OBJECTIVE To study the influence of focused ultrasound on the morphology of nasal mucosa in sheep. METHODS A model CZB ultrasound therapeutic system for rhinitis, developed and produced by Chongqing Haifu(HIFU)Technology Co.,Ltd.,Chongqing China,was used in this study. Linear scans were performed on bovine liver in vitro under different scan parameters, and the biologic focal field(BFF)was detected to evaluate if it met the requirements of designed. The nasal mucosa of inferior turbinate of sheep was exposed with the same scan parameters under the observation of nasal endoscope, and morphological changes of the nasal mucosa were observed by gross examination, light and electron microscopes. RESULTS This study revealed that the designed biological focal field in bovine liver in vitro could be obtained under the scan parameters mentioned above. Linear scan with the same condition,there was no obvious change in appearance and color of the treated nasal mucosa in the inferior turbinate of the sheep. However,3 days after treatment,there was an increased secretion in the nasal cavity,which recovered 7 days post-treatment. Light microscopic examination 3 days after exposure showed that the epithelia of the nasal mucosa was intact and there was diffused distribution of spot coagulated necroses in the subepithelia layer of treated nasal mucosa. Degeneration of vascular endothelial cells and thrombosis of blood vessels were found in the coagulated necrosis region. Besides,degeneration or necrosis of nerve cells was induced,and glandular cells werepartially or completely damaged. The structure of epithelial goblet cells and ciliated cells in the treated nasal mucosa appeared to be normal under the observation of electronic microscope. At the seventh day after treatment,signs of tissue regeneration such as hyperplasia of collagen fiber were found in the coagulated region,and the necrosis tissue began to dissolve and was absorbed at the 14th day post-treatment. CONCLUSION Under the above scan parameters,the energy of focused ultrasound could be deposited specifically at the subepithelia layer,and to ablate the targeted nasal mucous tissues which are rich in blood vessels,nerves and glands. There were no damage to the non-target area such as epithelial layer,which could maintain the normal structure and biological function of mucociliary of nasal mucosa.

Objective:To observe the pathological changes of VX2 implanted breast cancer ablated by high intensity focused ultrasound (HIFU) in rabbits. Methods:Thirty-six rabbits implanted VX2 breast carcinoma were randomly divided into treatment group (n=24) and control group (n=12) two weeks after implantation. HIFU ablation was performed in the treatment group guided by ultrasound B. The pathological changes were observed under light microscope after hematoxylin-eosin staining and then observed under electron microscope. The activity of succinate dehydrogenase (SDH) was measured. Proliferating cell nuclear antigen (PCNA) was determined by immunohistochemistry. Results:Histopathologic observation found that the morphological features and nucleus karyotypes of tumor cells had no significant changes, but vacuole-like structure appeared in cytoplasm. Typical coagulation necrosis of tumor cells were observed under electron microscope. SDH activity detection showed that tumor cells were inactivated. The expressions of PCNA was positive in control group and negative in treatment group. Conclusion:Electron microscopy, enzyme property test, and immunohistochemistry verified that VX2 implanted breast cancer cells were dead after HIFU ablation in rabbits.

Objective To investigate the influences of heart in patients with hepatocellular carcinoma closed to heart after high intensity focused ultrasound ablation(HIFU). Methods Thirty four patients with hepatocellular carcinoma closed to heart received detecting the values of periphery blood aspartate transarninase(AST), creatine kinase (CK), CK-MB, α-hydroxybutyrate dehydrogenase (α-HBDH), lactate dehydrogenase(LDH), myoglobin(Myo) and troponin I (cTnI) before and 1,3, 7 days after HIFU respectively. ECG was monitored in all patients simultaneously. Results The values of AST,CK,CK-MB,α-HBDH, LDH and Myo increased 1 day after HIFU significantly (P<0.05), which decreased greatly 3 days after HIFU and nearly recovered well (P>0.05) 7 days after HIFU. However, the value of cTnI and ECG were normal before and after HIFU. Conclusions No obvious myocardium injury was found after HIFU in patients with hepatocellular carcinoma dosed to heart, cTnI may be an important marker to evaluate myocardium injury after HIFU.

Objective To investigate the safety and effect of high intensity focused ultrasound ablation(HIFU) on residual liver cancer in patients after radiotherapy. Methods Twenty liver cancer patients with twenty five residual tumors after three-dimensional conformal radiotherapy or stereotactic radiotherapy received HIFU ablation. Liver function and periphery blood cell counts were performed before HIFU and at 1 week after HIFU in all patients. Enhanced MRI and α-fetoprotein (AFP) level were performed before HIFU and at 2 weeks after HIFU to evaluate the effect of HIFU ablation. The survival of all patients was assessed by the Kaplan-Meier method. Results The mean follow-up time was (12.6 ± 8.0)months. The median survival time and 1-year survival rate were 22 months and 87.5% respectively. No skin burns were observed in all patients. As compared with before HIFU,there were no significant differences in the levels of albumin,alanine transarninase, aspartate transarninase, total bilirubin, direct bilirubin, blood red cell counts,blood white cell counts and blood platelet counts at 1 week after HIFU (paired t test, P =0. 156,0. 356,0. 203,0.659,0. 531,0. 519,0. 310,0. 346, respectively). Significant difference in AFP level of 9 patients with AFP＞20 μg/L was observed before HIFU and 2 weeks after HIFU (paired t test, P =0.030). Among 25 residual liver tumors,sixteen with complete ablation and six with ablation volume of ≥80% were observed by enhanced MRI at 2 weeks after HIFU. Conclusions HIFU may be a safe and effective new method to ablate residual liver cancer after three-dimensional conformal radiotherapy or stereotactic radiotherapy.

Objective To study the genomic molecular organization and genotype of human astro-virus infected infants in Shanghai of China. Methods Based on the published genomic sequence of HAstV (GenBank), the whole genome of one isolate human astrovirus was sequenced by specific primers. The PCR-products were cloned to pMD18-T vector and sequenced, phylogenetic tree was constructed by the Neighbor-Joining method with MEGA 4 software. Results The genome of HAstV-SH is 6807 hp, contains three ORFs: ORF1a and 1b encode the non-structural protein (from 83 nt to 4372 nt), ORF2 encodes the structural protein (from 4364 nt to 6727 nt). Compared with the ORF2 gene of those eight astrovirus sero-types in GenBank, revealed that the highest homology is with genotype 1 (97%). Homology with other gen-otypes ranged between 63% and 70%. Conclusion HAstV-SH belonged to genotype 1 and closely clus-tered with a strain of Japan (AB009985).

Objective To observe the changes in proliferative capability of remnant tumors implanted in rabbit breast after ablation with high intensity focused ultrasound(HIFU). Methods Rabbit implanted models were established by implanting VX_2 tumor mass into the breast of New Zealand rabbits.HIFU was applied to the tumors,and the remnant tumors were harvested by controlling temperature around probe of tumors.Fifty-six rabbits were randomly divided into control group (n=10)and HIFU group(n=40).The expression of proliferating cell nuclear antigen(PCNA)was detected by immunohistochemistry at different time points after ablation,and the survival time and organ metastasis status were observed after ablation. Results After ablation in HIFU group,the positive expression of PCNA was decreased shortly in remnant tumors,and restored to the level before ablation 21 days after treatment.The survival time in HIFU group was much longer than that in control group,and the time of lung and abdominal viscera metastasis in HIFU group appeared significantly later than that in control group(P<0.05). Conclusion Though HIFU ablation can not completely eradicate tumor after one treatment,the growth and metastasis of remnant tumors can be effectively inhibited for a short time,and HIFU ablation can prolong the survival time.

Objective To explore the relationship between therapeutic dosage of ultrasound ablation in treatment of uterine fibroids and imaging characteristics of bloody supply of uterine fibroids by color Doppler ultrasound imaging. Methods One hundred and forty-two patients with 168 fibroids were treated by ultrasound ablation. Before treatment, bloody supply of fibroids were classified into grade 0 -4 by ultrasonography. Three patients lost follow-up with contrast MRI exam within 1 month after treatment, so 165 fibroids were enrolled in this study. Bloody supplies were 9 fibroids in grade 0, 34 fibroids in grade 1, 35 fibroids in grade 2, 55 fibroids in grade 3 and 32 fibroids in grade 4. After 1 month treatment, the treated area without blood supply and ratio of ablation were measured by contrast MRI to evaluate the efficacy of thermal ablation and compare status of blood supple based different therapeutic dosage. According to International Reditherapy for Society ( SIR ) standard, adverse effect and score of pain were evaluated. Results ( 1) Ratio of ablation based; ratios of ablation were 79% in grade 0, 89% in grade 1, 92% in grade 2, 86% in grade 3, 71% in grade 4. It reached statistical difference when blood supply of grade 0 compared with those of grade 2 and 3 (P ＜ 0. 05 ) and blood supply of grade 4 compared with those of grade 1, 2, 3 ( P ＜ 0. 05). (2) Factor of energy efficiency:factor of energy efficiency were 13.19 J/mm3 in degree 0, 9. 54 J/mm3 in degree 1, 12. 91 J/mm3 in degree 2, 17. 83 J/mm3 in degree 3 and 28. 10 J/mm in degree 4. Factor of energy of ablation in degree 4 was significantly higher than those in degree 1, 2 and 3 blood supply (P ＜ 0. 05). It exhibit the positive relationship between blood supply and factor of energy of ablation ( r = 0. 354 ,P ＜ 0. 01). ( 3 ) Score of pain and adverse effect: nearly 85% ( 120/142 ) patients could tolerate this treatment very well. Those scores of pain were in range of 0 to 4. All patients did not extend their hospitalization and C to F of SIR standard was not recorded. Conclusion blood supply of myoma measured by ultrasound could predict dosage of ultrasound ablation, it could help select indicated well patients.

Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.

OBJECTIVETo develop a new noninvasive limb-salvaging method in the treatment of primary malignant bone tumor in the extremities.

METHODSForty-four patients with primary malignant bone tumor were treated by extracorporal high intensity focused ultrasound (HIFU) with or without chemotherapy, with a mean follow-up of 17.6 months.

RESULTSThe overall survival and complication rates were 84.1% and 18.2%. In 34 patients with stage II b disease, 30 were disease-free, with 2 died of tumor metastasis to brain and lung and 3 developed local recurrence. In 10 patients with stage III b disease, 5 survived with tumor, with 1 developed local recurrence and 5 died of lung metastasis. Thirty-six of 44 patients were > or = 15 points by Enneking system.

CONCLUSIONHigh intensity focused ultrasound combined with chemotherapy for primary malignant bone tumor in the extremity is proved to be effective and safe, preserving good function in the limbs. HIFU may possibly become a new limb-salvaging treatment for this tumor.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; mortality ; pathology ; therapy ; Child ; Female ; Humans ; Male ; Middle Aged ; Survival Rate ; Ultrasonic Therapy ; Ultrasound, High-Intensity Focused, Transrectal

OBJECTIVETo investigate the efficacy and side-effects of high intensity focused ultrasound (HIFU) in the treatment of malignant solid tumors.

METHODSThirty such patients who refused surgery and or refractory to chemotherapy, were treated by HIFU alone, with the efficacy and side effects monitored in terms of vital organ signs observation, functional assay of important organs, imaging examinations: digital subtraction angiography (DSA), CT, MRI, single photoemission computed tomography (SPECT), large core needle biopsy, complications or metastasis.

RESULTSAfter HIFU therapy, the vital signs remained stable and the function of heart, lung, kidney and liver was also normal. DSA images showed that small or larger arteries were not damaged. After a follow-up of 10 - 38 months (23.1 months), 26 patients (87%) have been alive. The volume of the tumor underwent complete regression in 10 patients. Shrinkage of tumor volume >/= 50% was observed in 13. Eight of 13 patients were examined by large core needle biopsy, all showing necrosis and/or fibrosis though 3 patients (10%) had local recurrence. Two of these were retreated again by HIFU and the locally recurrent tumor became well controlled. New metastases developed in 5 patients after HIFU therapy. Two patients suffered from peripheral nerve injuries, most of which have recovered during the follow-up. However, one patient developed skin injury.

CONCLUSIONHigh intensity focused ultrasound alone is effective and safe in the treatment of malignant solid tumors.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; therapy ; Treatment Outcome ; Ultrasound, High-Intensity Focused, Transrectal