Metal ion-promoted chemodynamic therapy(CDT) combined with photodynamic therapy(PDT) offers broad application prospects for enhancing anti-tumor effects. In this study, glycyrrhizic acid(GA), copper ions(Cu~(2+)), and norcantharidin(NCTD) were co-assembled to successfully prepare a natural small-molecule, carrier-free hydrogel(NCTD Gel) with excellent material properties. Under 808 nm laser irradiation, NCTD Gel responded to the tumor microenvironment(TME) and acted as an efficient Fenton reagent and photosensitizer, catalyzing the conversion of endogenous hydrogen peroxide(H_2O_2) within the tumor into oxygen(O_2), and hydroxyl radicals(·OH, type Ⅰ reactive oxygen species) and singlet oxygen(~1O_2, type Ⅱ reactive oxygen species), while depleting glutathione(GSH) to stabilize reactive oxygen species and alleviate tumor hypoxia. In vitro and in vivo experiments demonstrated that NCTD Gel exhibited significant CDT/PDT synergistic therapeutic effects. Further safety evaluation and metabolic testing confirmed its good biocompatibility and safety. This novel hydrogel is not only simple to prepare, safe, and cost-effective but also holds great potential for clinical transformation, providing insights and references for the research and development of metal ion-mediated hydrogel-based anti-tumor therapies.
Hydrogels/chemistry* ; Animals ; Photochemotherapy ; Humans ; Mice ; Antineoplastic Agents/administration & dosage* ; Photosensitizing Agents/chemistry* ; Neoplasms/metabolism* ; Female ; Copper/chemistry* ; Reactive Oxygen Species/metabolism* ; Tumor Microenvironment/drug effects* ; Cell Line, Tumor ; Male

Poor water solubility is the primary obstacle preventing the development of many pharmacologically active compounds into oral preparations. Self-nanoemulsifying drug delivery systems(SNEDDS) have become a widely used strategy to enhance the oral bioavailability of poorly soluble drugs by inducing a supersaturated state, thereby improving their apparent solubility and dissolution rate. However, the supersaturated solutions formed in SNEDDS are thermodynamically unstable systems with solubility levels exceeding the crystalline equilibrium solubility, making them prone to drug precipitation in the gastrointestinal tract and ultimately hindering drug absorption. Therefore, maintaining a stable supersaturated state is crucial for the effective delivery of poorly soluble drugs. Incorporating polymers as precipitation inhibitors(PPIs) into the formulation of supersaturated self-nanoemulsifying drug delivery systems(S-SNEDDS) can inhibit drug aggregation and crystallization, thus maintaining a stable supersaturated state. This has emerged as a novel preparation strategy and a key focus in SNEDDS research. This review explores the preparation design of SNEDDS and the technical challenges involved, with a particular focus on polymer-based S-SNEDDS for enhancing the solubility and oral bioavailability of poorly soluble drugs. It further elucidates the mechanisms by which polymers participate in transmembrane transport, summarizes the principles by which polymers sustain a supersaturated state, and discusses strategies for enhancing drug absorption. Altogether, this review provides a structured framework for the development of S-SNEDDS preparations with stable quality and reduced development risk, and offers a theoretical reference for the application of S-SNEDDS technology in improving the oral bioavailability of poorly soluble drugs.
Solubility ; Administration, Oral ; Polymers/chemistry* ; Drug Delivery Systems/methods* ; Humans ; Emulsions/chemistry* ; Biological Availability ; Animals ; Pharmaceutical Preparations/administration & dosage*

OBJECTIVE: The self-defined multidisciplinary (endocrinology, vascular surgery, and orthopedics) scoring system (EMO scoring system for short) was designed. The feasibility of the EMO scoring system to guide the proximal tibial transverse transport (TTT) for diabetic foot wounds was preliminarily explored. METHODS: Based on the current commonly used clinical criteria for diabetic foot judgment, expert consensus, guidelines, and related research progress in the treatment of diabetic foot wounds, combined with clinical experience, a set of EMO scoring systems including endocrinology, vascular surgery, and orthopedics was formulated. The criteria for selecting conservative treatment, TTT after baseline improvement, and TTT based on scoring results was proposed. A total of 56 patients with diabetic foot wounds who were admitted between September 2017 and July 2022 and met the selection criteria was taken as the study subjects. Among them, 28 patients were treated with TTT and 28 patients were treated conservatively. The patients were graded according to the EMO scoring system, the corresponding treatment methods were selected, and the actual treatment methods and results of the patients were compared. RESULTS: The EMO scoring system was formed through literature retrieval and clinical experiences. The system included three criteria, namely endocrinology (E), macrovascular disease (M), and orthopedics (O), which were divided into multiple subtypes according to the relevant evaluation items, and finally the diabetic foot wound was divided into 8 types, which correspondingly selected TTT, TTT after baseline improvement, and conservative treatment. All 56 patients were followed up 12 months after treatment. Among them, the wound healing rate of the TTT group was 85.71% (24/28), which was higher than that of the conservative treatment group [53.57% (15/28)]. At 12 week after treatment, CT angiography showed that there were more small blood vessels in the wound and ipsilateral limb in TTT group than in the conservative treatment group. Based on the EMO scoring system, 14 of the 56 patients needed conservative treatment, 29 patients needed TTT, and 13 patients needed TTT after baseline improvement. Compared with the clinical data of the patients, the wound healing rate of the patients judged to be TTT was 75.86% (22/29), of which 21 cases were actually treated with TTT, and the healing rate was 90.48%; 8 patients were treated conservatively, and the healing rate was 37.50%. The wound healing rate of the patients judged to be conservative treatment was 92.86% (13/14), of which 1 case was actually treated with TTT, and the healing rate was 100%; 13 cases were treated conservatively, and the healing rate was 92.31%; 1 case experienced minor amputation. The wound healing rate of the patients judged to TTT after baseline improvement was only 30.77% (4/13), of which 6 cases were actually treated with TTT, and the healing rate was 66.67%; 7 cases were treated conservatively, and the healing rate was 0. CONCLUSION EMO scoring system can comprehensively evaluate the diabetic foot wounds, and make personalized judgment on whether TTT treatment is feasible, so as to improve the level of diabetic foot wound treatment and the prognosis of patients.
Humans ; Diabetic Foot/therapy* ; Feasibility Studies ; Male ; Female ; Middle Aged ; Aged ; Tibia/surgery* ; Wound Healing ; Adult ; Treatment Outcome ; Conservative Treatment

Objective:To identify the genetic mutation of coagulation factor Ⅶ(F7)gene in a pedigree with coagulation factor Ⅶ(FⅦ)deficiency and explore the molecular pathogenesis.Methods:The prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer(DD),fibrin degradation products(FDP)and coagulation factor Ⅶ activity(FⅧ:C)of the proband and her family members were detected by Sysmex-CS5100 analyzer.All exons and exon-intron boundaries of the F7 gene were amplified by PCR followed by direct sequencing.The detected mutation was confirmed by reverse sequencing.The ClustalW software was used to analyze the conservatism of the mutant site.Pathogenicity of the mutation was assessed with Mutation Taster and PolyPhen-2 online bioinformatics software.Structure of the mutant protein was analyzed using Swiss-PdbViewer software.Results:The results of routine coagulation tests showed that PT of the proband was markedly extended to 42.5 s,and her FⅦ:C significantly reduced to 2％.The FⅦ:C of her grandmother,mother and sister had slightly reduced to 49％,51％,and 42％,respectively.These coagulant parameters of her father were within the normal range.Genetic analysis reveled a heterozygous G＞A change at cDNA 646 in exon 6 of F7 gene in the proband,resulting in a replacement of glycine at 156 of FⅦ catalytic region with serine(p.Gly156Ser).The sequencing results of other exons and exon-intron boundaries of her F7 gene were normal.The proband's grandmother,mother and sister were all the carriers of this missense mutation except her father.Bioinformatics analysis showed that the p.Gly156Ser mutation caused polarity change of the amino acid at this site and formation of side chains,leading to increase of protein instability,which may affect catalytic activity of structural domain.Meanwhile,both Mutation Taster and PolyPhen-2 online bioinformatics software also predicted the pathogenicity of this missense mutation with high scores.Conclusion:The heterozygous p.Gly 156Ser mutation is the direct cause of the reduced FⅦ in this proband.

Objective:To evaluate the diagnostic performance of the Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)for clinically significant prostate cancer(CSPCa)in the peripheral zone(PZ),transitional zone(TZ)and multiple zones(MZs).Methods:We retrospectively studied the clinical data on 108 patients undergoing multiparametric magnetic resonance imaging(mpMRI)and transperineal prostate biopsy in our hospital from January 2021 to January 2023.Using PI-RADS v2.1,we ex-amined the MR images of the patients with suspected PCa,compared the PI-RADS v2.1 scores with the results of prostate biopsy,and analyzed the correlation of the PI-RADS v2.1 scores with CSPCa.We calculated the area under the receiver operating characteristic(ROC)curve(AUC),and described the diagnostic performance of PI-RADS v2.1 for CSPCa in the PZ,TZ and MZs.Results:Transperineal prostate puncture biopsy was successfully completed in all the patients,which revealed 66(61.11％)cases of CSPCa with Gleason score(GS)7-10.Suspected CSPCa was observed in 45(95.74％)of the 47 PZ lesions,8(47.06％)of the 17 TZ le-sions,and 40(90.91％)of the 44 MZ lesions.The PZ,TZ and MZ lesions diagnosed by PI-RADS v2.1 were significantly correlated with CSPCa(r=0.492,P＜0.001).The AUCs of PI-RADS v2.1 for PZ,TZ and MZs were 0.644,0.732 and 0.811,with specificities of 66.8％,57.6％and 62.1％,and sensitivities of 57.2％,78.4％and 93.2％,respectively.The negative predictive values were 46.5％,85.7％and 79.2％,and the positive predictive values 76.2％,43.4％and 84.8％,respectively.Conclusion:The PI-RADS v2.1 score has a high diagnostic value for CSPCa in the PZ,TZ and MZs,with the best performance for that in the MZs.

AIM To explore the clinical effects of Supplemented Buzhong Yiqi Decoction on patients with HP-positive chronic atrophic gastritis of Spleen-Stomach Deficiency Pattern.METHODS One hundred and thirty-two patients were randomly assigned into control group(66 cases)for 12-week intervention of conventional treatment,and observation group(66 cases)for 12-week intervention of both Supplemented Buzhong Yiqi Decoction and conventional treatment.The changes in clinical effects,HP clearance rate,miR-32,TGF-β1,IL-6,PGⅠ,PGⅡ,EGF,somatostatin,gastrin,motilin,gastroscopy pathological score and TCM symptom score were detected.RESULTS The observation group demonstrated higher total effective rate and HP clearance rate than the control group(P<0.05).After the treatment,the two groups displayed decreased miR-32,TGF-β1,IL-6,gastroscopy pathological score,TCM symptom score(P<0.05),and increased PGⅠ,PGⅡ,EGF,somatostatin,gastrin,motilin(P<0.05),especially for the observation group(P<0.05).CONCLUSION For the patients with HP-positive chronic atrophic gastritis of Spleen-Stomach Deficiency Pattern,Supplemented Buzhong Yiqi Decoction can alleviate inflammation,regulate gastrointestinal hormone levels,improve symptoms,and enhance efficacy.

Objective To analyze the differences in the expressions of the total and phosphorylated proteins in human colon cancer HCT116 cells after the knockout(KO)of retinoic acid-induced protein 16(RAI16)and explore the possible mechanism and related signaling pathways affecting its protein function in HCT116 cells.Methods HCT116 KO and WT cell proteins were collected and extracted,and the protein extraction efficiency was detected via a sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE)experiment.After protein digestion,the peptides were labeled with TMT and analyzed via mass spectrometry.We used bioinformatics methods to analyze the identified differential proteins and differentially phosphory-lated proteins by using GO,KEGG,and STRING databases.Results The results of SDS-PAGE showed no evident protein degradation.In addition,some key bands were significantly different between the experi-mental and control groups.A total of 147 up-regulated and 230 down-regulated differential proteins were screened in accordance with the conditions of Foldchange≥1.5 or Foldchange≤1/1.5 and P<0.05.Meanwhile,106 up-regulated and 217 down-regulated phosphorylation sites were screened.GO enrichment analysis revealed that the differential proteins were mainly enriched in the composition of nucleoplasm,nucleus and cytoplasm,RNA binding,cadherin and chromatin,DNA repair,RNA splicing,and positive regulation of DNA as template transcription.The results of KEGG enrichment indicated that the differential proteins were mainly enriched in nucleocytoplasmic transport,spliceosomes,cell cycle,cell-cell tight junctions,viral carcinogenesis,microRNAs in cancer,etc.The protein interaction network mainly focused on DDX17,NCL,EEF2,CDK1,SSRP1,and SMARCC1.The statistical findings unveiled the up-regulated changes in the two omics of SKP1,ORC1,and BAD and the down-regulated changes in RBL1,RB1,CDK1,CDC6,MCM4,TFDP1,CHD4,and SNW1.Moreover,the phosphorylation differences were more significant than the protein differences.Conclusion RAI16 plays the possible crucial role in multiple biological functions and signaling pathways through key proteins,such as SKP1,ORC1,RB1,and CDK1,which affect the cell cycle and thereby the occurrence and development of cancer.

Objective To investigate the morphological changes in the upper airway after bimaxillary surgery in patients with skeletal Class Ⅲ malocclusion and the relationship between jaw movement and airway changes using CBCT.Methods This study involved 44 individuals(21 males and 23 females)receiving Class Ⅲ bimaxillary surgery.Preoperative and 3-6-month postoperative CBCT data were examined using Dophin3D 11.95 software.The alterations before and after upper airway surgery were analysed using paired t-test and non-parametric Wilcoxon rank sum test.The association between airway alterations and jaw movement was examined using Pearson's correlation coefficient.Results Patients who underwent Class Ⅲ bimaxillary surgery had significantly reduced upper airway volume,sagittal cross-sectional area,and minimum cross-sectional area(P＜0.01).A correlation exists between oropharyngeal volume change and point B change(P＜0.05).When B point recession was＞7 mm,the decrease in upper airway volume increased significantly(P＜0.01),as did the risk of minimum cross-sectional area of the patient's airway(P＜0.01).Conclusion ClassⅢbimaxillary surgery re-duces upper airway capacity.Postoperative reduction in upper airway capacity coincides with mandibular recession.Mandibular reces-sion(＞7 mm)may reduce postoperative upper airway capacity and increase the risk of OSAHS.Patients at risk of upper airway stenosis should have their protocol modified to reduce airway risk.

Objective To investigate the efficacy and clinical results of total internal protection technique in anterior cru-ciate ligament reconstruction.Methods A total of 56 patients undergoing anterior cruciate ligament reconstruction treated from January 2018 to December 2019 were selected.According to the different surgical methods,they were divided into total inter-nal reconstruction group and standard bone tunnel group.There were 21 patients in the total internal reconstruction group,in-cluding 15 males and 6 females,aged from 20 to 48 with an average of(35.6±6.7)years old,and 35 patients in the standard tibial tunnel group,including 26 males and 9 females,aged 22 to 51 years old with an average of(33.7±9.6)years old.Preop-erative examination of Lachman test was positive,magnetic resonance indicated anterior cruciate ligament rupture.There were no significant differences between the two groups in age,sex,body mass index,time from injury to ACL reconstruction,com-bined meniscus injury and operation method,operation time,ligament diameter,ligament length and other general information.Postoperative evaluation included operation duration,length and diameter of transplanted tendon after braid.International Knee Documentation Committee(IKDC)score,Lysholm score,Tegner score and perioperative complications 2 years after surgery.Results Both groups were followed up,ranging from 24 to 30 months with an average of(26.9±3.4)months.Postoperative inci-sion healing was good,and no failure or joint infection occurred at the last follow-up.There was no statistically significant dif-ference between the two groups in IKDC score,Lysholm score and Tegner score before,1 year and 2 years after surgery.How-ever,IKDC score,Lysholm score and Tegner score at 1 year and 2 years after surgery.Conclusion The same postoperative function and stability of knee joint can be obtained by both the residual whole technique and the standardized reconstruction technique.In the residual whole group,only the semitendinosus muscle is taken,and the femoral thin muscle is retained,with greater tibial bone mass preserved,which is safe and effective in clinical practice.