Under the background of performance evaluation in nationwide tertiary public hospitals and the DRGs reform, how to improve the efficiency of daytime surgery management is becoming a hotspot for hospital managers. Since July 2020, a tertiary general hospital applied the theory of incentive compatibility to guide the medical workers to consciously strive to achieve such management goals as improving the quantity and quality of daytime surgeries by constructing an organizational management system, increasing performance rewards for daytime surgical teams, rewarding advanced collectives and individuals, convening work coordination and promotion meetings, formulating penalty terms, and strengthening supervision of surgical quality and safety indicators. The implementation rate of daytime surgery in hospitals, the number of departments conducting daytime surgery, the number of covered diseases, and the satisfaction rate of inpatients had increased from 6.94%, 6 departments, 64 diseases, and 90.5% in 2019 to 24.08%, 21 departments, 125 diseases, and 95.0% in 2022, respectively. The incidence of daytime surgical bleeding, and readmissions within 15 days decreased from 0.6% and 0.5% in 2019 to 0.5% and 0.2% in 2022, respectively. The theory of incentive compatibility was in line with the development goals of daytime surgery in China, providing an optimal strategy for improving the management efficiency of daytime surgery according to local conditions.

RNAi technology has aroused wide public interest due to its high efficiency and specificity to treat multiple types of diseases. However, the effective delivery of siRNA remains a challenge due to its large molecular weight and strong anionic charge. Considering their remarkable functions and features that are often desired in drug delivery carriers, biomimetic systems for siRNA delivery become an effective and promising strategy. Based on this, covalent attachment of synthetic cell penetrating peptides (CPP) to siRNA has become of great interest. We developed a monomeric covalent conjugate of low molecular weight protamine (LMWP, a well-established CPP) and siRNA a cytosol-cleavable disulfide linkage using PEG as a crosslinker. Results showed that the conjugates didn't generate coagulation, and exhibited much better RNAi potency and intracellular delivery compared with the conventional charge-complexed CPP/siRNA aggregates. Three different synthetic and purification methods were compared in order to optimize synthesis efficiency and product yield. The methodology using hetero-bifunctional NHS-PEG-OPSS as a crosslinker to synthesize LMWP-siRNA simplified the synthesis and purification process and produced the highest yield. These results pave the way towards siRNA biomimetic delivery and future clinical translation.

In this paper, we prepared a dual functional system based on dextrin-coated silver nanoparticles which were further attached with iron oxide nanoparticles and cell penetrating peptide (Tat), producing Tat-modified Ag-FeO nanocomposites (Tat-FeAgNPs). To load drugs, an -SH containing linker, 3-mercaptopropanohydrazide, was designed and synthesized. It enabled the silver carriers to load and release doxorubicin (Dox) in a pH-sensitive pattern. The delivery efficiency of this system was assessed using MCF-7 cells, and using null BalB/c mice bearing MCF-7 xenograft tumors. Our results demonstrated that both Tat and externally applied magnetic field could promote cellular uptake and consequently the cytotoxicity of doxorubicin-loaded nanoparticles, with the IC of Tat-FeAgNP-Dox to be 0.63 µmol/L. The delivery efficiency of Tat-FeAgNP carrying Cy5 to the mouse tumor was analyzed using the optical imaging tests, in which Tat-FeAgNP-Cy5 yielded the most efficient accumulation in the tumor (6.7±2.4% ID of Tat-FeAgNPs). Anti-tumor assessment also demonstrated that Tat-FeAgNP-Dox displayed the most significant tumor-inhibiting effects and reduced the specific growth rate of tumor by 29.6% ( = 0.009), which could be attributed to its superior performance in tumor drug delivery in comparison with the control nanovehicles.