1.Expert consensus on the positioning of the "Three-in-One" Registration and Evaluation Evidence System and the value of orientation of the "personal experience"
Qi WANG ; Yongyan WANG ; Wei XIAO ; Jinzhou TIAN ; Shilin CHEN ; Liguo ZHU ; Guangrong SUN ; Daning ZHANG ; Daihan ZHOU ; Guoqiang MEI ; Baofan SHEN ; Qingguo WANG ; Xixing WANG ; Zheng NAN ; Mingxiang HAN ; Yue GAO ; Xiaohe XIAO ; Xiaobo SUN ; Kaiwen HU ; Liqun JIA ; Li FENG ; Chengyu WU ; Xia DING
Journal of Beijing University of Traditional Chinese Medicine 2025;48(4):445-450
Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.
2.Effects of cinbufagin on proliferation,migration and invasion of human colon cancer cells via JAK2/STAT3 pathway
Jia CHEN ; Qi XIA ; Yi-Nan LI ; Yu-Jie HE ; Ze-Ting YUAN ; Yue LI ; Pei-Hao YIN
The Chinese Journal of Clinical Pharmacology 2024;40(12):1764-1768
Objective To investigate the effects of cinbufagin(CB)on the proliferation,migration and invasion ability as well as epithelial-mesenchymal transition(EMT)of human colon cells HCT116.Methods Logarithmically grown HCT116 cells were randomly divided into blank group and experimental-L,-M,-H groups;the blank group did not receive any treatment(0 nmol·L-1),and experimental-L,-M,-H groups were cultured in 1 640 medium containing 17.5,35 and 70 nmol·L-1 cinbufagin for 48 h.Cell counting kit-8(CCK-8)was used to detect the effect of cinbufagin on the survival rate of HCT116 cells;cloning assay was used to detect the effect of cinbufagin on the proliferation of HCT116 cells;cell scratch assay and Transwell assay were used to detect the effect of cinbufagin on the migration and invasive ability of HCT116 cells;Western blot was used to detect the expression levels of janus kinase 2(JAK2)/signal transducers and activators of transcription 3(STAT3)pathway and EMT-related proteins of HCT116 cells.Results The number of clone formation in blank group and experimental-L,-M,-H groups were 122.67±24.42,73.67±15.82,44.33±4.51 and 21.67±1.53;the rates of migration of scratches were(44.64±9.15)%,(26.91±2.94)%,(19.28±1.52)%and(6.33±2.30)%;the number of invaded cells were 120.33±1.15,58.33±9.07,33.33±1.53 and 18.33±3.21;the relative protein expression of phosphorylated JAK-2(p-JAK-2)/JAK-2 were 1.02±0.06,0.94±0.05,0.75±0.22 and 0.49±0.22;relative protein expression of phosphorylated STAT3(p-STAT3)/STAT3 were 0.89±0.10,0.72±0.04,0.65±0.06 and 0.52±0.18;relative protein expression of E-cadherin were 0.30±0.14,0.41±0.13,0.49±0.14 and 0.69±0.17;relative protein expression of N-cadherin were 0.96±0.11,0.78±0.04,0.69±0.12 and 0.40±0.15;Snail relative protein expression were 0.89±0.08,0.62±0.15,0.44±0.15 and 0.27±0.09;Vimentin relative protein expression were 0.92±0.09,0.76±0.13,0.63±0.01 and 0.43±0.09,respectively.The above indexes in experimental-H group showed statistically significant differences compared to blank group(all P<0.05).Conclusion HCT116 can inhibit the invasion and metastasis of human colorectal cancer cells HCT116 by inhibiting epithelial-mesenchymal transition through JAK2/STAT3 pathway.
3.Relationship between the expression level of ABCC4 and miR-125b-5p in prostate cancer tissues and postoperative prognosis
Yuan JIA ; Hongfu WANG ; Nan LIU ; Kai YIN ; Wenqian QI
International Journal of Laboratory Medicine 2024;45(10):1159-1164,1170
Objective To explore the relationship between the expression levels of adenosine triphosphate binds to the box transporter C4(ABCC4)and microRNA-125b-5p(miR-125b-5p)and survival 3 years after surgery in prostate cancer(PCa)tissue.Methods A total of 60 patients with PCa diagnosed in Huanghua People's Hospital from November 2017 to February 2020 were selected,and PCa tissues(PCa group)and pa-racancer tissues(control group)were collected intraoperatively.The expression levels of ABCC4 mRNA,miR-125b-5p and ABCC4 in the samples were detected;the patients were followed up for 3 years.The correlation between the expression levels of ABCC4 mRNA and miR-125b-5p in PCa tissues,their relationship with clini-copathological features and prognosis,and the factors affecting the prognosis of PCa patients,the predictive value of both for 3-year survival of patients were analyzed.Results The expression level and positive rate of ABCC4 mRNA in PCa group were higher than those in control group,and the expression level of miR-125b-5p was lower than that in control group,and the differences were statistically significant(P<0.05).The expres-sion level of ABCC4 mRNA and miR-125b-5p in PCa tissue was negatively correlated(P<0.05).The expres-sion level of ABCC4 mRNA and miR-125b-5p in PCa tissue was related to tumor stage,serum prostate specific antigen,Gleason score and tumor metastasis(P<0.05).The 3-year cumulative survival rate of patients in the ABCC4 mRNA high expression group and the miR-125b-5p low expression group was lower than that in the ABCC4 mRNA low expression group and the miR-125b-5p high expression group,respectively,and the differ-ences were statistically significant(P<0.05).The expression level of ABCC4 mRNA in the PCa tissue in death group was higher than that in survival group,and the expression level of miR-125b-5p was lower than that in survival group,and the differences were statistically significant(P<0.05).High expression of ABCC4 mRNA and low expression of miR-125b-5p were independent risk factors for poor prognosis in PCa patients(P<0.05).Compared to the area under the curve(AUC)predicted by ABCC4 mRNA and miR-125b-5p alone for 3-year survival in PCa patients,the combined prediction of the two had a higher AUC(P<0.05).Conclu-sion ABCC4 is highly expressed and miR-125b-5p is low expressed in PCa patients'cancer tissues,and the combination of the two has a high predictive power for 3-year survival in PCa patients.
4.Effects of inhibiting KDM2A gene on the proliferation,invasion,and migration of liver cancer cells
Ji-Nan HE ; Hong-Yan KONG ; Dan-Dan XIANG ; Shuai-Wen HUANG ; Qi-Qin SONG ; Rui MIAO ; Jia-Quan HUANG
Medical Journal of Chinese People's Liberation Army 2024;49(7):814-822
Objective To investigate the effects of inhibiting KDM2A gene on the proliferation,invasion and migration of liver cancer cells and its possible regulatory mechanism.Methods Forty pairs of HCC tissues and their adjacent normal counterparts were collected from 2014 to 2017 in Tongji Hospital,Tongji Medical College Affiliated to Huazhong University of Science and Technology.Human liver cancer cell lines HepG2,Huh7,HCCLM3,MHCC-97H and normal liver cells LO2 were cultured in vitro.The mRNA and protein expression levels of KDM2A in HCC tissues and cells were detected by qRT-PCR and Western blotting.Huh7 cells were taken and set up as follows:(1)si-NC group(transfected with si-NC)and si-KDM2A group(transfected with si-KDM2A);(2)mimic-NC group(transfected with mimic-NC),miRNA-29a-3p mimic group(transfected with miRNA-29a-3p mimic),inhibitor-NC group(transfected with inhibitor-NC)and miRNA-29a-3p inhibitor group(transfected with miRNA-29a-3p inhibitor).The mRNA and protein expression levels of KDM2A were detected by qRT-PCR and Western blotting.The invasion and migration of cells were detected by Transwell,the proliferation of cells was detected by CCK-8 methods.The online databases TargetScan,miRDIP,miRWalk,Starbase and miRDB were used to predict the binding sites of KDM2A and miR-29a-3p.The KDM2A 3'-UTR(WT)or KDM2A 3'-UTR(MUT)report plasmid was co-transfected with NC-miRNA or miR-29a-3p mimics respectively for 48 h in 293T cells,and the luciferase activity was detected by the luciferase reporter gene detection system.Results Compared with adjacent normal counterparts,the relative mRNA and protein expression levels of KDM2A in HCC tissues increased significantly(P<0.05).Compared with LO2,the relative mRNA and protein expression levels of KDM2A in HepG2,Huh7,HCCLM3 and MHCC-97H increased significantly(P<0.05).Compared with si-NC group,the proliferation,invasion and migration of Huh7 cells in si-KDM2A group decreased significantly(P<0.05 or P<0.01).The analysis results of TargetScan,miRDIP,miRWalk,Starbase and miRDB showed that there were binding sites between KDM2A and miR-29a-3p.The results of the dual luciferase reporter assay showed that miR-29a-3p mimic significantly reduced KDM2A-MUT luciferase activity(P<0.01).After overexpression of miRNA-29a-3p,the relative mRNA and protein expression levels of KDM2A were decreased(P<0.01),the proliferation,invasion and migration abilities were decreased(P<0.05)in Huh7 cells.After inhibiting the expression of miRNA-29a-3p,the relative mRNA and protein expression levels of KDM2A were increased(P<0.05),the proliferation,invasion and migration abilities were enhanced(P<0.05)in Huh7 cells.Conclusion Inhibiting the expression of KDM2A can reduce the proliferation and migration ability of Huh7 cells.miR-29a-3p may be the upstream regulator of KDM2A and participate in the occurrence and development of hepatocellular carcinoma.
5.The mechanism of modified Xiangsha Liujunzi Decoction in regulating apoA-Ⅰ and improving endoplasmic reticulum stress in hyperlipidemic mice
Qi ZHANG ; Guoyuan SUI ; Nan SONG ; Jie WANG ; Yu LIU ; Haoran CAI ; Lianqun JIA
Journal of Beijing University of Traditional Chinese Medicine 2024;47(9):1236-1246
Objective To explore the mechanism of modified Xiangsha Liujunzi Decoction in regulating apolipoproteinA-Ⅰ (apoA-Ⅰ),improving endoplasmic reticulum stress,regulating glucose and lipid metabolism,and preventing and treating dyslipidemia in mice. Methods Wild-type (WT) C57BL/6J mice were randomly divided into the WT,WT+high-fat diet(HFD),and WT+HFD+Xiangsha Liujunzi Decoction(XSLJZ) groups according to the random number table method. ApoA-Ⅰ-/-mice were randomly divided into the apoA-Ⅰ-/-,apoA-Ⅰ-/-+HFD,and apoA-Ⅰ-/-+HFD+XSLJZ groups (n=10) according to the random number table method. D12492 was used for HFD feeding to establish a hyperlipidemic mouse model. Modified XSLJZ (23.66g/kg) was administered daily by gavage from the ninth week. Serum and liver tissue were collected for testing after 4 weeks. An automatic biochemical analyzer was used to detect blood lipid levels;an enzyme-linked immunosorbent assay was used to detect serum fasting blood glucose (FBG) and insulin (INS) levels,and the INS resistance index (HOMA-IR) was calculated. Hematoxylin and eosin staining was used to observe the pathological changes in the liver. Oil red O staining was used to observe the lipid deposition in the liver. TG levels in liver tissue were detected using the microplate method. Real-time PCR was used to detect apoA-Ⅰ,glucose-regulated proteins (GRP78),sterol regulatory element binding protein-1c (SREBP-1c),acetyl CoA carboxylase 1 (ACC1),and fatty acid synthase (FASN) mRNA expression levels in liver tissue. The WES fully automated protein expression analysis system was used to detect apoA-Ⅰ,GRP78,inositol-requiring enzyme 1 (IRE1),p-IRE1,c-Jun N-terminal kinase (JNK),p-JNK,insulin receptor substrate (IRS1),p-IRS1,protein kinase B (Akt),p-Akt,SREBP-1c,ACC1,and FASN protein expression levels in liver tissue. Results Compared to the WT group,the WT+HFD group showed a significant increase in serum lipids,FBG,INS levels,and the HOMA-IR index (P<0.05). The orange-red lipid droplets in liver tissue increased,fat vacuoles were apparent,and TG levels were significantly increased. ApoA-Ⅰ mRNA and protein expression levels were significantly reduced,whereas GRP78,SREBP-1c,ACC1,and FASN mRNA expression levels were increased,GRP78,SREBP-1c,ACC1,and FASN protein levels and the IRE1,JNK,IRS1,and Akt phosphorylation degree were increased (P<0.05). The serum TG,HDL-C,LDL-C,FBG,and INS levels and the HOMA-IR index in the WT+HFD group were significantly reduced after administering modified XSLJZ (P<0.05). The orange-red lipid droplets in liver tissue were significantly reduced,fat vacuolization was alleviated,and TG levels were significantly reduced,ApoA-Ⅰ mRNA and protein expression levels were significantly increased,whereas GRP78,SREBP-1c,ACC1,and FASN mRNA expression levels were reduced,GRP78,SREBP-1c,ACC1,and FASN protein expression levels and the IRE1,JNK,IRS1,and Akt phosphorylation degree were reduced (P<0.05). Compared to the WT+HFD group,the TG,LDL-C,and FBG levels and HOMA-IR index in the serum of the apoA-Ⅰ-/-+HFD group were significantly increased,whereas the HDL-C levels were significantly decreased (P<0.05). Diffuse orange-red lipid droplets in liver tissue and a significant increase in fat vacuoles were observed. Furthermore,TG levels were significantly increased,SREBP-1c,ACC1,FASN mRNA,SREBP-1c,and ACC1 protein expression levels and IRE1,JNK,IRS1,and Akt phosphorylation levels were significantly increased (P<0.05). Compared to the WT+HFD+XSLJZ group,the apoA-Ⅰ-/-+HFD+XSLJZ group showed a significant increase in serum TG,LDL-C,FBG,and INS levels,and the HOMA-IR index,whereas HDL-C levels decreased significantly (P<0.05). The deposition of orange-red lipid droplets in liver tissue improved,and TG levels significantly decreased,GRP78,SREBP-1c,ACC1,and FASN mRNA expression levels,GRP78,SREBP-1c,and ACC1 protein levels,and IRE1,JNK,IRS1,and Akt phosphorylation levels increased (P<0.05). Conclusion Modified XSLJZ improves liver glucose and lipid metabolism disorder by regulating apoA-Ⅰ to alleviate endoplasmic reticulum stress.
6.Value of contrast-enhanced ultrasonography in microwave ablation treatment of symptomatic focal uterine adenomyosis
Xiao-Long LI ; Jia-Xin LI ; Song-Yuan YU ; Pei-Li FAN ; Yun-Jie JIN ; Er-Jiao XU ; Sai-Nan GUAN ; Er-Ya DENG ; Qiu-Yan LI ; Zheng-Biao JI ; Jiu-Ling QI ; Hui-Xiong XU ;
Ultrasonography 2024;43(1):68-77
Purpose:
This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis.
Methods:
This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up.
Results:
No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered.
Conclusion
CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.
7.Value of contrast-enhanced ultrasonography in microwave ablation treatment of symptomatic focal uterine adenomyosis
Xiao-Long LI ; Jia-Xin LI ; Song-Yuan YU ; Pei-Li FAN ; Yun-Jie JIN ; Er-Jiao XU ; Sai-Nan GUAN ; Er-Ya DENG ; Qiu-Yan LI ; Zheng-Biao JI ; Jiu-Ling QI ; Hui-Xiong XU ;
Ultrasonography 2024;43(1):68-77
Purpose:
This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis.
Methods:
This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up.
Results:
No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered.
Conclusion
CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.
8.Value of contrast-enhanced ultrasonography in microwave ablation treatment of symptomatic focal uterine adenomyosis
Xiao-Long LI ; Jia-Xin LI ; Song-Yuan YU ; Pei-Li FAN ; Yun-Jie JIN ; Er-Jiao XU ; Sai-Nan GUAN ; Er-Ya DENG ; Qiu-Yan LI ; Zheng-Biao JI ; Jiu-Ling QI ; Hui-Xiong XU ;
Ultrasonography 2024;43(1):68-77
Purpose:
This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis.
Methods:
This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up.
Results:
No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered.
Conclusion
CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.
9.Value of contrast-enhanced ultrasonography in microwave ablation treatment of symptomatic focal uterine adenomyosis
Xiao-Long LI ; Jia-Xin LI ; Song-Yuan YU ; Pei-Li FAN ; Yun-Jie JIN ; Er-Jiao XU ; Sai-Nan GUAN ; Er-Ya DENG ; Qiu-Yan LI ; Zheng-Biao JI ; Jiu-Ling QI ; Hui-Xiong XU ;
Ultrasonography 2024;43(1):68-77
Purpose:
This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis.
Methods:
This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up.
Results:
No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered.
Conclusion
CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.
10.Value of contrast-enhanced ultrasonography in microwave ablation treatment of symptomatic focal uterine adenomyosis
Xiao-Long LI ; Jia-Xin LI ; Song-Yuan YU ; Pei-Li FAN ; Yun-Jie JIN ; Er-Jiao XU ; Sai-Nan GUAN ; Er-Ya DENG ; Qiu-Yan LI ; Zheng-Biao JI ; Jiu-Ling QI ; Hui-Xiong XU ;
Ultrasonography 2024;43(1):68-77
Purpose:
This study evaluated the value of contrast-enhanced ultrasonography (CEUS) in the ultrasound-guided microwave ablation (MWA) treatment of symptomatic focal uterine adenomyosis.
Methods:
This retrospective study was conducted between March 2020 and January 2023, enrolling 52 patients with symptomatic focal uterine adenomyosis who had undergone MWA. All patients were examined with CEUS before and after MWA. The non-perfused volume (NPV) was compared between CEUS and dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) following ablation. Therapeutic efficacy and safety were evaluated at 3-, 6-, and 12-month follow-ups. Additionally, this study explored the correlations between pre-treatment CEUS features and a volume reduction ratio indicating sufficient ablation, defined as 50% or more at the 3-month follow-up.
Results:
No significant differences in NPV were noted between CEUS and DCE-MRI immediately after MWA and during follow-up (all P>0.05). At the 3-month follow-up, the median VRRs for the uterus and adenomyosis were 33.2% and 63.9%, respectively. Sufficient ablation was achieved in 69.2% (36/52) of adenomyosis cases, while partial ablation was observed in the remaining 30.8% (16/52). The identification of non-enhancing areas on pre-treatment CEUS was associated with sufficient ablation (P=0.016). At the 12-month follow-up, significant decreases were observed in both the uterine and adenomyosis volumes (all P<0.001). Dysmenorrhea and menorrhagia were significantly alleviated at 12 months, and no major complications were encountered.
Conclusion
CEUS can be used to evaluate the ablation zone of focal adenomyosis that has been treated with MWA, similarly to DCE-MRI. The identification of non-enhancing areas on pretreatment CEUS indicates satisfactory treatment outcomes.


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