A colon-specific drug delivery system has great potential for the oral administration of colorectal cancer. However, the uncontrollable in vivo fate of liposomes makes their effectiveness for colonic location, and intratumoral accumulation remains unsatisfactory. Here, an oral colon-specific drug delivery system (CBS-CS@Lipo/Oxp/MTZ) was constructed by covalently conjugating Clostridium butyricum spores (CBS) with drugs loaded chitosan (CS)-coated liposomes, where the model chemotherapy drug oxaliplatin (Oxp) and anti-anaerobic bacteria agent metronidazole (MTZ) were loaded. Following oral administration, CBS germinated into Clostridium butyricum (CB) and colonized in the colon. Combined with colonic specifically β-glucosidase responsive degrading of CS, dual colon-specific release of liposomes was achieved. And the accumulation of liposomes at the CRC site furtherly increased by 2.68-fold. Simultaneously, the released liposomes penetrated deep tumor tissue via the permeation enhancement effect of CS to kill localized intratumoral bacteria. Collaborating with blocking the translocation of intestinal pathogenic bacteria from lumen to tumor with the gut microbiota modulation of CB, the intratumoral pathogenic bacteria were eliminated fundamentally, blocking their recruitment to immunosuppressive cells. Furtherly, synchronized with lipopolysaccharide (LPS) released from MTZ-induced dead Fusobacterium nucleatum and the tumor-associated antigens produced by Oxp-caused immunogenic dead cells, they jointly enhanced tumor infiltration of CD8⁺ T cells and reactivated robust antitumor immunity.

Objective:To explore the application effect of quantitative exercise nursing intervention based on WeChat platform in the recovery of patients with lower extremity arteriosclerosis obliterans.Methods:A total of 128 patients with lower extremity arteriosclerosis obliterans who were treated in Department of Vascular Surgery of the First Affiliated Hospital of Zhengzhou University were selected from June 2019 to February 2021. They were randomly divided into the control group and the observation group, with 64 cases in each group. The control group used routine nursing, while the observation group used the quantitative exercise nursing intervention based on the WeChat platform. Ankle-brachial index (ABI) and walking ability [Walking Impairment Questionnaire (WIQ) ] were compared between the two groups. The quality of life and nursing satisfaction of patients in two groups were investigated by World Health Organization Quality of Life Assessment Brief Scale (WHOQOL-BREF) and Newcastle Satisfaction with Nursing Scale (NSNS) .Results:After the intervention, scores of ABI, WIQ, WHOQOL-BREF and nursing satisfaction of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Quantitative exercise nursing intervention based on the WeChat platform can promote the functional rehabilitation of patients with lower extremity arteriosclerosis obliterans and improve quality of life and satisfaction of patients, which is worthy of clinical application.

OBJECTIVETo explore the application of immediate recurrent laryngeal nerve reconstruction in the treatment of thyroid cancer invading the recurrent laryngeal nerve.

METHODSTen patients with thyroid cancer invading unilateral recurrent laryngeal nerve underwent radical surgery and immediate recurrent laryngeal nerve reconstruction. The reconstructive surgical approach included recurrent laryngeal nerve decompression surgery, end-to-end anastomosis of the recurrent laryngeal nerve, anastomosis of ansa cervicalis nerve to the recurrent laryngeal nerve, and nerve-muscle pedicle (NMP) technique. Among the ten patients, one underwent nerve decompression, one underwent end-to-end anastomosis of the recurrent laryngeal nerve, seven had anastomosis of ansa cervicalis to recurrent laryngeal nerve, and one case had anastomosis of ansa cervicalis to recurrent laryngeal nerve combined with nerve-muscle pedicle (NMP) technique. The effect of surgery was evaluated by videolaryngoscopy, maximum phonation time (MPT), phonation efficiency index (PEI) and voice assessment. T-test was used in the statistical analysis.

RESULTSAll of the 10 patients had no complications including tumor recurrence and hypoparathyroidism after the surgery. Their hoarseness symptoms were improved, and the patients returned to normal or near-normal voice. Postoperative videolaryngoscopy showed that paralyzed vocal cord returned to normal muscle tone and volume, and the vocal cord vibration and mucosal wave were symmetric and the patients got good glottal closure. The pre- and post-operative maximum phone times of the patients were (4.52 ± 0.89) s and (11.91 ± 1.87) s, respectively (P < 0.01). The pre- and post-operative phonation efficiency indices were (1.37 ± 0.43) s/L and (4.02 ± 1.33) s/L, respectively (P < 0.05).

CONCLUSIONSIn patients with thyroid cancer invading unilateral recurrent laryngeal nerve, immediate recurrent laryngeal nerve reconstruction following radical surgery of thyroid cancer can effectively achieve recovery in phonation function and improve the quality of life of the patients.

Anastomosis, Surgical ; Humans ; Neoplasm Recurrence, Local ; surgery ; Neurosurgical Procedures ; Phonation ; Postoperative Complications ; Quality of Life ; Reconstructive Surgical Procedures ; Recurrent Laryngeal Nerve ; pathology ; surgery ; Thyroid Neoplasms ; surgery ; Vocal Cord Paralysis ; Vocal Cords

Objective To investigate the diagnostic value of the craniocerebral magnetic resonance angiography(MRA) in adult moyamoya disease.Methods 20 adult patients with Moyamoya disease were examined by DSA,MRI and MRA.Results DSA showed that the ending of internal carotid artery system were stenosis or occlution,and the fog-like blood vessel networks at base of skull were observed in the 20 patients.By MRI,the cerebral ischemical changes were found in 11 cases,intracerebral hamrrahge was found in 9 cases.MRA showed that cerebral artery were stenosis or obstruction in all of the 20 patients,16 cases(80%) with the fog-like blood vessel net in the thalamus-basal ganglia region.The detectable rate of abnormal cerebral basal vascular network was no statistical difference between DSA and MRA.Conclusions MRA can provide more information of cerebral artery straitness or obstruction and fog-like blood vessel net in the adult patients with Moyamoya disease,and without hammerless.MRA has a very importent value of diagnosis in the adult moyamoya disease.