Photodiagnosis and photodynamic therapy最新文献

Background: Photodynamic therapy (PDT) has emerged as a promising minimally invasive modality for the treatment of colorectal cancer (CRC), offering localized cytotoxicity and potential immune activation. However, a comprehensive overview of the global research landscape in this field is lacking. This study aims to systematically assess the global trends, collaborative networks, influential contributors, and current research status in the use of PDT for CRC via bibliometric analysis.

Methods: Publications from 1986 to April 2025 were retrieved from the Web of Science Core Collection via a defined search strategy. VOSviewer and CiteSpace were employed to analyze publication trends, country and institutional networks, journal impact, citation and co-citation patterns, and keyword evolution.

Results: A total of 828 publications were included. Global research on PDT for CRC has increased steadily since 2015, with China and the United States being the most prolific contributors. The Chinese University of Hong Kong and the University of Chicago was prominent in terms of productivity and citation impact, respectively. Photodiagnosis and Photodynamic Therapy was the leading journal. Keyword and citation burst analyses revealed major research themes and mapped the overall research landscape of PDT in CRC. Enhanced endoscopic visualization has facilitated the application of PDT in CRC, improving the precision of both lesion localization and therapeutic light delivery.

Conclusion: PDT research for CRC is undergoing rapid expansion and increasing interdisciplinary integration. Although substantial progress has been made, its clinical translation remains at a relatively early stage. This bibliometric analysis presents the research landscape of PDT for CRC and highlights key contributors and major themes. While it offers a comprehensive overview for researchers and clinicians, it does not evaluate the validity or clinical relevance of individual studies.

Objective: This study aimed to evaluate intraoperative adverse events in patients undergoing photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT) using oral 5-aminolevulinic acid (5-ALA) (ALA-PDD-TURBT) under spinal anesthesia.

Methods: This single-center retrospective study included 109 patients who underwent ALA-PDD-TURBT under spinal anesthesia between January 2019 and April 2023. Hypotension was defined as a systolic blood pressure ≤ 80 mmHg. We evaluated the incidence of any adverse events and investigated the risk factors for hypotension, nausea, and vomiting.

Results: Hypotension was observed in 64 patients (58.7 %), while nausea and vomiting were observed in 29 patients (26.6 %). No adverse events of Clavien-Dindo grade ≥ 3 were observed. No significant association was found between hypotension and various patient-related factors, including age, sex, smoking history, comorbidities, presence of hypertension, use of antihypertensive agents, continuation of antihypertensive medication on the day of surgery, and administration of α-blockers for benign prostatic hyperplasia on examination. Regarding nausea and vomiting, the use of phenylephrine was identified as a significant risk factor (odds ratio, 10.2; 95 % confidence interval, 1.92-53.90; P < 0.01).

Conclusions: Our findings suggest that ALA-PDD-TURBT is a safe procedure with a low risk of severe complications. Although hypotension, nausea, and vomiting were relatively common, they were generally manageable with pharmacological interventions. No strong predictive risk factors for hypotension were identified; however, the use of phenylephrine was associated with an increased risk of nausea and vomiting.

Significance: Colorectal cancer (CRC) has a high incidence and mortality rate, with lung metastasis being the second most common site. Current treatments have limited efficacy, and novel approaches are needed.

Approach: We report a case of a middle-aged female with CRC and lung metastasis treated with four cycles of PDT and five cycles of systemic therapy, including chemotherapy, targeted therapy, and immunotherapy.

Results: After treatment, the lung metastases showed cystic changes, and the primary tumor significantly regressed (TRG: AJCC 0, Becker 1a). The patient successfully underwent surgical treatment.

Conclusions: This multimodal therapy shows promise in CRC lung metastasis, offering new insights for treatment.

Patients with locally advanced colorectal cancer (LACRC) are at high risk of recurrence and metastasis and benefit little from neoadjuvant radiotherapy (nCRT) or neoadjuvant chemotherapy (nCT). Although the Microsatellite instability-high (MSI-H) status has been identified as a valid predictive marker for immunotherapy response, heterogeneity in the treatment response remains. In this study, we report a case of a 70-year-old woman with locally advanced rectal cancer with MSI-H status who had no chance of surgery due to tumor invasion of the uterine wall (cT3N2Mx) and who underwent a systemic treatment regimen of photodynamic therapy (PDT) in combination with a PD-1 inhibitor and antiangiogenic therapy. The treatment consisted of four tumor-directed PDT sessions and a 6-cycle systemic regimen (sintilimab/tislelizumab 200 mg/q3W combined with bevacizumab 7.5 mg/kg/q3W and capecitabine 1000 mg/m²). After six cycles, the tumor achieved near-complete remission, with negative mesorectal fascia (MRF) and extramural vascular invasion (EMVI) status. As of the most recent telephone follow-up prior to manuscript submission, the patient remained progression-free for 17 months. This case demonstrates the synergistic efficacy of PDT combined with immune-targeted therapy in MSI-H LACRC, offering a novel non-surgical treatment option for organ preservation in such patients.

Background: Microsporum canis is a predominant cause of dermatophytosis, presenting a significant therapeutic challenge due to the limitations of conventional antifungal agents and the emergence of drug resistance. Methylene Blue-mediated Photodynamic Therapy (MB-PDT) represents a promising alternative; however, the comprehensive transcriptomic response and specific molecular pathways disrupted by this modality in M. canis remain largely elusive.

Methods: This study employed RNA-sequencing (RNA-Seq) to elucidate the global transcriptomic response of M. canis to a sub-inhibitory concentration of MB-PDT. Differentially expressed genes (DEGs) were identified, and their biological functions were characterized via Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Furthermore, the expression profiles of key marker genes were validated using qRT-PCR.

Results: A total of 619 DEGs were identified, comprising 341 upregulated and 278 downregulated genes. Functional enrichment analysis highlighted the "ribosome" and "steroid biosynthesis" pathways as the most significantly impacted. The transcriptomic profile suggests that MB-PDT induces multi-target oxidative damage, specifically compromising cell membrane integrity, mitochondrial function, and ribosomal activity. Notably, the expression patterns of key marker genes indicate that M. canis activates an intrinsic programmed cell death (PCD) pathway in response to this irreparable oxidative stress.

Conclusion: Our findings suggest that MB-PDT exerts its antifungal effect against M. canis through a multi-target mechanism that overwhelms cellular repair systems, ultimately triggering the initiation of PCD. This mode of action may mitigate the risk of resistance development, underscoring MB-PDT as a potent therapeutic alternative for the management of dermatophytosis.

Superficial fungal infections caused by Trichophyton indotineae are spreading globally, with mutations in its SQLE gene (F397L/L393S) increasing resistance to traditional antifungals like terbinafine, creating an urgent need for new therapies. This study evaluated the clinical efficacy of methylene blue-mediated photodynamic therapy (MB-PDT). In vitro susceptibility testing was performed on a multidrug-resistant T. indotineae strain isolated from a 25-year-old Indian male with extensive skin lesions (confirmed by ITS sequencing). A randomized controlled trial was conducted: the experimental group (forearm lesions) received topical 1 % methylene blue plus 630 ± 5 nm red light irradiation (100 J/cm², once weekly for 4 weeks), while the control group (other lesions) were treated with topical 1 % terbinafine cream twice daily. Results showed the strain was highly sensitive to methylene blue (MIC = 1.0 μg/mL) but resistant to terbinafine (MIC = 8.0 μg/mL). After 2 weeks, the experimental group achieved scaling resolution and negative fungal microscopy, with sustained efficacy at 4 weeks; the control group retained residual hyphae. Conclusion: MB-PDT rapidly eradicates drug-resistant T. indotineae infections, outperforming traditional topical agents and providing a safe, effective alternative for drug-resistant dermatophytosis.

Purpose: To evaluate the effects of intravitreal Conbercept (IVC) loading injections on proliferative diabetic retinopathy (PDR) retinal microvasculature using novel optical coherence tomography angiography (OCTA) parameters.

Methods: This retrospective study included 25 eyes of 25 treatment-naïve PDR patients who received monthly IVC for 3 consecutive months. At baseline and after IVC loading injections, OCTA novel parameters, including vessel skeleton density (VSD), vessel diameter index (VDI), fractal dimension (FD), branch vessel tortuosity (BVT) and percentage area of nonperfusion (PAN), were measured in the superficial capillary plexus (SCP) and deep capillary plexuses (DCP). Best-corrected visual acuity (BCVA), central macular thickness (CMT), and traditional OCTA parameters such as vessel density (VD) and foveal avascular zone (FAZ) metrics were also recorded. Patients were grouped by baseline hemoglobin A1c (HbA1c) (<8% vs. ≥8%) for subgroup analysis.

Results: After IVC loading injections, BCVA improved (P = 0.036), and CMT decreased (P < 0.001). SCP-FD, DCP-VSD, and DCP-FD increased (P = 0.023, 0.031,0.036, respectively). Multivariate analysis revealed that baseline SCP-PAN was positively correlated with CMT reduction (β = 1.821, P = 0.016). In HbA1c <8% group, SCP-VDI, DCP-VSD, and DCP-FD increased (P = 0.022, 0.033, 0.033, respectively) after loading injections.

Conclusions: Novel OCTA parameters revealed that IVC loading injections can improve retinal microvasculature in PDR patients. However, using these novel parameters for follow-up and treatment assessment remains challenging under varying image processing conditions.

Objective: To investigate the incidence of dry eye syndrome following refractive corneal surgery and identify prognostic factors, thereby providing evidence-based guidance for precise clinical assessment and individualized management.

Methods: A retrospective cohort study was conducted including 778 patients (1,598 eyes) aged 18-45 years who underwent refractive corneal surgery at our hospital between January and December 2020. Surgical procedures included LASIK, FS-LASIK, PRK, Smart transepithelial photorefractive keratectomy, and ICL implantation. Comprehensive preoperative ophthalmic examinations were performed, including assessment of dry eye-related parameters such as tear meniscus height and tear film break-up time (BUT). Subjective symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Dry eye symptoms were assessed at 2 months postoperatively. Univariate analysis and multivariate logistic regression analysis were employed to identify independent risk factors for postoperative dry eye development.

Results: Among the 778 patients, 526 were male and 252 were female, with a mean age of 22.1±5.2 years. The overall incidence of dry eye at 2 months postoperatively was 41.4% (662/1,598 eyes). Ocular dryness was the most common symptom (78.5%), followed by foreign body sensation (65.3%) and photophobia (42.8%). Significant differences in dry eye incidence were observed among different surgical procedures (P=0.012). Surface ablation procedures (PRK + Smart transepithelial PRK) demonstrated an incidence of 45.7%, significantly higher than lamellar procedures (LASIK + FS-LASIK) at 39.7% (P=0.005). Univariate analysis revealed associations between postoperative dry eye and female gender, age 26-30 years, surface ablation procedures, preoperative tear meniscus height <0.2mm, and preoperative BUT <10s (P<0.05). Multivariate logistic regression analysis identified independent risk factors: female gender (OR=1.24, 95%CI: 1.02-1.51, P=0.032), surface ablation procedures (OR=1.32, 95%CI: 1.08-1.61, P=0.007), preoperative tear meniscus height <0.2mm (OR=1.58, 95%CI: 1.29-1.94, P<0.001), and preoperative BUT <10s (OR=1.45, 95%CI: 1.19-1.77, P<0.001).

Conclusion: Dry eye syndrome exhibits a relatively high incidence following refractive corneal surgery. Female gender, surface ablation procedures, and compromised preoperative tear film function constitute independent risk factors for postoperative dry eye development. Systematic preoperative assessment of tear film function is essential, with proactive intervention and individualized surgical planning recommended for high-risk patients to reduce postoperative dry eye incidence and enhance patient satisfaction.

Background: To investigate the influences of accommodation on peripheral retinal defocus in school-age children with corrective glasses before and after cycloplegia.

Methods: In total, 69 children, aged 7-12 years, with spherical equivalent between +1.75 D and -9.75 D were recruited. Peripheral retinal defocus values (RDV) before and after cycloplegia were measured using multispectral refraction tomography (MRT), and compared among different severities of myopia. The correlation between retinal defocus and axial length was also evaluated. The parameters were measured in different circular areas (15°, 30°, 45°, and 53°), annular areas (15°-30°, 30°-45°, and 45°-53°), and quadrants (superior, inferior, temporal, and nasal). Data was obtained from the right eyes of all participants. An average of three values was used for analysis.

Results: Before cycloplegia, significant variations were identified in the inferior retinal quadrant across different severities of myopia and age groups. After cycloplegia, multiple retinal areas showed significant differences among different severities of myopia, while there were no differences in each area among different age groups. After cycloplegia, retinal defocus shifted significantly towards more hyperopic across all areas, except for the RDV-15^o area. Superior retinal defocus was positively correlated with axial length before and after cycloplegia, whereas inferior retinal defocus was negatively correlated with axial length before cycloplegia.

Conclusion: This study revealed various distribution of defocus across different retinal areas in school-age children. Peripheral retinal defocus can be induced with cycloplegia. Alterations in accommodation can influence peripheral retinal defocus in school-age children.