Abstract: Objective To summarize the method and effective result of thoracoscopic intrapleural perfusion hyperthermochemotherapy(TIPHC) for treating malignant pleural effusion caused by lung cancer. Methods Fiftyeight patients with malignant pleural effusion caused by lung cancer were randomly divided into therapeutic group(30 cases) and control group(28 cases) between February 1999 and March 2005. Pleural biopsy and TIPHC under general ansthesia with unilateral ventilation were performed in the therapeutic group, and intrapleural injection of cisplatin was administered in control group after drainage of pleural effusion. The effect on malignant pleural effusion， the change for the concentration of carcinoembryonic antigen(CEA)， cytokeratin-19 fragments (CYFRA21-1)， neuronspecific enolase (NSE) and the side effect were compared before and after the treatment. Results The therapeutic group achieved total response rate of 100.0%, but only 53.6% in control group, with significant difference(χ 2=3.863, Plt;0.05). Furthermore, the concentration of CEA， CYFRA21-1， NSE in therapeutic group dramatically descended than control group(t=2.562,Plt;0.05). But there was no significant difference in side effect (Pgt;0.05). The pathological diagnosis of all the patients were determined in the therapeutic group. Conclusion TIPHC has the advantage of both diagnosis and treatment of malignant pleural effusions. It is safe and effective, and also able to determine the diagnosis. Furthermore, it offers the superiority of small wound， best visualization and convenient pleural biopsy.
Objective To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of central exudative chorioretinopathy. Methods Tweenty-nine eyes with central exudative chorioretinopathy were treated with Iris 810 nm diode laser TTT. The laser beam size was 1.0, 2.0 or 3.0 mm with power settings between 80-300 mW and treatment time 60 sec. The follow up periods were wihzin 4-40 weeks. The therapeutic effect was accessed by visual acuity examination,dinect ophthalmoscopy and fluorescein or indocyanine green angiography. Results The visual acuity improved in 8 eyes (28%), remained no change in 19 eyes (65%) and decreased in 2 eyes (7%). Choroidal neovascularization were closed in 12 eyes in fundus angiography. The symptoms alleviated in 10 patients. Conclusion Transpupillary thermotherapy is a potential treatment for the central exudative chorioretinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 184-186)
Objective To compare the clinical results of photodynamic therapy(PDT) and transpupillary thermotherapy (TTT) for patients with choroidal neovascu larization caused by exudative age-related macular degeneration. Methods Seventy cases (82 eyes) with exudative AMD were divided into PDT and TTT groups. Thirty-five cases (42 eyes) were treated with PDT. Nineteen eyes had occult or predominantly occult CNV. Twenty-three eyes had classic or predominantly classic CNV. Thirty-five cases (40 eyes) were treated with TTT. Twenty-five eyes had occult or predominantly occult CNV. Fifteen eyes had classic or predominantly classic CNV . Visual acuity, FFA, ICGA and OCT were evaluated before and after treatment. All cases were subfoveal or juxtafoveal CNV. The follow-up was 3-6 months. Results Visual acuity in 3 eyes (15.8％) of PDT group and 1 eye (4.0％) in TTT group increased at least 2 lines. The difference was no significant(P=0.1778), FFA showed cessation or reduction of fluorescein leakage from CNV in 15 eyes(78.9％) in PDT group and 13 eyes(52.0％) in TTT group. The difference was not significant (P=0 .0657). Three months after treatment, The visual acuity of 2 eyes(10.5％) in PDT group and 2 eyes (8.0％) in TTT group increased at least 2 lines. The difference was not significant (P=0.7728). FFA showed cessation or reduction of fluorescein leakage from CNV in 8 eyes(42.1％) in PDT group and 21 eyes(84.0％) in TTT group. The difference was significant (P=0.0037). Conclusion For classic CNV, the short-term effect of PDT is better than TTT concerning visual acuity. The effect of PDT is apparently better than TTT in cessation or reduction of fluorescein leakage one month after treatment. But there was no significant difference between PDT and TTT in cessation or reduction of fluorescein leakage three month after treatment. For occult CNV, there is no significant short-term difference between PDT and TTT concerning visual acuity. There was no significant difference between PDT and TTT in cessatin or reduction of fluorescein leakage one month after treatment. But three month after treatment TTT is apparently better than PDT in cessation or reduction of fluorescein leakage. We need more cases and longer follow-up to evaluate these two kinds of treatments in treating exudative age-related macular degeneration.(Chin J Ocul Fundus Dis，2004，20：285-288)
Objective lt;brgt;To evaluate the clinical effect of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangioma (CCH). Methods lt;brgt;The clinical data of 12 eyes of 12 patients with CCH treated with TTT were retrospectively analysed. Infrared diode laser Iridex, oculight SLX was used in TTT at 810 nm and power between 220 and 1000 mW with a beam diameter of 1.2 or 2.0 or 3.0 mm, with 1 to 2 minutes of exposure time. The visual acuity, subretinal fluid, complication ,thickness and hyperfluorescence of CCH were observed pre- and postoperatively in the treated eyes. The average period of follow-up was 10 months (6-16 months). lt;brgt; lt;brgt;Results lt;brgt;Among the 8 eyes with peripheral retinal detachment in 12 cases of CCH the peripheral subretinal fluid was completely absorbed in 6 eyes, and partially absorbed in 2 eyes after TTT treatment. In 8 patients undergone ultrasonography, the mean value of tumor thickness went down by 21.75 % in 7 eyes. The resultant visual acuity after treatment was improved in 3 eyes, maintained no change in 7 eyes and reduced in 2 eye. The fundus fluorescein angiography in 10 eyes revealed a significant decrease of the leakage in tumor. Postoperative complication of TTT in the 12 eyes included retinal hemorrhage (5 eyes) and retinal fold (1 eye). Conclusion lt;brgt;TTT is an effective treatment for CCH. lt;brgt; lt;brgt;(Chin J Ocul Fundus Dis, 2002, 18: 190-092)
ObjectiveTo quantify the global burden of chronic obstructive pulmonary disease (COPD) attributable to high temperature, low temperature, and non-optimal temperatures from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data. MethodsWe analyzed global, regional, and national COPD mortality and disability-adjusted life years (DALYs) attributable to high, low, and non-optimal temperatures. Joinpoint regression, age-period-cohort modeling, and Bayesian prediction models were employed. ResultsGlobally, age-standardized mortality rates (ASMRs) and DALY rates for COPD attributable to low temperature and non-optimal temperatures declined. However, the burden from high temperature increased. Low temperature consistently exerted a greater burden than high temperature across all metrics. Significant geographical disparities emerged: high-temperature mortality was highest in South Asia; low-temperature burden was most severe in East Asia; and high-income North America exhibited accelerated high-temperature mortality growth. The highest low-temperature burden occurred in middle-SDI regions, while high-temperature impacts predominated in low-middle-SDI regions. Age patterns showed rising high-temperature burden in the 15-39 age group and increasing low-temperature burden among adults aged ≥80 years. Bayesian projections revealed divergent gender trajectories: a continuing decline in low-temperature burden for males versus a decelerated decline for females (2020-2030). ConclusionLow temperature exposure remains the primary risk factor for COPD within non-optimal temperatures globally, although high-temperature impacts are increasing. Significant regional variations necessitate targeted interventions for three key populations: older adults vulnerable to cold, working-age adults with occupational heat exposure, and older women requiring rehabilitative support.
Objective To observe the therapeutic efficacy and complications of plaque radiotherapy (PRT) combined with transpupillary thermotherapy (TTT) on choroidal melanoma (CM). Methods Thirty unilateral CM patients (30 eyes, including 15 males and 15 females) were treated by PRT and TTT. The visual acuity ranged from 0.1 to 0.8 with an average of 0.3plusmn;0.2. The largest base diameter of tumor ranged from 6.8 mm to 17.9 mm with an average of (11.3plusmn;2.8) mm；The tumor height ranged from 3.9 mm to 10.6 mm with an average of (7.2plusmn;2.4) mm. The criteria of controlled local tumor: based on B-scan ultrasound measurement, the tumor was considered as ldquo;growingrdquo; if tumor height increased 2 mm or tumor largest base diameter increased 250 mu;m, otherwise the tumor was considered ldquo;controlledrdquo;. The followup ranged from 15 to 57 months with an average (33.01plusmn;9.81) months. The local tumor control rate, enucleation rate and visual acuity, complications after treatment were observed.Results The tumor largest base diameter after treatment ranged from 4.6 mm to 17.0 mm with an average (9.79plusmn;3.35) mm, which had statistically significant difference（t=2.195，F=0.49；P=0.032) with that before treatment. The tumor height after treatment ranged from 2.7 mm to 11.9 mm with an average (5.19plusmn;2.57) mm, which had statistically significant difference（t=2.069，F=0.018；P=0.0435) with that before treatment. At the end of follow up, the tumor largest diameter and height increased in two eyes respectively compared with those before treatment. Local tumor control rate was 86.7%. Three eyeballs were enucleated after treatment，the enucleation rate was 10.0%. The visual acuity remained unchanged in 12 eyes，improved in one eye and decreased in 17 eyes. Treatment complications included radiation retinopathy in 12 eyes (40.0%), secondary retinal detachment in three eyes (10.0%), secondary glaucoma in one eye (3.3%), cataract in four eyes (13.3%) and dry eye syndrome in five eyes (16.7%). Conclusion PRT combined with TTT is an effective therapy for choroidal melanoma with less complications.
The Influence of microwave and hot water immersion hyperthermia on the lymphedematous skin of lower extremity on 12 patients was studied by using immunohistochemical and lymphoscintigraphic methods. We assumed that the subsidence of inflammatory changes in the lymphedematous limb and/or local absorption of tissue fluid protein following local microwave heating, but not the augmented lymph How seemed to be responsible for the reduction of edema.
Objective To observe the vascular endthelial cellular apoptosis induced by transpupillary thermotherapy (TTT). Methods Vascular endothelial cells (VEC) cultured in vitro were treated with TTT, hyperthermia and TTT combined with indocyanine green (ICG) pretreatment. The cellular apoptosis was detected by doublelabelled flow cytometer (annexin Vfluroescein isothiocyanate and propidium iodide) analysis, fluorescent microscopy, nucleolus stainned with DNA dye hoechst 33258, DNA ladder detection and electron microscopy. Results Without significant rising of the temperature, TTT couldnprime;t increase the apoptosis of VEC. Pure hyperthermia and TTT combined with ICG pretreatment could increase apoptosis of VEC significantly, and the effect of the latter method was more obvious. The higher power of TTT was used and the longer duration the cells were cultured, the higher apoptosis rate of VEC was. Conclusion The induction of apoptosis of VEC might play an important role in the mechanism of the occlusion of CNV by TTT, and combining with ICG may obviously enhance the apoptosis rate at the same temperature, which may supply a theoretical basis for promoting the clinical effect of TTT.