Polyethylene glycol (PEG) is extensively used to increasing the in vivo and in vitro stability of liposomes. However, PEGylated liposomes also produce some negative effects with further research, such as low cellular uptake, poor "endosomal escape" of pH sensitive liposome (PSL) and accelerated blood clearance (ABC) phenomenon, and this situation is referred as the "PEG dilemma". "PEG dilemma" posed severe challenges for the targeted delivery of PEGylated liposomes-loaded anticancer drugs, effective intracellular release of PEGylated PSL-encapsulated gene and protein drugs, and repeated administration of PEGylated liposomes. Therefore, it is urgent to solve the "PEG dilemma". This review focused on the definition, classification of "PEG dilemma", and discussed several possible approaches to overcome "PEG dilemma".
Antineoplastic Agents ; chemistry ; Drug Carriers ; chemistry ; Liposomes ; chemistry ; Polyethylene Glycols ; chemistry

Bacteremia ; etiology ; Catheterization ; adverse effects ; Child ; Coagulase ; metabolism ; Cross Infection ; etiology ; Drug Resistance, Bacterial ; drug effects ; Endocarditis, Bacterial ; etiology ; Humans ; Methicillin ; pharmacology ; Quinolones ; pharmacology ; Staphylococcal Infections ; complications ; drug therapy ; microbiology ; Staphylococcus ; classification ; drug effects ; pathogenicity ; Urinary Tract Infections ; etiology ; Vancomycin ; pharmacology

Child, Preschool ; Humans ; Male ; Nevus, Blue ; pathology ; Skin Neoplasms ; pathology

Objective To explore the association between clinical pathological characteristics and the expressions of epidermal growth factor receptor (EGFR) and protein kinase B (AKT) in gastric carcinomas.Methods The expressions of EGFR and AKT were measured with immunohistochemical method in the cancer tissues and cancer-adjacent normal tissues from 153 cases of patients with gastric cancer.The association between clinical pathological characteristics and their expressions were analyzed.Results The expressions of AKT and EGFR in gastric cancer tissues had no relationship with gender,age,pathological type,and the degree of differentiation (P ＞ 0.05).A positive correlation was existed between the EGFR and TNM stages (x2 =5.43,P ＜0.05).The AKT was positively related to the size,T stage,and TNM stage of the tumor,respectively (x2 =4.73,4.95,5.32,P ＜0.05 orP ＜0.01).The levels of AKT (x2=4.83,4.75,P ＜0.05) and EGFR(x2 =4.67,4.58,P ＜0.05) in the gastric cancer tissues with lymph node and/or distant metastasis were significantly higher than the gastric cancer tissues without metastasis,respectively.Conclusions The over-expressions of AKT and EGFR would benefit the diagnosis and stages of a gastric cancer and the determination of its metastasis.

Objective To investigate the effects of methylprednisolone on lung function and inflammation during one-lung ventilation in patients undergoing pulmonary lobectomy.Methods Sixty patients (46 males, 10 females, aged 18-60 years, ASA grade Ⅰ or Ⅱ) scheduled for pulmonary lobectomy were randomly divided into two groups (n=30 each) using a random number table: the control group (group C) and the methylprednisolone group (group M).Patients in group M were treated with methylprednisolone before induction of anesthesia within 30 min, whereas patients in group G received equal volume of normal saline at the same time.The heart rate (HR), mean arterial pressure (MAP), peak airway pressure (Ppeak), plateau airway pressure (Pplat), and dynamic lung compliance (Cdyn) were recorded at the momment before OLV (T1), 30 min after OLV (T2), 1 h after OLV (T3), 10 min after resuming two-lung ventilation (T4) and the end of the surgery (T5).The arterial blood gas analysis were performed at the above time points in order to determined the oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2), then the oxygenation index (OI), alveolar to arterial difference of oxygen tension (A-aDO2) and respiratory index (RI) of each patient was evaluated.The concentration of serum TNF-α, IL-6 and IL-10 were determined by ELISA at T0, T4, 6 h (T5) and 24 h (T6) after surgery using venous blood samples.The incidence of pulmonary complications at 72 h after operation were also recorded.Results Compared with T0, the MAP and Cdyn was decreased, whereas the Ppeak and Pplat was increased significantly in both group at T1, T2 (P＜0.05), the OI was decreased and the A-aDO2, RI was increased significantly at T1-T4 (P＜0.05), and the concentration of serum TNF-α, IL-6 and IL-10 at T4-T6 was increased significantly in both group (P＜0.05).Compared with group C, the Cdyn was increased, the Ppeak and Pplat were decreased significantly in group G at T1, T2 (P＜0.05), the concentration of serum TNF-α and IL-6 were decreased, and IL-10 was increased significantly in group G at T4-T6 (P＜0.05).The incidence of postoperative pulmonary complications had no statistically signifcant differences between the two groups.Conclusion Methylprednisolone can significantly improve the pneumodynamics and lung compliance, alleviates the inflammatory responses, but have no significant effect on intrapulmonary oxygenation and gas exchange during one-lung ventilationin patients undergoing pulmonary lobectomy.

Objective To investigate the protective effects of creatine phosphate pretreatment on circulato ry function in prone position in elder patients with general anesthesia.Methods Forty patients in ASA physical status Ⅰ or Ⅱ of male and female,aged 60 to 75 years undergoing percutaneous nephrolithotripsy in prone position,were randomly divided into two groups (n =20 each):the control group (gToup N) and the creatine phosphate group (group P).In the group P,creatine phosphate sodium (30 mg·kg-1 in 50 mL normal saline) was continuous infused at a speed of 100 mL· h-1,while only normal saline 50 mL in the group N at the same time.HR,MAP,CO,SV,CVP,Pulse Pressure Variation (PVV) and Systemic Circulation Resistance (SVR) were monitored and recorded at 1 min before prone position (T0) and 1 min (T1),3 min (T2),5 min (T3),10 min (T4) after prone position.The requirement for vasoactive agents were also recorded.Results Compared with T0,HR began to increase significantly at T1 in the group N(P ＜ 0.05),while MAP,CO and SV began to decrease at T1 to T3,and CVP,PVV and SVR began to increase significantly at the same time in the group N (P ＜ 0.05).Compared with the group N,MAP,CO and SV were decreased,PPV,CVP and SVR were increased significantly at T1 to T2 in the group P (P ＜ 0.05).The requirement for vasoactive agents in the group P was obviously lower than that in the group N (P ＜ 0.05).Conclusion Creatine phosphate pretreatment can stabilize the hemodynamic change effectively,and prevent the adverse cardiovascular events caused by prone position in elder patients with general anesthesia.

Objective To investigate the characteristics of children′s recurrent abdominal pain(RAP) with gastroscopy and analyze the etiology.Methods Three hundred and thirteen children were investigated with gastroscopy.Gastric antrum mucosa was taken for histo-pathology and the determination of helicobacter pylori(Hp) antibody.Results Ninty-nine point six eight percent of the cases had lesions under the gastroscope.The former 4 cases had chronic superficial gastritis(CSG),CGS and bile reflux,CGS and duodenitis,CGS and bulb ulcer,and Hp infection rate was 31.36%,25%,38.64%,60.61%.Hp infection rates of active gastritis and inactive gastritis were 92% and 23.19%,which showed significant differences in 2 groups(P

Objective To explore the blood drug concentration monitoring of sustained-release valproate(DK)in children with epilepsy,focusing on the selection of sampling time and evaluation of the results.Methods Two hundred and seventy-one children taking DK and 155 children taking sodium valproate syrup(VPA Syr)were involved and their serum were taken when achieved steady state to determine the valproic acid level using fluorescence polarization immunoassay.They were divided into 4 groups,which were DK taken once daily group(DK qd group,126 children),DK taken once daily at night and sampled on morning group(DK qn group,26 children),DK taken every 12 h group(DK q12 h group,119 children),VPA Syr q12 h group(155 children).Determine the proportion of the blood drug concentration of each group below,ithin and above the therapeutic range for valproate(50-100 mg/L)were determined.The data were analyzed by t test.Results The Cmin of DK qd group were(73.09?19.91)mg/L,significantly lower from the serum concentration of DK qn and sampled on morning group [(94.94?25.44)mg/L](P0.05).Conclusions DK qn should sampled at night before the night dose.The Cmin of DK q12 h was higher according to the therapeutic range,it's favorable range still needs clinical practice.

Objective To investigate the association of human leukocytes antigen(HLA)-DR/DQ with oral lichen planus(OLP) in the area of Yangtze River Delta. Methods HLA-DRB1 and DQB1 genotyping of 44 unrelated OLP patients and 150 normal controls were performed by polymerase chain reaction-sequence specific primers(PCR-SSP) method.The data were compared between the OLP group and normal controls,and between different types of OLP patients. Results The frequency of HLA-DRB1*09 and HLA-DRB1*07 alleles were significantly higher in OLP group than those in normal controls(56.8% vs 31.3% and 27.3% vs 13.3%,P

Objective To assess the clinical value of dual-energy CT (DECT) Volume software in quantitative analysis of urate crystals.Methods The DECT data of 60 gout patients based on the American College of Rheumatology diagnostic criteria were analyzed retrospectively.The volumes of urate crystals were quantitatively analyzed by using Volume software with two senior radiologists.The results were statistically analyzed.Results Seventy-two joints of 60 gout patients were scanned by DECT.40 of 43 joints had urate crystals in foot and ankle with the average volume of (0.621±0.742) cm3;18 of 19 joints had urate crystals in knee with the average volume of (0.842±1.086) cm3;10 of 10 joints had urate crystals in hand and wrist with the average volume of (0.796±0.583) cm3.There was no statistical difference for volume measurement between two doctors (P>0.05).The volumes of urate crystals in 4 patients with regular medication were reduced.Conclusion Volume software of DECT can quantitatively analyze urate crystals with a good repeatability, which has high application value in clinical diagnosis and treatment monitoring of gout.