Objective To study the medicine dynamics, distribution in tissue and abdominal cavity fluid concentration of 5-FU after giving intraperitoneal by using a gelatin carrier to be made 5-FU slowing-release microballoons. Methods 5-FU slowing-release microballoons medicine release speed, tissue distributing and the concentration in abdominal cavity fluid were measured by high performance liquid chromatography. Results 5-FU wrapped by gelatin were slowly released. The concentration in abdominal cavity fluid was obviously higher than that in tissue or in blood. Using established standard curve line, it was proved that in body area under curve (AUC) of 5-FU slowing-release microballoons group was obviously higher than that of simple 5-FU injection group, analyzed by 3p97 pharmacokinetic software management. Conclusion 5-FU enwrapped by gelatin can retain an effective anticancer activity concentration in abdominal cavity 7 days after giving intraperitoneal and it is distributed mostly in abdominal cavity.
Objective To investigate effectiveness of transconjunctival lower eyelid blepharoplasty with “super released” orbital fat in correction of lower eyelid pouch protrusion and tear trough and palpebromalar groove depression. Methods A clinical data of 82 patients (164 sides) with lower eyelid pouch protrusion and tear trough and palpebromalar groove depression, who met the selection criteria between September 2021 and May 2022, was retrospectively analyzed. Of the included patients, 3 were males and 79 were females, with an average age of 34.5 years (range, 22-46 years). All patients had varying degrees of eyelid pouch protrusion and tear trough and palpebromalar groove depression. The deformities were graded by the Barton grading system as gradeⅠ in 64 sides, grade Ⅱ in 72 sides, and grade Ⅲ in 28 sides. The orbital fat transpositions were performed through the lower eyelid conjunctival approach. The membrane surrounding the orbital fat was completely released, allowing the orbital fat to fully herniate until the herniated orbital fat did not retract significantly in a resting and relaxed state, which is regarded as the “super released” standard. The released fat strip was spread into the anterior zygomatic space and the anterior maxillary space, and percutaneous fixed to the middle face. The suture that penetrates the skin was externally fixed by adhesive tape pasting without knotted. Results There were 3 sides with chemosis after operation, 1 side with facial skin numbness, 1 side with mild lower eyelid retraction at the early stage after operation, and 5 sides with slight pouch residue. No hematoma, infection, or diplopia occurred. All patients were followed up 4-8 months, with an average of 6.2 months. The eyelid pouch protrusion, tear trough, and palpebromalar groove depression were significantly corrected. At last follow-up, the deformity was graded by Barton grading system as grade 0 in 158 sides and grade Ⅰ in 6 sides, with a significant difference compared to the preoperative score (P<0.001). Patient’s self-evaluation satisfaction reached very satisfied in 67 cases (81.7%), satisfied in 10 cases (12.2%), generally satisfied in 4 cases (4.8%), and dissatisfied in 1 case (1.2%). Conclusion The “super released” orbital fat can effectively prevent the retraction of orbital fat, reduce the probability of residual or recurrence of eyelid pouches, and improve the correction effect.
Objective To evaluate the effectiveness and safety of implanted sustained-release fluorouracil in gastric cancer surgery. Methods Literature search was conducted in the following databases: PubMed, EMbase, The Cochrane Library (Issue 6, 2012), CNKI, VIP and WanFang Data from inception to June, 2012. Randomized controlled trials (RCTs) or quasi-randomized controlled trials on implanted sustained-release fluorouracil for gastric cancer were included. Two reviewers independently identified the literature according to the inclusion and exclusion criteria, and then extracted the data and assessed the quality of the included studies. Then, meta-analysis was conducted using RevMan 5.1 software. Results A total of 7 studies involving 742 patients were included. The results of meta-analysis showed no significant difference in the rate of postoperative complications between the two groups (OR=0.93, 95%CI 0.54 to 1.59, P=0.79), while a significant reduction was found in the recurrence rate in the sustained-release fluorouracil group during 1 to 3 year follow-up (1 year after surgery: OR=0.32, 95%CI 0.22 to 0.46, P=0.02; 2 years after surgery: OR=0.19, 95%CI 0.08 to 0.42, Plt;0.001; 3 years after surgery: OR=0.40, 95%CI 0.24 to 0.67, P=0.004). As for the survival rate, no significant difference was found between the two groups 1 year after surgery (OR=1.98, 95%CI 0.92 to 4.25, P=0.08), while it was significantly higher in the sustained-release fluorouracil group than in the control group 2 to 3 years after surgery (2 years after surgery: OR=2.63, 95%CI 1.17 to 5.91, P=0.02; 3 years after surgery: OR=2.42, 95%CI 1.53 to 3.83, P=0.002). Adverse reaction rates in the sustained-release fluorouracil group were lower than those in the control group, but without significantly differences between the two groups (OR=1.22, 95%CI 0.49 to 3.07, P=0.67). Conclusion Compared with the control group, implanted sustained-release fluorouracil for gastric cancer can significantly reduce the recurrence rate 1 to 2 years after surgery and improve the overall survival rate 2 to 3 years after surgery without increasing the incidences of the postoperative complications and adverse reaction. However, due to the limitation of quantity and quality of the included studies, this conclusion should be further confirmed by more high quality, larger sample and multi-center RCTs.
Objective
To review the research progress of growth factor sustained-release microspheres in fat transplantation.
Methods
The recently published 1iterature at home and abroad related the growth factor sustained-release microspheres in fat transplantation was reviewed and analyzed.
Results
The sustained-release microsphere carrier materials include natural polymer materials and synthetic polymer materials.The sustained-release complexes of different microsphere materials with different growth factors can promote the vascularization of transplanted fat in a timely manner, improve the survival rate of grafts, and reduce the incidence of complications such as liquefaction, calcification, and necrosis.
Conclusion
The growth factor sustained-release microspheres have the characteristics of persistence and controllability, which is a research hotspot in the field of fat transplantation and has broad application prospects.
A multiple-stimuli-responsive drug-conjugated cross-linked micelles was prepared by radical copolymerization. The chemical structure, morphology, and size of the cross-linked micelles were characterized, and the drug loading of the micelle was calculated. The experimental results indicated that the hydrodynamic size of the drug-loaded micelles were about 100 nm, and the as prepared micelles could be degraded and swelled in presence of reducing glutathione (GSH). The low critical solution temperature (LCST) of the micelle was around 39.4℃. According to the experimental results, the micelles will shrink at temperature above the LCST. Subsequently, the accumulative drug release rate was up to 91.78% under acidic (pH 5.0), reductive (GSH 10 mmol/L) and high temperature (42.0℃) conditions mimicking the tumor microenvironment, while a relatively low release rate of 1.12% was observed without stimulation. The drug-conjugated cross-linked micelles showed a strong cell uptake behavior. In the cytotoxicity assay, the micelles exhibited effective anti-cancer activity and excellent biocompatibility. In brief, the experimental results show that the as-prepared drug-conjugated cross-linked micelle exhibits multiple stimuli-responsiveness, which holds great promise for anti-cancer drug delivery.
ObjectiveTo observe effect and safety of interstitial chemotherapy with 5-fluorouracil sustained release agent in radical operation of colorectal cancer.
MethodsOne hundred and sixty patients with colorectal cancer from October 2011 to December 2013 were randomly divided into observation group and control group according to an incomplete random method, 78 cases of them were in the observation group and 82 cases of them were in the control group. All the patients were performed radical resection of colorectal cancer. The abdominal cavity and pelvic cavity were washed after surgery. 5-fluorouracil sustained release agent was implanted in the observation group patients for interstitial chemotherapy, the implant site was at the tumor resection area and the mesenteric artery. Routine chemotherapy was performed in these two groups after operation. The postoperative complications were observed. The postoperative local recurrence rate, liver metastasis rate, and 24-month survival rate were recorded.
ResultsThe rates of abdominal complications and toxic effects had no significant differences between these two groups (P > 0.05). The rates of 12-month and 24-month local recurrence and the rate of liver metastasis in the observation group were significant lower than those in the control group[1.3% (1/78) versus 8.5% (7/82), x2=8.934, P=0.023; 5.2% (4/78) versus 23.2% (19/82), x2=14.834, P=0.004; 10.3% (8/78) versus 18.3% (15/82), x2=12.034, P=0.016]. The rate of 24-month survival in the observation group was significant higher than that in the control group[94.9% (74/78) versus 84.1% (69/82), x2=11.465, P=0.010].
ConclusionThe good safety of interstitial chemotherapy with 5-fluorouracil sustained release agent could effectively decrease local recurrence rate and liver metastasis rate of colorectal cancer after radical operation and improve survival time of patients.
ObjectiveTo explore the safety and preliminary effectiveness of transintervertebral release, bone impaction grafting, and posterior column compressed-closing in the treatment of osteoporotic vertebral fracture combined with moderate to severe spinal kyphosis.MethodsThe clinical data of 21 elderly patients with osteoporotic vertebral fracture combined with moderate to severe spinal kyphosis were retrospectively analyzed between March 2016 and November 2017. There were 1 male and 20 females, aged 55-75 years, with an average of 64.8 years. The disease duration was 8-24 months, with an average of 13.1 months. The bone density T value ranged from ?3.4 to ?2.1, with an average of ?2.3. Lesion segments: T11 in 2 cases, T12 in 6 cases, L1 in 8 cases, L2 in 1 case, T11, 12 in 1 case, T12, L1 in 2 cases, and T12, L2 in 1 case. Preoperative neurological function was classified according to the American Spinal Injury Association (ASIA): 5 cases of grade D and 16 cases of grade E. All patients underwent transintervertebral release, bone impaction grafting, and posterior column compressed-closing. The effectiveness was evaluated by visual analogue scale (VAS) score and Oswestry dysfunction index (ODI) score before operation, at 3 months after operation, and at last follow-up. The neurological function was assessed by ASIA at last follow-up. Local kyphosis Cobb angle (LKCA), thoracic kyphosis (TK), lumbar lordosis (LL), and sagittal vertebral axis (SVA) were measured on the X-ray films of the full-length lateral spine of the patient before operation, at 1 week after operation, and at last follow-up.ResultsNo complication such as fracture of internal fixator or nerve injury occurred. LKCA, TK, and SVA were significantly improved at 1 week after operation and at last follow-up (P<0.05). There was no significant difference between at 1 week after operation and at last follow-up (P>0.05). There was no significant difference in LL before and after operation (F=3.013, P=0.057). The VAS and ODI scores were significantly improved at 3 months after operation and at last follow-up, and further improved at last follow-up when compared with the scores at 3 months after operation, showing significant differences between time points (P<0.05). Five patients with ASIA grade D neurological function recovered to grade E at 6 months after operation.ConclusionTransintervertebral release, bone impaction grafting, and posterior column compressed-closing for treating osteoporotic vertebral fracture combined with moderate to severe spinal kyphosis has definite effectiveness, strong orthopaedic ability, and minimal trauma, which can effectively restore the sagittal balance of the spine, alleviate pain, and improve the patients’ quality of life.
ObjectiveTo explore the effect of spinal dural release on the effectiveness of expansive cervical laminoplasty for treating multi-segmental cervical myelopathy with ossification of posterior longitudinal ligament.
MethodsA retrospective analysis was made on the clinical data of 32 patients with multi-segmental cervical myelopathy with cervical ossification of posterior longitudinal ligament who underwent expansive cervical laminoplasty and spinal dural release between February 2011 and October 2013 (group A); and 36 patients undergoing simple expansive cervical laminoplasty between January 2010 and January 2011 served as controls (group B). There was no significant difference in gender, age, disease duration, affected segments, combined internal disease, preoperative cervical curvature, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS) score between 2 groups (P>0.05). Postoperative JOA score and improvement rate, VAS score, posterior displacement of the spinal cord, and the change of cervical curvature were compared between 2 groups.
ResultsSpinal dural tear occurred in 3 cases (2 cases in group A and 1 case in group B) during operation. Cerebrospinal fluid leakage occurred in 3 cases (2 cases in group A and 1 case in group B) after operation. The patients were followed up 12-46 months (mean, 18.7 months). At last follow-up, the JOA score and VAS score were significantly improved in 2 groups when compared with preoperative scores (P<0.05). JOA score and improvement rate of group A were significantly higher than those of group B (P<0.05), but VAS score of group A was significantly lower than that of group B (P<0.05). At last follow-up, no significant difference in cervical curvature was found between 2 groups (P>0.05); posterior displacement of the spinal cord of group A was significantly larger than that of group B (P<0.05). No reclosed open-door was observed during follow-up.
ConclusionFor patients with multi-segmental cervical myelopathy with ossification of posterior longitudinal ligament, full spinal dural release during expansive cervical laminoplasty can increase the posterior displacement of spinal cord, and significantly improve the effectiveness.
ObjectiveTo improve clinicians' understanding of severe cytokine release syndrome (CRS) through reporting the clinical manifestation, diagnosis, treatment, and prognosis of CRS after chimeric antigen receptor T (CAR-T) cell therapy in a patient with solid tumor. Methods A patient with ovarian cancer who suffered severe CRS after CAR-T cell therapy in the Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University was reviewed. Relevant studies were searched for literature review. Results The patient, a 55-year-old woman, was diagnosed with ovarian cancer in early 2016 and continued to progress despite multiple lines of treatment, so she received CAR-T cell therapy on September 16, 2022. The patient developed a fever 2 days after infusion, and developed dyspnea and shortness of breath with oxygen desaturation 2 days later. Her condition kept deteriorating with respiratory distress and severe hypoxia 6 days after infusion, and the level of interleukin-6 and interferon-gamma continued to be elevated. Chest CT showed pleural effusion and massive exudation of both lungs. Considered to have acute respiratory distress syndrome (ARDS) due to severe CRS, she was transferred to the intensive care unit (ICU). The patient was treated with tocilizumab, high-dose intravenous glucocorticoid pulses, mechanical ventilation, and sivelestat sodium for ARDS. Her symptoms were gradually relieved, and the results of laboratory tests were gradually stabilized. The patient was extubated 6 days after ICU admission and discharged from ICU a week later. Six patients were screened out with ARDS or acute respiratory failure caused by CRS after CAR-T cell therapy, whose treatments were mainly anticytokine agents combined with high-flow oxygen therapy or invasive mechanical ventilation. One of them died. ConclusionsClinicians should be alert to severe CRS during the administration of CAR-T cell. Rapid interruption of the inflammation development is the key to all treatments. If respiratory and/or circulatory dysfunction occurs, patients should be transferred to ICU in time for organ support therapy.
This research aims to investigate the encapsulation and controlled release effect of the newly developed self-assembling peptide R-LIFE-1 on exosomes. The gelling ability and morphological structure of the chiral self-assembling peptide (CSAP) hydrogel were examined using advanced imaging techniques, including atomic force microscopy, transmission electron microscopy, and cryo-scanning electron microscopy. The biocompatibility of the CSAP hydrogel was assessed through optical microscopy and fluorescent staining. Exosomes were isolated via ultrafiltration, and their quality was evaluated using Western blot analysis, nanoparticle tracking analysis, and transmission electron microscopy. The controlled release effect of the CSAP hydrogel on exosomes was quantitatively analyzed using laser confocal microscopy and a BCA assay kit. The results revealed that the self-assembling peptide R-LIFE-1 exhibited spontaneous assembly in the presence of various ions, leading to the formation of nanofibers. These nanofibers were cross-linked, giving rise to a robust nanofiber network structure, which further underwent cross-linking to generate a laminated membrane structure. The nanofibers possessed a large surface area, allowing them to encapsulate a substantial number of water molecules, thereby forming a hydrogel material with high water content. This hydrogel served as a stable spatial scaffold and loading matrix for the three-dimensional culture of cells, as well as the encapsulation and controlled release of exosomes. Importantly, R-LIFE-1 demonstrated excellent biocompatibility, preserving the growth of cells and the biological activity of exosomes. It rapidly formed a three-dimensional network scaffold, enabling the stable loading of cells and exosomes, while exhibiting favorable biocompatibility and reduced cytotoxicity. In conclusion, the findings of this study support the notion that R-LIFE-1 holds significant promise as an ideal tissue engineering material for tissue repair applications.
