Malignant tumors are major diseases that endanger human health. Due to their complex and variable microenvironment, most anti-tumor drugs cannot precisely reach the focal tissue and be released in a controlled manner. Intelligent responsive nano carriers have become a hot spot in the field of anti-tumor drug delivery systems. As an excellent nano material, mesoporous silica has the advantages of non-toxic, stable, adjustable pore volume and pore diameter, and easy functional modification on the surface. By virtue of its perceptive response to the tumor microenvironment or physiological changes, it can achieve the targeted drug release or controlled drug release of the drug delivery system in the tissue, making it an ideal carrier for intelligent response drug delivery system. In this paper, we review the design strategies and current research status of smart responsive anti-tumor drug delivery systems based on mesoporous silica, in order to provide a reference for the development of anti-tumor drug nanoformulations.

OBJECTIVE: To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema (BCRL). METHODS: This was a retrospective cohort study using a paired control design. Fifty-two BCRL patients were assigned to the control group (27 cases) and the treatment group (25 cases). The patients in the control group were treated with lymphedema comprehensive detumescence treatment (CDT) for 4 weeks, including systematic therapy composed of manual lymphatic drainage, compression bandage, skincare, and functional exercise. The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods. Each treatment lasted for 30 min and was applied twice a week for 4 weeks. The arm circumference (AC) of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment. The clinical efficacy was evaluated according to the degree of edema before and after treatment. All adverse events during treatment were recorded. RESULTS: The patients' AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment. Compared with the control group, AC of the wrist joint transverse stria, the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced (P<0.05). The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant (P<0.01). The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment, and was significantly lower compared with the control group after treatment (P<0.01). The total effective rate was 72% in the treatment group, significantly higher than that in the control group (55.56%, P<0.05). No serious adverse events occured in either group. CONCLUSIONS TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL. The effect is better than that of CDT therapy alone. (Registration No. ChiCTR2200062075).
Humans ; Female ; Breast Neoplasms/therapy* ; Acupuncture Points ; Retrospective Studies ; Lymphedema/complications* ; Acupuncture Therapy/adverse effects* ; Upper Extremity ; Treatment Outcome

Asian Continental Ancestry Group/genetics* ; Charcot-Marie-Tooth Disease/genetics* ; China ; Genetic Profile ; Humans ; Pedigree

Objective The aim of this study is to investigate the macrolide resistance rate and molecular type withmultiple-locus variable-number tandem-repeat analysis (MLVA) of Mycoplasma pneumoniae of Beijing in 2016 in pediatric patients. Methods Real-time quantitative polymerase chain reaction (PCR) was used to identify M. pneumoniae, and MLVA was performed. The domain V of the 23S rRNA was sequenced to detect macrolide-resistant point mutations. We also investigated the activities of antibiotics against M. pneumoniae isolates in vitro. Results The PCR detection rate of M. pneumoniae in children in Beijing was 40％, and the macrolide resistance rate was 66％. The A2063G mutation in the 23S rRNA V region is the dominant mutation (137/146, 93.84％), whereas the A2064G mutation is rare (9/146, 6.16％). Seventy-three samples were typed successfully by MLVA typing, including 86.3％ (63/73) were MLVA type 4-5-7-2, and 13.7％ (10/73) were MLVA type 3-5-6-2. No other types were found. No strains were resistant to levofloxacin or tetracycline. Conclusion In 2016, a specific decrease in the macrolide resistance rate occurred in Beijing. The detection rate and macrolide resistance rate of outpatients are lower than those of inpatients. The A2063G mutants M. pneumoniae have high levels of resistance to erythromycin and azithromycin. The primary MLVA type is 4-5-7-2, followed by 3-5-6-2. No other MLVA types were detected. No strains resistant to tetracycline or levofloxacin were found in vitro.

OBJECTIVETo study clinical effects of fibular osteotomy for the treatment of knee osteoarthritis.

METHODSFrom January 2015, 12 patients (15 knees) with knee osteoarthritis were treated with fibular osteotomy. The main symptom was interval inside pain. All the patients were female with an average age of 61.3 years old. Early postoperative ambulation of joints was carried out after surgery, and the corresponding radiographic assessment before and after operations were performed with record. Finally, the following indicators were analyzed:VAS, KSS, HSS, respectively before, 2 days and 2 months after the operation.

RESULTSThe average hospitalization time was (6.0±2.4) days, and the time of unilateral operation was (33.3±8.4) minutes without significant bleeding. There were no obvious complications such as wound infection, delayed healing and nerve damage. All the patients could walk around 1 day after operations with a chief complaint of the obvious reduction or disappear of the interval medial knee pain. The VAS score, HSS score and KSS clinical score were significantly improved 2 days after surgery compared to the scores before operation. These above scores and functional score were significantly improved 2 months after operation compared to the scores before operation. X ray films of the weight bearing knees were taken 2 days after surgery, showing increased height of medial joint space to some extent compared to that before operation.

CONCLUSIONSA fibular osteotomy has been proved to significantly reduce the postoperative pain and facilitate the good recovery of joint function with the advantages of simple surgical procedures and slighttrauma. Therefore, it is an effective method for the treatment of knee osteoarthritis with varus deformity.

Objective To analyze the viscoelastic properties of adjacent segments after anterior fusion under prolonged flexion, and further reveal the mechanism of accelerated adjacent segment degeneration after intervertebral fusion. Methods The same prolonged flexion lasted 30 minutes was applied on the two-level ovine lumbar specimen before and after anterior fusion respectively, and the moment relaxation and viscoelastic deformation of adjacent segments were measured. The moment relaxation curves from two groups were then fitted to obtain the quantitative viscoelastic results. Results After fusion，the initial and final moment in two groups significantly increased by 30.68% and 34.34%, and the viscoelastic deformation of the adjacent segments increased by 28.21%. The Prony model could perfectly fit the moment relaxation curves (R2=99.50%). The integral stiffness significantly increased by 47.82% and 31.14% for two groups, while the viscoelasticity significantly decreased by 27.19% and 28.16%, respectively(P<0.05). Conclusions After intervertebral fusion, to maintain the same posture with the same time, the joints should bear larger loads than before. The viscoelastic deformation of adjacent segments becomes larger, which increases the risk of instability or injury, and further leads to the accelerated degeneration of adjacent segments. The mechanism of quasi-static daily loading on adjacent segment degeneration should be focused in clinical research.

BACKGROUNDThe cause of the adjacent segment degeneration (ASD) after fusion remains unknown. It is reported that adjacent facet joint stresses increase after anterior cervical discectomy and fusion. This increase of stress rate may lead to tissue injury. Thus far, the load rate of the adjacent segment facet joint after fusion remains unclear.

METHODSSix C2-C7 cadaveric spine specimens were loaded under four motion modes: Flexion, extension, rotation, and lateral bending, with a pure moment using a 6° robot arm combined with an optical motion analysis system. The Tecscan pressure test system was used for testing facet joint pressure.

RESULTSThe contact mode of the facet joints and distributions of the force center during different motions were recorded. The adjacent segment facet joint forces increased faster after fusion, compared with intact conditions. While the magnitude of pressures increased, there was no difference in distribution modes before and after fusion. No pressures were detected during flexion. The average growth velocity during extension was the fastest and was significantly faster than lateral bending.

CONCLUSIONSOne of the reasons for cartilage injury was the increasing stress rate of loading. This implies that ASD after fusion may be related to habitual movement before and after fusion. More and faster extension is disadvantageous for the facet joints and should be reduced as much as possible.

Biomechanical Phenomena ; Humans ; In Vitro Techniques ; Lumbar Vertebrae ; physiopathology ; Range of Motion, Articular ; physiology ; Spinal Fusion ; adverse effects ; Spine ; physiopathology

BACKGROUNDEndovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.

METHODSBetween June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34 - 82 years of age with a mean age (61.9 + or - 11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n = 47), brachial artery (n = 1, involving bilateral subclavian disease) or both (n = 11). Sixty stents were implanted. All patients were followed-up at 1, 3, 6, and 12 months post-procedure, and annually thereafter.

RESULTSWe achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6 + or - 10.8)% and (2.5 + or - 12.5)% (P < 0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7 + or - 18.5) vs. (2.2 + or - 3.9) mmHg (P < 0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.

CONCLUSIONSEndovascular therapy for proximal subclavian arterial obstructive lesions is effective and successful. This minimally invasive treatment may be the first choice of treatment for proximal subclavical arterial obstructive lesions.

Adult ; Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stents ; Subclavian Artery ; pathology ; Subclavian Steal Syndrome ; pathology ; therapy ; Vertebrobasilar Insufficiency ; pathology ; therapy

The clinical throat swab specimen of an imported suspected case of influenza A (H1N1) was detec ted with real-time PCR, RT-PCR and subsequently confirmed by gene sequencing. The presence of influ enza A (H1N1) virus confirmed the first case with A (H1N1) infection in Mainland China.
China ; Humans ; Influenza A Virus, H1N1 Subtype ; classification ; genetics ; isolation & purification ; Influenza, Human ; virology ; Molecular Sequence Data ; Phylogeny

Objective To investigate the epidemiological,genealogic characteristic,familial history of the families with fatal familial insomnia,its clinical and pathological features as well as the heredity rule of related genes.Methods 135 familial members of 7 eras were studied.Vein blood samples from patients as well as from some familial members were collected.PRNP gene was studied with PCR,its serial was determined and then authenticated with Nsp I.Brain tissue was obtained for neuropathological test and PrPSc test with Western blot method.Results Clinical symptoms of the 2 diagnosed cases were typical.11 familial members died of similar neural disease.32 samples of their familial members,codon at D178N of PRNP of 11 members was mutated,with mutation rate as 34.38% while D129N showed as methionine.Brain tissue of both probands denaturalized into spongiform and the nerve fiber was absent but PrPSc protein was identified.Conclusion Genealogy was described in the family with fatal familial insomnia since the patients had typical clinical symptoms and pathological characteristics.It seemed necessary to confirm cases of fatal familial insomnia and their genealogy with epidemiological data and to investigate its gene characteristics as well as with neuropathological and Western blot tests.