. Plotnikova, V. O. Stramova, N. Morozova, A. Plyutinskaya, P. Ostroverkhov, M. Grin, A. Mironov, R. Yakubovskaya, A. Kaprin
The aim of the paper was to obtain a stable micellar emulsion of potent photosensitizer (PS) –O-propyloxime-N-propoxybacteriopurpurinimide methyl ester absorbing light in long-wave region of the spectrum (λmax= 800±2 нм). Solubilizates of the dye based on different surfactants (Kolliphor ELP, Poloxamer 407, Emuxol 268) were obtained. Taking into account the physical and chemical parameters, the most potent micellar emulsion for injection was selected and characterized. The emulsion based on Kolliphor ELP remains stable for 4 months, with no changes in the fluorescence spectrum and absorption, as well as the particle diameter.
本文的目的是制备一种稳定的强效光敏剂(PS) - o -丙氧基肟- n -丙氧基细菌嘌呤酰亚胺甲酯胶束乳液,在光谱的长波区(λmax= 800±2 нм)吸收光。得到了不同表面活性剂(Kolliphor ELP, poloxam407, Emuxol 268)对染料的增溶剂。综合考虑理化参数,选择了最有效的注射用胶束乳液,并对其进行了表征。基于Kolliphor ELP的乳液在4个月内保持稳定,荧光光谱和吸收没有变化,颗粒直径也没有变化。
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引用次数: 1
Комбинированное эндоскопическое лечение больного раком гортаноглотки с распространением на верхнюю треть пищевода 喉咽癌的内镜联合治疗,扩散到食管上三分之一
Q3 Medicine Pub Date : 2019-01-14 DOI: 10.24931/2413-9432-2018-7-4-35-40
В. М. Легостаев, О. Ю. Бабенков, Г. В. Балицкий
We present a clinical case with a complete endoscopic and clinical effect after endoscopic treatment of a patient with laryngeal cancer involving the upper third of the esophagus. The patient was treated as follows: conformal radiation therapy TFD = 40 gr, targeted chemotherapy using Cetuximab (total dose of 1800 mg). 1.5 months after the end of the treatment, a residual laryngopharyngeal tumor with a spread into the upper third of the esophagus was found during videolaryngoscopy examination. The result of the following histological examination was G2 squamous cell carcinoma. From August 2015 to February 2017, the patient underwent 8 photodynamic therapy sessions in combination with argon plasma coagulation. A control videolaryngoscopy, carried out 1 month after the fnal session, showed complete tumor regression without cicatricial deformity and narrowing of the esophageal lumen.
我们提出了一个临床病例,在对一名涉及食管上三分之一的喉部癌症患者进行内窥镜治疗后,获得了完整的内窥镜和临床效果。患者接受如下治疗:适形放射治疗TFD=40 gr,使用西妥昔单抗进行靶向化疗(总剂量1800 mg)。治疗结束1.5个月后,在视频喉镜检查中发现一个残留的咽喉肿瘤,并扩散到食道上三分之一。随后的组织学检查结果为G2鳞状细胞癌。2015年8月至2017年2月,患者接受了8次光动力治疗,并结合氩等离子体凝固。fnal术后1个月进行的对照视频喉镜检查显示,肿瘤完全消退,没有瘢痕畸形和食管管腔狭窄。
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引用次数: 1
Cluster analysis of the results of intraoperative optical spectroscopic diagnostics In brain glioma neurosurgery 脑胶质瘤神经外科术中光谱诊断结果的聚类分析
Q3 Medicine Pub Date : 2019-01-14 DOI: 10.24931/2413-9432-2018-7-4-23-34
I. Osmakov, T. Savelieva, V. Loschenov, S. Goryajnov, A. Potapov
The paper presents the results of a comparative study of methods of cluster analysis of optical intraoperative spectroscopy data during surgery of glial tumors with varying degree of malignancy. The analysis was carried out both for individual patients and for the entire dataset. The data were obtained using combined optical spectroscopy technique, which allowed simultaneous registration of diffuse reflectance spectra of broadband radiation in the 500–600 nm spectral range (for the analysis of tissue blood supply and the degree of hemoglobin oxygenation), fluorescence spectra of 5‑ALA induced protoporphyrin IX (Pp IX) (for analysis of the malignancy degree) and signal of diffusely reflected laser light used to excite Pp IX fluorescence (to take into account the scattering properties of tissues). To determine the threshold values of these parameters for the tumor, the infltration zone and the normal white matter, we searched for the natural clusters in the available intraoperative optical spectroscopy data and compared them with the results of the pathomorphology. It was shown that, among the considered clustering methods, EM‑algorithm and k‑means methods are optimal for the considered data set and can be used to build a decision support system (DSS) for spectroscopic intraoperative navigation in neurosurgery. Results of clustering relevant to thepathological studies were also obtained using the methods of spectral and agglomerative clustering. These methods can be used to postprocess combined spectroscopy data.
本文对不同恶性程度神经胶质肿瘤术中光学光谱数据的聚类分析方法进行了比较研究。该分析是针对个别患者和整个数据集进行的。数据采用组合光谱学技术获得,该技术允许同时注册500-600 nm光谱范围内的宽带辐射漫反射光谱(用于分析组织血供和血红蛋白氧合程度);5‑ALA诱导原卟啉IX (Pp IX)的荧光光谱(用于分析其恶性程度)和用于激发Pp IX荧光的漫反射激光信号(考虑组织的散射特性)。为了确定肿瘤、浸润区和正常白质的这些参数的阈值,我们在术中可用的光学光谱数据中寻找自然簇,并将其与病理形态学结果进行比较。结果表明,在考虑的聚类方法中,EM算法和k均值方法对考虑的数据集最优,可用于构建神经外科术中光谱导航的决策支持系统(DSS)。采用光谱聚类和聚类聚类的方法,得到与病理研究相关的聚类结果。这些方法可用于组合光谱数据的后处理。
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引用次数: 2
Study of pharmacokinetics of liposomal photosensitiser based on hydroxyaluminium tetra-3-phenylthiophthalocyanine on mice 羟基铝四-3-苯硫酞脂质体光敏剂在小鼠体内的药动学研究
Q3 Medicine Pub Date : 2019-01-14 DOI: 10.24931/2413-9432-2018-7-4-16-22
A. Budko, Z. G. Deichman, G. Meerovich, L. Borisova, I. G. Мeerovich, A. Lantsova, Kulbachevskaya N.Yu. Kulbachevskaya N.Yu. Kulbachevskaya N.Yu.
The present work is devoted to the study of pharmacokinetics of infrared photosensitizer (PS) based on hydroxyaluminium tetra‑3‑phenylthiophthalocyanine in a sterically stabilized liposomal form. The study was carried out on adult female mice. The PS was administered once intravenously at a dose of 6 mg / kg. Evaluation of the PS accumulation dynamics in the mice tissues and organs was performed at time intervals from 5 minutes to 7 days using spectral‑fluorescent method. The maximum accumulation of the PS photoactive form was recorded in lungs (32 µg / g in the interval of 5–30 minutes after introduction), liver (20.8 µg / g in the interval of 4–24 hours after introduction) and spleen (28 µg / g 4 hours after introduction). At the same time, by the end of the observation period (7 days after administration), trace amounts of the PS photoactive form were still detected in the liver and the spleen at a calculated concentration of 0.5‑1 µg / g. The PS accumulated the least in muscles and skin. The fluorescent signal from the PS accumulated in skin was detectable almost immediately, and its concentration remained at the same level (1.2‑1.5 µg / g) for up to 3 days of observation. In the muscles, the concentration of the PS reached 1.5 µg / g 15 minutes after administration, and then gradually decreased until 0.25 µg / g at 24 hours. Data on the pharmacokinetics of PS in blood, basic organs and tissues of animals were obtained, pharmacokinetic parameters were calculated. 7 days after the administration, the PS concentration in the skin and muscles was below the detection limit. The studies confrmed that PEGylation of the PS liposomal form slows down the process of its capture by reticulo‑endothelial system. It was shown that the PS circulates in blood and organs of mice for a long time and it completely distributes only when 4 hours pass after administration.
本文研究了基于羟基铝四‑3‑苯噻吩酞菁的红外光敏剂(PS)在空间稳定脂质体中的药代动力学。这项研究是在成年雌鼠身上进行的。PS以6mg / kg的剂量静脉注射一次。采用光谱荧光法每隔5分钟至7天对PS在小鼠组织和器官中的蓄积动态进行评估。PS光活性形式的最大蓄积量记录在肺部(在引入后5-30分钟内32µg / g),肝脏(在引入后4 - 24小时内20.8µg / g)和脾脏(在引入后4小时内28µg / g)。同时,在观察期结束时(给药后7天),肝脏和脾脏中仍检测到微量PS光活性形式,计算浓度为0.5 - 1µg / g,肌肉和皮肤中PS积累最少。PS在皮肤中积累的荧光信号几乎可以立即检测到,其浓度在长达3天的观察中保持在相同水平(1.2 - 1.5µg / g)。给药15分钟后,肌肉中PS浓度达到1.5µg / g, 24小时后逐渐降低至0.25µg / g。获得了PS在动物血液、基本器官和组织中的药动学数据,计算了药动学参数。给药后7 d,皮肤和肌肉中PS浓度均低于检测限。研究证实,聚乙二醇化的PS脂质体形式减缓了其被网状内皮系统捕获的过程。结果表明,PS在小鼠血液和脏器中循环时间较长,给药4小时后才完全分布。
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引用次数: 2
Cytological effects in lymph nodes of abdominal lymphodissection zone after intraoperative photodynamic therapy of gastrointestinal cancers 胃肠癌术中光动力治疗后腹腔淋巴夹层淋巴结的细胞学影响
Q3 Medicine Pub Date : 2019-01-14 DOI: 10.24931/2413-9432-2018-7-4-11-15
V. Kravtsov, E. S. Pirozhenko, K. V. Pavelec, M. A. Protchenkov, U. A. Drozd
Cytological studies on lymph nodes of abdominal lymphodissection zone after local intraoperative photodynamic therapy (IOPDT) of gastrointestinal cancers were carried out. As a result of the PDT, the metastatic cells are destroyed, their cytoplasmic membranes and the cytoplasm disappears, leaving behind interphase nuclei ("naked nuclei") (p<0,0001). Cytological confrmation of apoptosis (the presence of apoptotic bodies) in metastatic lymph nodes after IOPDT sessions on the lymph nodes of the abdominal lymphodissection zone is also presented.
对胃肠道肿瘤术中局部光动力疗法(IOPDT)后腹腔淋巴清扫区淋巴结进行细胞学研究。PDT的结果是,转移细胞被破坏,其质膜和细胞质消失,留下间期细胞核(“裸核”)(p<00001)。还介绍了腹部淋巴清扫区淋巴结IOPDT治疗后转移淋巴结中细胞凋亡(凋亡体的存在)的细胞学证实。
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引用次数: 0
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Biomedical Photonics
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