Peptide-based radiopharmaceuticals targeting integrin α5β1 show promise for precise tumor diagnosis and treatment. However, current peptide-based radioligands that target α5β1 demonstrate inadequate in vivo performance owing to limited tumor retention. The use of PEGylation to enhance the tumor retention of radiopharmaceuticals by prolonging blood circulation time poses a risk of increased blood toxicity. Therefore, a PEGylation strategy that boosts tumor retention while minimizing blood circulation time is urgently needed. Here, we developed a PEGylation-enabled peptide multidisplay platform (PEGibody) for PR_b, an α5β1 targeting peptide. PEGibody generation involved PEGylation and self-assembly. [⁶⁴Cu]QM-2303 PEGibodies displayed spherical nanoparticles ranging from 100 to 200 nm in diameter. Compared with non-PEGylated radioligands, [⁶⁴Cu]QM-2303 demonstrated enhanced tumor retention time due to increased binding affinity and stability. Importantly, the biodistribution analysis confirmed rapid clearance of [⁶⁴Cu]QM-2303 from the bloodstream. Administration of a single dose of [¹⁷⁷Lu]QM-2303 led to robust antitumor efficacy. Furthermore, [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 exhibited low hematological and organ toxicity in both healthy and tumor-bearing mice. Therefore, this study presents a PEGibody-based radiotheranostic approach that enhances tumor retention time and provides long-lasting antitumor effects without prolonging blood circulation lifetime. The PEGibody-based radiopharmaceutical [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 shows great potential for positron emission tomography imaging-guided targeted radionuclide therapy for α5β1-overexpressing tumors.

The activation proteins released by fibroblasts in the tumor microenvironment regulate tumor growth, migration, and treatment response, thereby influencing tumor progression and therapeutic outcomes. Owing to the proliferation and metastasis of tumors, fibroblast activation protein (FAP) is typically highly expressed in the tumor stroma, whereas it is nearly absent in adult normal tissues and benign lesions, making it an attractive target for precision medicine. Radiolabeled agents targeting FAP have the potential for targeted cancer diagnosis and therapy. This comprehensive review aims to describe the evolution of FAPI-based radiopharmaceuticals and their structural optimization. Within its scope, this review summarizes the advances in the use of radiolabeled small molecule inhibitors for tumor imaging and therapy as well as the modification strategies for FAPIs, combined with insights from structure-activity relationships and clinical studies, providing a valuable perspective for radiopharmaceutical clinical development and application.

Objective: To evaluate the influence of enhanced recovery after surgery (ERAS) nursing model for perioperative patients in orthopedic surgery on complications. Methods: Computer-based search of electronic databases the Cochrane Library, PubMed, Embase, Web of Science, CNKI, WF and CBM Database to search for randomized controlled trials on the application of ERAS nursing models in orthopaedic patients at domestic and foreign before March 16, 2018, data were selected and screened according to the inclusion and exclusion criteria. RevMan 5.3 was used for meta-analysis of the included studies. Results: A total of 25 RCTs were included in the study and a total of 2 412 patients were included. Meta-analysis showed that the incidence of deep venous thrombos[RR=0.38, 95%CI(0.24, 0.61), P<0.01], and incidence of pulmonary infection[RR=0.26, 95% CI (0.10, 0.67), P=0.005], incidence of urinary tract infections[RR=0.28, 95%CI(0.10,0.78), P=0.01], incidence of constipation [RR=0.30, 95% CI (0.17,0.56), P=0.0001], The incidence of bloating [RR=0.35, 95%CI(0.13, 0.95), P=0.04], they were lower in the experimental group than in routine care, they were statistically significant. Incidence of incision infection [RR=0.75, 95% CI(0.17, 3.27), P= 0.70], incidence of pressure sores [RR=0.34, 95% CI(0.09, 1.27), P=0.11], incidence of nausea and vomiting [RR=0.81, 95% CI(0.52, 1.25), P=0.34] were not statistically significant; postoperative hospital stay, hospitalization costs, and patient satisfaction were statistically significant. Conclusions Compared with routine care, the ERAS nursing model can promote the recovery of orthopedic patients during perioperative period, reduce postoperative deep venous thrombosis, constipation, pulmonary infection, urinary tract infection, postoperative hospital stay, hospitalization costs, and patient satisfaction. All have a positive impact, but more multicentre and large sample clinical trials are needed for validation.