Objective To develop a novel targeted delivery system for the treatment of brain metastases from breast cancer.Methods Micelles were prepared by membrane hydration method,and the micelles were connected to Angiopep-2.Results The micelles were confirmed to be well targeted in vitro.Conclusion Nano-particles with the targeting molecule Angiopep-2 has good brain-targeting function.

Objective To investigate the clinical efficacy and safety of phakic posterior chamber intraocular lens (ICL) implantation for high myopia. Methods Twenty-four eyes of 12 patients with high myopia were treated with ICL implantation. The best corrected visual acuity, intraocular pressure and lens changes shape between post-operative and pre-operative were compared. Results Successful implantations were done in all patients. All eyes had a significant increase in uncorrected visual acuity. Exactly improved visual function in patients with high myopia status. The intraocular pressure was ( 14.26 ± 2.13) mm Hg(1 mm Hg = 0.133 kPa) of pre-operative , and was ( 14.79 ± 2.77) mm Hg at 1 year after post-operative, the intraocular pressure was stability after the operation. UBM showed that there was a certain gap between ICL and the lens. During the follow-up period,no complications such as cataract,chronic uveal infusion were found. Conclusion Phakic posterior chamber ICL implantation is effective,safe and reliable method for the correction of high myopia.

Objective To systematically assess the efficacy of the low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right frontal cortex for depression. Methods Clinical randomized controlled trials (RCT) studies about low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) for depression were collected from database such as PubMed, SCI, CBM, CNKI, and VIP. The meta-analysis using the software of RevMan 5.2 was conducted to com?pare the response rate of low-frequency rTMS to the right DLPFC with sham stimulation and high-frequency rTMS to the left DLPFC, respectively. Results Nine RCT studies with 156 patients in low-frequency rTMS group and 162 patients in sham stimulation group were included. Meta-analysis showed that low-frequency rTMS to the right DLPFC significantly improved response rate compared with sham stimulation(RR=2.15,95%CI:1.57~2.95,P<0.01). Eleven RCT studies with 178 patients in low-frequency rTMS group and 200 patients in high-frequency group were included. There was no significant difference in response rate between the two groups(RR=0.80,95%CI:0.63~1.02,P=0.07). Conclusion The efficacy of low-frequency rTMS to the right frontal cortex for depression is significant but the efficacy is not superior in comparison with the high-frequency rTMS to left DLPFC.

Objective To evaluate the long-term therapeutic results of intersphincteric resection (ISR) in the treatment of ultra-low rectal cancer.Methods Sixty cases of ultra-low rectal cancer with the inferior border of the tumor within 5 cm to the edge of anus underwent intersphincteric resection (ISR),and the clinical data were analyzed retrospectively.There were 39 males,21 females and their average age was 55 years old (range from 30 to 77 years old).The inferior border of the tumor were from 28 to 50 mm to the edge of anus,averaging 42 mm.Results Sixty patients underwent intersphincteric resection successfully with 3 cases developing anastomotic leakage and 2 cases anastomotic stenosis postoperatively.After a median follow-up period of 49 months (range from 18 to 90 months),local and distant recurrence were observed in 6 and 4 patients respectively.Five-year overall survival rate and disease-free survival rate were 88.3％ and 83.3％ respectively.The mean stool frequency were (3.8 ± 1.3) times in each day based on data from 53 patients,and the stool control function of 73.6％ of all patients was preserved satisfactorily according to Kirwan classification.Conclusions This study indicated that intersphincteric resection might be a candidate technique in the treatment of early stage ultra-low rectal cancer restricted within rectal wall and could achieve satisfactory long-term results in both oncologic and functional respects.

Objective To compare the application,safety and theraputic effect of local resection of early rectal tumours by transanal endoscopic microsurgery(TEM) and the conventional transanal excision(TAE).Methods The data of seventy-six patients who were treated by conventional transanal excision from January 2003 to July 2006 and fifty-three patients who were treated by transanal endoscopic microsurgery from September 2006 to February 2010 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were reviewed.Results Age,sex,tumour size,blood loss,postoperative hospital stay were similar in the two groups(P＞0.05).The median distance from the anal verge was significantly higher in the TEM group ( TEM/TAE =7.0/5.0 cm,P ＜ 0.01 ).The operation time was significantly longer in the TEM group (TEM/TAE =70.00/30.00 min,P ＜ 0.01 ).There was no operation-related mortality in both groups (P ＞ 0.05 ).Two patients in the TEM group developed postoperative haemorrhage,and one patient developed pulmonary infection and retention of urine respectively.There were two secondary haemorrhage cases in the TAE group.On median follow-up of 30 months,there was 7.8％ recurrence rate in the TEM group,compared with 23.2％ the in TAE group.Conclusions Transanal endoscopic microsurgery is a safe and effective mininally invasive surgical technique for the treatment of early rectal neoplasm.It has broader indication,and better theraputic effect than the conventional transanal excision.

Objective To analyse the effect of dual-antiplatelet drugs on S100β,IL-1β, adiponectin(ADPN)and NIHSS score in patients with acute cerebral infarction.Methods 58 patients diagnosed with acute cerebral infarction in first hospital of Qinhuangdao.All patients were collected and randomly divided into experimental group and control group according to random number table , 29 cases in each group.Both group were given the treatrnent of improvng the cerebral vascular circulation, protect brain cells, control blood pressure, blood glucose, oxygen when necessary.On the basis of conventional treatment, control group was treated with aspirin 200 mg, one time per day,orally.And experimental group was treated with clopidogrel 75 mg/d on the basis of control group,one time per day,orally.After treatment, the serum levels of S100β, IL-1β, ADPN and NIHSS score were detected in all patients.ResuIts After treatment, compared with control group,the serum S100βprotein level was significantly lower in the experimental group (P<0.05); the serum IL-1βlevel in experimental group was significantly lower (P<0.05);ADPN level in experimental group was significantly higher (P<0.05); NIHSS score of patients in experimental group was significantly lower (P<0.05).ConcIusions Dual antiplatelet drugs can reduce serum S100βprotein,IL-1βin serum of patients with acute cerebral infarction, increase the level of serum adiponectin, decrease NIHSS score, can effectively improre neurological function in patients with acute cerebral infarction.

Objective: To perfect the theory system of minimally invasive treatment for osteonecrosis of the femoral head (ONFH) with β tricalcium phosphate (β-TCP) bioceramic system and evaluate the effectiveness. Methods: Eighteen New Zealand white rabbits aged 7-8 months were used to establish an animal model to verify the vascularization of porous β-TCP bioceramic rods. Micro-CT based three-dimensional reconstruction and fluorescence imaging were used to display the new blood vessels at 4, 8, and 12 weeks after operation. The inserting depth, number and diameter of vessels in the encapsulated area were analyzed. Nine pig femoral specimens were randomly divided into 3 groups ( n=3): group A was normal femur; group B had cavity (core decompression channel+spherical bone defect in femoral head); in group C, mixed bioceramic granules were implanted to fill the defect in femoral head, and porous β-TCP bioceramic rod was implanted into decompression channel. The stiffness and yield load of specimens were analyzed by biomechanical test. A multicenter retrospective study was conducted to analyze 200 patients (232 hips) with femoral head necrosis treated with bioceramic system in 7 hospitals in China between January 2012 and July 2018. There were 145 males and 55 females, with an average age of 42 years (range, 17-76 years). According to the Association Research Circulation Osseous (ARCO) stage, 150 hips were in stage Ⅱ and 82 hips in stage Ⅲ. Postoperative imaging assessment was carried out regularly, and hip function was evaluated by Harris score. The effectiveness of ARCO stage Ⅱ and Ⅲ was also compared. Results: Animal experiments showed that blood vessels could grow into the encapsulated area and penetrate it at 12 weeks. The inserting depth, number and diameter of blood vessels in the encapsulated area gradually increased, and there was significant difference between different time points ( P<0.05). Biomechanical tests showed that the stiffness and yield load of specimens in groups B and C were significantly lower than those in group A, while the yield load in group B were significantly lower than that in group C ( P<0.05). The stiffness in group C was restored to 41.52%±3.96% in group A, and the yield load was restored to 46.14%±7.85%. Clinical study showed that 200 patients were followed up 6-73 months, with an average of 22.7 months. At last follow-up, 12 patients (16 hips) underwent total hip arthroplasty, and the hip survival rate was 93.10%. According to the imaging evaluation, 184 hips (79.31%) were stable and 48 (20.69%) were worse. Harris score (79.3±17.3) was significantly higher than that before operation (57.3±12.0) ( t=18.600, P=0.000). The excellent rate of hip function was 64.22% (149/232). The survival rate of hip joint, imaging score and Harris score of patients in ARCO stage Ⅱ were better than those in ARCO stage Ⅲ ( P<0.05). Conclusion: β-TCP bioceramic system can guide the abundant blood supply of greater trochanter and femoral neck to the femoral head to promote repair; it can partly restore the mechanical properties of the femoral head and neck in the early stage, providing a new minimally invasive hip-preserving method for patients with ONFH, especially for those in early stage.

Anthracyclines are one of the widely used anti-tumor drugs in clinical practice.Its dose-related cardiotoxicity can affect the quality of life and survival rate of cancer patients,so early identification of anthracycline related cardiotoxicity is particu-larly important.This article provides a review of the research progress on early biomarkers of anthracycline related cardiotoxicity.

OBJECTIVE: Three genes including the OTOF, the DFNB59 and the DIAPH3 have been implicated previously in human non-syndromic auditory neuropathy. In this study, we aim to investigate whether DIAPH3 gene or the known deafness loci of 25 cloned autosomal dominant deafness (DFNA) genes contribute to the nonsyndromic hearing loss of a Chinese pedigree with dominantly inherited auditory neuropathy (AN). METHOD: Nine members of the kernal pedigree in this family were selected. Genomic DNA was isolated from the peripheral leukocytes of the subjects using the Puregene DNA Isolation Kits. Firstly, the 5'UTR of DIAPH3 gene was PCR amplified in all subjects. Then, the DNA fragments spanning the entire coding regions of DIAPH3, GJB2 and GJB3 genes, and 50 exons in other 23 cloned DFNA genes were amplified using specific primers. Each fragment was purified and analyzed by direct sequencing. The resultant sequence data were compared with the standard sequence to identify deafness-associated mutations. RESULT: PCR amplifications were successfully conducted. We failed to detect the presence either of c. --172G > A mutation in the 5'UTR that have been reported, or any other deafness-associated mutations in the whole DIAPH3 gene, by sequence analysis. We also did not find any known deafness-causing mutations among the 25 cloned DFNA genes. CONCLUSION The DIAPH3 gene, and the known deafness loci of 25 cloned DFNA genes seem not contribute to the pathogenesis of this Chinese AN family in this study, which suggesting new gene(s) involvement.
Adaptor Proteins, Signal Transducing ; genetics ; Asian Continental Ancestry Group ; China ; Connexins ; DNA Mutational Analysis ; Deafness ; Exons ; Hearing Loss ; Hearing Loss, Central ; genetics ; Hearing Loss, Sensorineural ; genetics ; Humans ; Mutation ; Pedigree ; Polymerase Chain Reaction

OBJECTIVETo investigate the relationship of mitochondrial DNA mutations with inherited deafness in a maternally inherited pedigree with non-syndromic deafness.

METHODSThe diagnosis was validated by hearing tests. Blood samples were collected from 18 maternal members of the family and 53 controls including 6 paternal members, 7 spouses and 40 unrelated individuals. DNA was extracted from the leukocytes in blood samples. The gene fragments of mitochondrial DNA 12S rRNA, tRNA(Ser(UCN)) and GJB2 gene were amplified by polymerase chain reaction(PCR). PCR products were analyzed by sequencing. Computerized 12S rRNA secondary structure modeling was carried out to characterize the mutation found in the family.

RESULTSA novel mitochondrial DNA 12S rRNA 709 G to A transition was detected from all maternal members including 8 patients with hearing loss and other 10 symptom-free maternal members. Non-maternal members and other controls did not carry this mutation. In addition, the tRNA(Ser(UCN))A7445G, 12S rRNA A1555G and GJB2 gene mutations were not observed in the study. Computerized modeling showed that this mutation changed the eighth and ninth loop-stem structure of the 12S rRNA secondary structure.

CONCLUSIONIn this family, 8 deaf patients carried the mitochondrial DNA 12S rRNA 709 G to A mutation, which is highly conservative in healthy adults. It was confirmed that the mitochondrial DNA 12S rRNA gene G709A was associated with non-syndromic inherited hearing loss. The other 10 maternal members carried the mutation, but they did not suffer from deafness, which might suggest that the G709A mutation may cause hearing impairment in combination with a synergistic effect of some other nuclear modifier genes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Base Sequence ; Child ; Connexins ; DNA Mutational Analysis ; DNA, Mitochondrial ; chemistry ; genetics ; Deafness ; congenital ; genetics ; Female ; Genomic Imprinting ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Nucleic Acid Conformation ; Pedigree ; Point Mutation ; RNA, Ribosomal ; chemistry ; genetics ; Young Adult