BACKGROUND:Electrospun porous nanofiber exhibits excellent properties and designability.It is an effective way to control the release of traditional Chinese medicine and improve the bioavailability to design an advanced drug delivery system,which has a broad application prospect. OBJECTIVE:To review the construction methods of the electrospinning drug delivery system of traditional Chinese medicine and its related research progress in the medical field. METHODS:The literature search was performed in CNKI,PubMed,and Web of Science databases with the search terms"electrospinning,traditional Chinese medicine,drug carrier,drug delivery system,tissue engineering,dressing"in both English and Chinese for articles published from 2013 to 2023.Finally,62 articles were included in this review. RESULTS AND CONCLUSION:(1)The key elements of the electrospinning drug delivery system of Chinese medicine preparation are substrate material,traditional Chinese medicine composition,and drug loading method.(2)The preparation of the electrospinning drug delivery system of Chinese medicine can be carried out according to the application scenario and therapeutic purpose.Firstly,the types of Chinese medicine are selected,then the polymer matrix and solution suitable for them are selected,and finally,the fiber structure is designed according to the drug release requirements and the appropriate drug loading method is adopted.(3)At present,the medicinal agents used are mainly plant Chinese medicine,and there is a lack of systematic research on animal and mineral Chinese medicine.(4)Blended drug loading is the most studied and applied drug loading method,and its drug release characteristics and adaptation scenarios are constantly expanded by optimizing the physicochemical properties of the solution and selecting the diversity of loaded substances.Multilayer fibers with different compositions and properties can be prepared by coaxial,multi-axis,and sequential electrospinning methods,which have broad development prospects.(5)The early application of the electrospinning drug delivery system of Chinese medicine focused on medical dressings according to the antibacterial and hemostatic functions.In recent years,it has been studied in the field of tissue engineering because some components of traditional Chinese medicine can promote cell adhesion,proliferation,and differentiation.(6)At present,the research mainly focuses on the characterization and optimization of loading materials,processes,physicochemical properties,and biological properties,but the research on the mechanism is less.Its clinical application has not been widespread;the adverse reactions in vivo and the interaction between its degradation behavior and drug release behavior are still unknown.(7)Future studies need to consider:We should expand the application of Chinese medicine by improving the physicochemical properties and increasing the purification of Chinese medicine extracts.We need to comprehensively study the therapeutic effects and application mechanisms of Chinese medicine,and clarify the interaction of degradation behavior and drug release behavior,to achieve a more perfect combination and application of Chinese medicine and electrospinning nanofibers under a more accurate mechanism.

Objective: To investigate the efficacy and safety of using pegylated recombinant human granulocyte-colonystimulating factor (PEG-rhG-CSF) in preventing neutropenia in multiple chemotherapy cycles. Methods: A multicenter, prospective, open-label, singlearmstudy was designed. Patients with malignant tumors, such as lung, ovarian, and colorectal cancers, who received multiple cycles of chemotherapy with the prophylactic use of PEG-rhG-CSF for 2-4 consecutive cycles participated in the study. Results: After the prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 4.76% (13/273) in the first cycle to 1.83% (5/273), 1.15% (2/174), and 2.08% (2/96) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 11.36% (31/ 273) in the first cycle to 6.23% (17/273), 2.87% (5/174), and 3.13% (3/96) in subsequent cycles. The incidence of febrile neutropenia (FN) during the first cycle was 0.73% (2/273). The duration of FN was 2 days in one case and 5 days in another case. FN was not observed during the second, third, or fourth cycle. After the secondary prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 25% (7/28) to 3.57% (1/28), 0% (0/28), and 6.67% (1/15) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 71.43% (20/28) to 10.71% (3/28), 14.29% (4/28), and 0% (0/15) in subsequent cycles. The proportion of patients who received antibiotic therapy during the entire chemotherapy period was 10.48% (44/420). Conclusion: The application of PEG-rhG-CSF once per chemotherapy cycle can effectively reduce the occurrence of neutropenia in patients under multiple cycles of chemotherapy treatment with good safety.

Purpose To investigate the relationship between HPV infection and p53,p16,EGFR expression and prognosis in patients with salivary adenoid cystic carcinoma (ACC).Methods Totally 76 cases of adenoid cystic carcinoma specimens were selected,PCR-reverse dot blot hybridization was used to detect infection of HPV and SP immunohistochemical method was adopted to detect the expression of p53,p16,EGFR,Cdc2 in tumor tissues.Clinical data were collected and all the patients were followed up.The Kaplan-Meier method was used to estimate median overall survival and the Log-rank test to compare survival curves.Cox regression model was used for multivariate analyses.Results Infection rate of HPV in adenoid cystic carcinoma tissues was 0(0/76).The expression rate of p53,p16,EGFR,Cdc2 protein in adenoid cystic carcinoma tissues were 76.3％ (58/76),57.9％ (44/76),60.5％ (46/76) and 64.5％ (49/76)respectively.There was no correlation of the expression of p53,p16,EGFR and Cdc2 with gender,age,tumor location,TNM stage and histological type of patient.Kaplan-Meier survival analysis showed that EGFR-positive patients had shorter median overall survival rate (OS) than the negative ones (x2 =19.111,P ＜ 0.001).EGFR-positive patients had shorter median progression-free survival rate (PFS)than the negative ones (x2 =6.621,P ＜ O.01).Cdc2 positive patients had shorter median OS than the negative ones (x2 =3.870,P ＜ 0.05).Cdc2 positive patients had shorter median PFS than the negative ones (x2 =6.755,P ＜0.01).Cox regression analysis showed that expression of EGFR and Cdc2 was independent risk factors for the prognosis of patients with salivary gland ACC (relativerisk=13.417,13.075,P＜0.001).Conclusion There is no HPV infection detected in adenoid cystic carcinoma tissues.p53,p16,EGFR and Cdc2 are positively expressed in most salivary adenoid cystic carcinoma,p16 is unsuitable as a surrogate for HPV infection status of patient with ACC.Expression of EGFR and Cdc2 is independent risk factors in the prognosis of patients with salivary gland ACC.For the EGFR or Cdc2 positive patients should be followed up closely.

Objective To investigate the effects of dendritic cells (DCs)loading alpha-Galactosylce-ramide (α-GalCer)combined with tumor specific cytotoxic T lymphocytes (CTLs)on the growth of transplanted Heps hepatoma in mice.Methods We induced the augmentation of the DC cells and T lymphocyte derived from the mice bone marrow,and enabled them to be specific CTLs.DC cells loaded α-GalCer in vitro.First we established a Heps liver cancer xenograft model,then divided the model mice into 4 groups by random number table method (n =9):control group (intravenous injection with physiological saline),CTL group,DC loadingα-Galcer group and DC loading α-Galcer combined with CTLs group.After 2 weeks of intervention,we extrac-ted the tumor tissue,weighed the tumor and calculated the inhibition rate of tumor.The expressions of Bax/Bcl-2 cells in groups of transplanted tumor tissues were detected using immunohistochemistry and Western blotting. Results The average tumor weight of CTL group,DC loading α-GalCer group and combined treatment group were (1 .07 ±0.1 5)g,(1 .1 1 ±0.1 7)g,(0.79 ±0.1 4)g,respectively.All of them were lower than that of control group (1 .69 ±0.23)g,with significant differences (t =1 4.1 76,P =0.023;t =1 2.351 ,P =0.034;t =1 8.672,P =0.000).The average tumor weight of combined treatment group was lower than those of the CTL group and DC loading α-GalCer group,with significant differences (t =1 5.236,P =0.01 2;t =1 1 .1 76, P =0.037).Compared to the CTL group (36.69%)and DC loading α-GalCer group (34.32%),the com-bined treatment group had a higher tumor inhibition rate (53.25%;P =0.034,P =0.021 ).Immunohisto-chemical assay showed that the numbers of Bax-positive cells in CTL group,DC loading α-GalCer group and combined treatment group were 35.83 ±0.75,33.67 ±0.82,41 .1 7 ±1 .1 7 respectively,and compared with the control group (21 .67 ±2.1 6),the differences were statistically significant (t =-1 3.789,P =0.002;t =-1 5.1 1 6,P =0.001 ;t =-1 7.452,P =0.000).The numbers of Bax-positive cells in combined treatment group were different with CTL group and DC loading α-GalCer group (t =-7.730,P =0.009;t =-5.872, P =0.01 1 ).The numbers of Bcl-2-positive cells in CTL group,DC loading α-GalCer group and combined treatment group were 30.83 ±0.75,31 .67 ±1 .03,25.00 ±0.89,and compared with the control group (38.67 ±1 .21 ),the differences were statistically significant (t =9.234,P =0.007;t =1 1 .738,P =0.003;t =20.608,P =0.000).The numbers of Bcl-2-positive cells in combined treatment group were different with CTL group and DC loading α-GalCer group (t =1 1 .952,P =0.003;t =1 2.223,P =0.002).Western blot-ting test results showed that the expression levels of Bax in CTL group,DC loading α-GalCer group and com-bined treatment group were 0.46 ±0.01 ,0.42 ±0.03,0.55 ±0.01 ,and compared with the control group (0.31 ±0.02),the differences were statistically significant (t =1 .035,P =0.032;t =1 .1 24,P =0.027;t =1 .425,P =0.01 0).The expression level of Bax in combined treatment group was different with CTL group and DC loading α-GalCer group (t =1 .305,P =0.01 3;t =1 .421 ,P =0.01 0).The positive expressions of Bcl-2 in CTL group,DC loading α-GalCer group and combined treatment group were 0.34 ±0.03,0.33 ± 0.02,0.24 ±0.01 ,and compared with the control group (0.46 ±0.01 ),the differences were statistically sig-nificant (t =-1 .1 23,P =0.025;t =-1 .061 ,P =0.031 ;t =1 .278,P =0.01 4);the positive expression level of Bcl-2 in combined treatment group was different with CTL group and DC loading α-GalCer group (t =1 .1 60,P =0.021 ;t =1 .21 9,P =0.01 5).Conclusion It has synergistic killing effect on transplanted Heps hepatoma in mice using DC loading α-GalCer combined with the tumor specific CTL.

OBJECTIVETo investigate the indications of the pretemporal transcavernous approach for cavernous sinus tumors resection and design individually tailored surgery according to the extent of tumors and operation requirements.

METHODSA retrospective analysis of clinical data, surgical outcomes and complications in a series of 31 cases with cavernous sinus tumor operated via the individually tailored pretemporal transcavernous approach between May 2012 and September 2015 in Department of Neurosurgery, Xiangya Hospital, Central South University. There were 13 male and 18 female patients, aging from 17 to 67 years with a mean of (41±14) years. The patients included 18 cases of shwannomas, 4 cases of meningiomas, 3 cases of cavernous hemangiomas, 2 cases of invasive pituitary adenomas, 1 case of chordoma, 1 case of chondroma, 1 case of recurrent teratoma, 1 case of metastatic nasopharyngeal carcinoma. The first followed-up visit was on the 3(rd) month after surgery, and if tumor progression or recurrence was observed on MRI, the Gamma knife treatment was recommended, the patient was followed up every 6 months, otherwise the patient was followed up again 6 months later, then, every 12 months.

RESULTSGross total removal of tumors was achieved in 22 cases of 31 patients (71.0%), containing 17 cases of shwannomas, 3 cases of hemangiomas, 1 case of chondroma, 1 case of teratoma; subtotal removal in 6 cases (19.3%), including 3 cases of meningiomas, 1 case of pituitary adenoma, 1 case of chordoma, 1 case of metastatic carcinoma; partial removal in 3 cases (9.7%), comprising 1 case of meningioma, 1 case of recurrent shwannoma, 1 case of recurrent pituitary adenoma. The symptoms of cranial never aggravated in 5 cases, the new postoperative cranial never palsy was observed in 7 cases. There was no surgical mortality, intracranial hematoma, intracranial infection and cerebrospinal fluid leakage cases, ect. Twenty-eight cases were followed up for more than 3 months (3 to 40 months), 1 case of chordoma had tumor progression; the nerve function was restored in 5 cases, among the 12 cases with postoperatively new occurred or deteriorated cranial nerve paralysis.

CONCLUSIONSThe pretemporal transcavernous approach can be used to resect tumors limited in cavernous sinus or tumors simultaneously involving the cavernous sinus and its vicinity areas, it can be individually tailored based on the extent and exposure of the tumor. This approach can improve the surgical results in terms of high tumor resection rate, less complication, is an ideal approach for cavernous sinus tumor resection.

Adenoma ; surgery ; Adolescent ; Adult ; Aged ; Cavernous Sinus ; pathology ; surgery ; Chordoma ; surgery ; Female ; Hemangioma ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Meningioma ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Pituitary Neoplasms ; surgery ; Postoperative Period ; Radiosurgery ; Retrospective Studies ; Young Adult

Objective To observe the clinical efficacy of the combination of modification ofChaihu Jia Longgu MuliDecoction with psychological intervention in the treatment of post tumor depression.MethodsTotally 122 cases of post tumor depression were divided into treatment group and control group by simple numeration table random method, with 61 cases in each group. The treatment group was given modification ofChaihu Jia Longgu Muli Decoction orally, at the same time psychological intervention was given. The control group was given escitalopram oxalate tablets for 6 weeks. HAMD scale scores of the two groups were observed before and after treatment to evaluate the clinical efficacy. Changes in life quality of two groups were scored with SF-36 scale. The adverse reactions were also observed.ResultsAfter treatment, the HAMD score of treatment group was lower than control group (P<0.05). The total effective rate was 88.52% (54/61) in the treatment group and 72.13% (44/61) in the control group, with statistical significance (P<0.05). The scores of life quality of treatment group were higher than control group (P<0.05), and the incidence of adverse reactions was lower than control group (P<0.05).Conclusion Combination of modification ofChaihu Jia Longgu MuliDecoction with psychological intervention in the treatment of post tumor depression can significantly improve the depressive state and life quality of the patients with post tumor depression, which is better than the control group, without significant adverse reactions.

Objective To investigate the method and effectiveness of the digital artery series and parallel of island flap for repairing degloved injuries of the fingertip of thumb or adjacent finger Methods Between September 2008 and July 2012,the finger artery series retrograde island flaps tiled in the repair of finger degloving injury in 13 cases,repair of adjacent finger tip degloving injury in 11 cases; 8 cases of degloved injuries of the fingertip were tiled with the digital artery parallel island flap from ulnaris middle finger and radialis ring finger of arteria digitalis communis pedicled which were from the same palm side.The size of skin and soft tissue defect ranged from 2.0 cm × 1.8 cm-7.2 cm ×5.5 cm,gutted flap minimum ranged from 1.1 cm × 1.0cm-1.5 cm × 1.3cm,and the maximum ranged from 3.0 cm × 2.2 cm-5.5 cm × 4.5 cm.The donor sites were repaired with the intermediate split thickness free skin grafts and performed with pressure dressing.Results The group of 32 cases,in 1 case the flap vasospasm occurred in operation of free process,the symptoms disappeared after local application of papaverine and hot compress ; 1 case of flap occurred disturbance of blood circulation after operation because of tight suturing for pedicle,the symptoms relieved after removing the stitches at intervals; 2 cases blisters appeared after operation,disappeared after a week.All skin flaps were survived,incision and skin graft donor sites healed by first intention.Twenty patients were followed-up from 6 to 12 months after operation.All flaps presented the satisfactory appearance and texture,recovered protective feeling.At last follow-up,the two-point discrimination was 7 to 10mm,and the flexion and extension function of wounded fingers recovered to normal.According to the functional assessment criteria of upper limb formulated by the Hand Surgery Branch of Chinese Medical Association,there were excellent in 19 cases,good in 10 cases,and moderate in 3 cases.No significant loss to the donor shape and function.Conclusion The surgery by adopted the digital artery series or parallel of island flap for repairing degloved injuries of the fingertip of thumb or adjacent finger,not only has the advantages of simpleness,safety and reliability,but also can satisfy the patients who aren't willing to accept or because of physical reasons can't accept the treatment of abdominal skin tube or nail flap from hallux toe,which performs in both high-end and low level hospitals,and deserves of general application.

Objective To evaluate the efficacy and survival rate of neoadjuvant chemotherapy with docetaxe and pirarubicin in triple negative breast cancer (TNBC).Methods Total 51 breast cancer patients were divided into TNBC group (n =26,including 16 of stage Ⅱ and 10 of stage Ⅲ patients) and non-TNBC group (n =25,including 14 of stage Ⅱ and 11 of stage Ⅲ patients).All patients received a median of 4 treatment cycles with TAC regimen [docetaxe 75 mg/m2 on day 1,pirarubicin 40 mg/m2 on day 1 and cyclophosphamide (CTX) 500 mg/m2 on day 1 of each 21 day cycle].The efficacy of treatment and survival rate of two groups were evaluated.Results In TNBC group,9 out of 26 (34.62 ％) patients achieved clinical complete response (cCR),and 14 (53.85 ％) had partial response (cPR).Overall,88.46 ％ of TNBC patients had clinical response and 26.92 ％ (7/26) showed pathology complete response (pCR).In non-TNBC group,6 (24.00 ％) patients reached cCR and 8 (32.00 ％) showed cPR.The overall response rate was of 56.00 ％,and 4 (16.00 ％) patients achieved pCR.The overall 3-year survival rates in TNBC and non-TNBC groups were 73.08 ％ and 88.00 ％,respectively,indicating a poorer prognosis of TNBC.The 5-year survival rates of TNBC patients with and without pCR were 88.89 ％ and 47.06 ％,respectively.Conclusion TAC regimen improves the prognosis for locally advanced TNBC,indicating that the neoadjuvant chemotherapy is effective and safe for TNBC patients.

Purpose To explore the relationship between expression of PCNA and COX-2 in the early laryngeal cancer with negative surgical margins and the local recurrence of tumor. Methods Totally 63 patients with early laryngeal cancer were enrolled in this stud-y, CO2 laser surgery was adopted as treatment, the expression of PCNA and COX-2 was detected in the resected tumor tissue and surgi-cal margins, and the survival and tumor recurrence were also observed. Results The positive rate of the expression of PCNA and COX-2 in the 63 patients with early laryngeal cancer tumor tissues were 73. 02% and 71. 43%, while that in the cutting edge were 33. 33% and 30. 16%, respectively. The expression of PCNA and COX-2 in tumor tissue and cutting edge were of all positive in 41 cases and 13 cases, and the positive rate was 65. 08% and 20. 63%, respectively. In the all followed-up patients, 17 cases were detected of local recurrence, the recurrence rate was 26. 98%, and the recurrence rate in the patients with PCNA positive was 71. 43%, while in the patients with COX-2 positive was 73. 68% (P<0. 05). The combined detection of PCNA and COX-2 positive recurrence rate was significantly higher than that of single positive (P<0. 05). Conclusion PCNA and COX-2 in the early laryngeal cancer with negative surgical margins are important biological markers for the evaluation of prognosis of laryngeal cancer patients, and to formulate the subse-quent treatment regimen. The combined detection of two proteins is more reliable for postoperative management.

Objective: This study aimed to investigate the effects and side effects of Jinlong Capsule with concurrent three-dimen-sional conformal radiotherapy for advanced primary hepatic carcinoma. Methods: A total of 85 patients with inoperable primary hepat-ic carcinoma were randomly divided into a research group and a control group. Forty-two cases in the control group were treated with three-dimensional conformal radiotherapy alone, whereas 45 cases in the research group were treated with three-dimensional conformal radiotherapy and Jinlong Capsule oral administration. All cases were irradiated with 6 MV X-rays, 2 Gy per day, 5 days a week to a to-tal dose of 60 Gy in 6 weeks. Jinlong Capsule (1 g) was administered orally three times daily until disease progression for at least one year. The short-term therapeutic effect and adverse events were evaluated for 2 months after treatment. The long-term therapeutic effect was assessed at the end of follow-up. Results: The objective response rate of the research group was significantly higher than that of the control group at 74.4% and 47.6%, respectively (P=0.011). The disease control rates were 97.7% and 85.3% (P=0.030) for the re-search and control groups, respectively. No obvious difference was found between the complete response rates of the two groups, 20.9% and 14.3% (P=0.422). The 1- and 3-year overall survival rates of the research group (74.4% and 34.9%) were significantly high-er than those of the control group (66.7% and 16.7%) at P=0.046. The 1- and 3-year progression free survival rates of the research group (74.4% and 27.9%) were significantly higher than those of the control group (61.9% and 9.5%) at P=0.038. The main adverse events were grade 1–2 bone marrow suppression, abdominal distension, nausea, vomiting, and transaminase elevation. No obvious dif-ference was observed between the adverse events in the two groups. Conclusion: The short- and long-term effects of the combination therapy of Jinlong Capsule and three-dimensional conformal radiotherapy on primary hepatocellular carcinoma were significantly high-er than those of three-dimensional conformal radiotherapy alone. The patients also tolerated the adverse effects.