Dual Activation of Calcium Channels Using Near-Infrared Responsive Conjugated Oligomer Nanoparticles for Precise Regulation of Blood Glucose Homeostasis.

The rarity of efficient tools with spatiotemporal resolution and biocompatibility capabilities remains a major challenge for further progress and application of signaling manipulation. Herein, biomimetic conjugated oligomeric nanoparticles (CM-CONs) were developed to precisely modulate blood glucose homeostasis via the two-pronged activation of calcium channels. Under near-infrared (NIR) laser irradiation, CM-CONs efficiently generate local heat and reactive oxygen species (ROS), thereby simultaneously activating thermosensitive transient receptor potential V1 (TRPV1) and ROS-sensitive transient receptor potential A1 (TRPA1) calcium channels in small intestinal endocrine cells. The activation of the channels mediates inward calcium flow and then promotes glucagon-like peptide (GLP-1) secretion. Both in vitro and in vivo studies indicate that CM-CONs effectively regulate glucose homeostasis in diabetic model mice upon NIR light irradiation. This work develops a two-pronged attack strategy for accurately controlling blood glucose homeostasis, holding great prospects in the treatment for diabetes.

Randomized controlled trial of intravesical electrical stimulation for underactive bladder.

AIM: To evaluate the efficacy and safety of intravesical electrical stimulation (IVES) performed with a novel device in patients with underactive bladder (UAB). PATIENTS AND METHODS: This was a multicentre, prospective, single-blind, randomized controlled clinical trial of patients with UAB in China. Eligible patients were randomly assigned in a 1:1 ratio to receive conventional IVES (n = 38) or IVES with an open circuit (n = 38). The primary efficacy measure was change from baseline in post-void residual urine volume (PVR) after 4 weeks of treatment. Secondary efficacy measures included changes in maximum urinary flow rate (Qmax ), bladder voiding efficiency (BVE), number of 24-h clean intermittent catheterization (CIC) procedures, and Patient Perception of Bladder Condition-Scale (PPBC-S) and American Urological Association Symptom Index Quality of Life (AUA-SI-QoL) scores from baseline after 4 weeks of treatment. Adverse events (AEs) were monitored throughout the trial. RESULTS: In the full analysis set (FAS), the mean (sd) PVR changes in the trial and control groups at 4 weeks were -97.1 (107.5) mL and -10.5 (86.7) mL, respectively (P < 0.01). Similar results were obtained in the per-protocol set (PPS): -102.9 (100.0) mL vs 0.7 (82.5) mL (P < 0.01). In the FAS and PPS, Qmax improved significantly at 4 weeks (P = 0.04 and P = 0.03). In the FAS and PPS, BVE was significantly improved at 4 weeks in the two groups (P < 0.01 and P < 0.01), whereas no significant differences in the number of 24-h CIC procedures, PPBC-S score or AUA-SI-QoL score were observed between the groups. Six possible therapy-related AEs occurred in six patients (four in the trial group and two in the control group; P = 0.67), all of which were urinary tract infections. No severe AEs were reported. CONCLUSIONS: The results of this clinical study strongly demonstrate that UAB patients benefit from this novel IVES device. More research is needed to validate the clinical utility of this device.

Aligned Millineedle Arrays for Solar Power Seawater Desalination with Site-Specific Salt Formation.

As a sustainable and clean water production technology, solar thermal water evaporation has been extensively studied in the past few years. One challenge is that upon operation, salt would form on surface of the solar absorbers leading to inefficient water supply and light absorption and thus much reduced water vaporization rate. To address this problem, a simple solar evaporator based on an array of aligned millineedles for efficient solar water evaporation and controlled site-specific salt formation is demonstrated. The maximum solar evaporation rate achieved is 2.94 kg m-2 h-1 under one Sun irradiation in brine of high salinity (25 wt% NaCl), achieving energy conversion efficiency of 94.5% simultaneously. More importantly, the spontaneously site-specific salt formation on the tips of millineedles endows this solar evaporator with salt harvesting capacity. Rationally separating the clean water and salt from brine by condensation and gravity assistance, this tip-preferential crystallization solar evaporator is not affected by the salt clogging compared with conventional 2D solar evaporators. This study provides new insights on the design of solar evaporators and advances their applications in sustainable seawater desalination and wastewater management.

Bladder mesenchymal stromal cell-derived exosomal miRNA-217 modulates bladder cancer cell survival through Hippo-YAP pathway.

BACKGROUND: Donor cell-derived exosomes regulate recipient cell functions. The aim of this study was to investigate the effect of human normal bladder stromal cell (hBSC) derived exosomal miR-217 on bladder cell cancer proliferation and migration. METHODS: Human BSCs were transfected with miR-217 mimic or inhibitor and hBSC-derived exosomes were isolated. Human bladder cancer cell lines (T24 and 5367) were co-cultured with hBSC-derived exosomal miR-217 mimic or inhibitor. Proliferation, migration, and apoptosis of the bladder cancer cells were assessed by Edu assay, Transwell migration assay, and Annexin V assay. RESULTS: Expression of miR-217 was significantly higher in the T24 and 5367 cell lines (P < 0.01). Exosomal miR-217 mimic enhanced proliferation and migration of T24 and 5367 cells, but inhibited apoptosis of the cells (P < 0.01); in contrast, exosomal miR-217 inhibitor suppressed proliferation and migration but stimulated apoptosis of the two cancer cell lines (P < 0.01). Moreover, exosomal miR-217 mimic stimulated YAP and its target proteins including Cyr61, CTGF, and ANKRD1 (P < 0.01), and in contrast, exosomal miR-217 inhibitor suppressed YAP and its target proteins (P < 0.01). CONCLUSION: These findings suggested that hBSC-derived exosomal miR-217 may act as oncogene in bladder cancer cells, and that Hippo-YAP signaling pathway maybe the target for miR-217 in the bladder cancer cell lines.

Water-Soluble Organic Nanoparticles with Programable Intermolecular Charge Transfer for NIR-II Photothermal Anti-Bacterial Therapy.

Extensive recent efforts have been put on the design of high-performance organic near-infrared (NIR) photothermal agents (PTAs), especially over NIR-II bio-window (1000-1350 nm). So far, the development is mainly limited by the rarity of molecules with good NIR-II response. Here, we report organic nanoparticles of intermolecular charge-transfer complexes (CTCs) with easily programmable optical absorption. By employing different common donor and acceptor molecules to form CTC nanoparticles (CT NPs), absorption peaks of CT NPs can be controllably tuned from the NIR-I to NIR-II region. Notably, CT NPs formed with perylene and TCNQ have a considerably red-shifted absorption peak at 1040 nm and achieves a good photothermal conversion efficiency of 42 % under 1064 nm excitation. These nanoparticles were used for antibacterial application with effective activity towards both Gram-negative and Gram-positive bacteria. This work opens a new avenue into the development of efficient PTAs.

Water-Splitting Based and Related Therapeutic Effects: Evolving Concepts, Progress, and Perspectives.

Water-splitting has been extensively studied especially for energy applications. It is often not paid with enough attention for biomedical applications. In fact, several innovative breakthroughs have been achieved in the past few years by employing water-splitting for treating cancer and other diseases. Interestingly, among these important works, only two reports have mentioned the term "water-splitting." For this reason, the importance of water-splitting for biomedical applications is significantly underestimated. This progress work is written with the aims to explain and summarize how the principle of water-splitting is employed to achieve therapeutic results not offered by conventional approaches. It is expected that this progress report will not only explain the importance of water-splitting to scientists in the biomedical fields, it should also draw attention from scientists working on energy applications of water-splitting.

Single-Photomolecular Nanotheranostics for Synergetic Near-Infrared Fluorescence and Photoacoustic Imaging-Guided Highly Effective Photothermal Ablation.

Multi-modality imaging-guided cancer therapy is considered as a powerful theranostic platform enabling simultaneous precise diagnosis and treatment of cancer. However, recently reported multifunctional systems with multiple components and sophisticate structures remain major obstacles for further clinical translation. In this work, a single-photomolecular theranostic nanoplatform is fabricated via a facile nanoprecipitation strategy. By encapsulating a semiconductor oligomer (IT-S) into an amphiphilic lipid, water-dispersible IT-S nanoparticles (IT-S NPs) are prepared. The obtained IT-S NPs have a very simple construction and possess ultra-stable near-infrared (NIR) fluorescence (FL)/photoacoustic (PA) dual-modal imaging and high photothermal conversion efficiency of 72.3%. Accurate spatiotemporal distribution profiles of IT-S NPs are successfully visualized by NIR FL/PA dual-modal imaging. With the comprehensive in vivo imaging information provided by IT-S NPs, tumor photothermal ablation is readily realized under precise manipulation of laser irradiation, which greatly improves the therapeutic efficacy without any obvious side effects. Therefore, the IT-S NPs allow high tumor therapeutic efficacy under the precise guidance of FL/PA imaging techniques and thus hold great potential as an effective theranostic platform for future clinical applications.

Multiple inferior vena cava aneurysms mimic a retroperitoneal tumor: a case report.

BACKGROUND: Inferior vena cava (IVC) aneurysms are extremely rare with variable clinical manifestations. Patients are usually asymptomatic or present with complications of thrombosis and rupture. To date, there have been only a few reports of the condition in the literature, and diagnosis of IVC aneurysms may be difficult. CASE PRESENTATION: A 33-year-old male patient presented to hospital because of a retroperitoneal mass found by computerized tomography during a health examination. He was asymptomatic, and post medical history and physical examination were unremarkable. Laboratory tests including tests for paraganglioma were all negative. Contrast-enhanced computed tomography scan revealed a stenosis of IVC in the suprarenal segment and two retroperitoneal mass on the right side of IVC. The larger one is about 3 cm in diameter and the smaller one is about 1 cm in diameter, which was considered as a retroperitoneal tumor with an enlarged lymph node. However, two IVC diverticular aneurysms were confirmed during the retroperitoneal laparoscopic exploration. The larger aneurysm was resected from the IVC successfully. Since the smaller aneurysm was about 1 cm in diameter without thrombosis, we did not resect it during surgery. The patient recovered well from surgery and discharged from our department successfully. CONCLUSIONS: This is the first report of multiple IVC aneurysms. Because of the extremely low prevalence of IVC diverticular aneurysm, it may be misdiagnosed as other disease. Due to the high rate of thrombosis, surgical treatment especially retroperitoneal laparoscopy is recommended for small diverticular aneurysms.

Renal medullary carcinoma masquerading as renal infection: a case report.

BACKGROUND: Renal medullary carcinoma is a rare and aggressive tumor and often seen in young adults with sickle cell hemoglobinopathies. CASE PRESENTATION: We report a case of renal medullary carcinoma in a 29-year old male patient with an occupying renal lesion who presented with fever, flank pain and hematuria. The patient received intensive antibiotics treatment, but no improvement was seen. The symptoms disappeared after laparoscopic radical left nephrectomy. Postoperative pathological study showed that the mass was renal medullary carcinoma. CONCLUSIONS: Our case suggests that renal medullary carcinoma should be considered in differential diagnoses of patients with occupying renal lesions who have fever of unknown origin.

A fluorometric assay of thrombin using magnetic nanoparticles and enzyme-free hybridization chain reaction.

A fluorescence method based on functionalized magnetic nanoparticles (FMNPs) and hybridization chain reaction (HCR) is developed for the enzyme-free amplified determination of thrombin. In the proposed design, aptamer against thrombin was hybridized with the capture DNA-modified magnetic nanoparticles to yield the FMNPs. In the presence of thrombin, aptamers are released due to the specific and high-affinity binding between thrombin and its aptamer. The exposed capture DNA subsequently hybridized with the partial sequence of helper DNA, and the vacant sequence of helper DNA further hybridized with HCR products which is pre-formed by the alternate hybridization of single-stranded DNAs (H1 and H2). The immobilized HCR products were then labeled with YOYO-1 for fluorescence measurement. Fluorescence signal intensity of labeled YOYO-1 was measured at an emission wavelength of 519 nm (excitation under 488 nm) and used for calibration. By taking advantage of HCR amplification, this direct assay strategy showed a linear response in the 20- to 200-pM concentration range, and the limit of detection is 9.2 pM which is about 3-orders of magnitude lower than the serum thrombin concentration (10 nM) that triggers blood clotting. This developed method can efficiently differentiate the target protein from a protein matrix, and it is verified by determination of thrombin in spiked serum samples with recoveries in the range of 94.5-103.3%. Graphical abstract A fluorometry method for thrombin detection using magnetic nanoparticles and enzyme-free hybridization chain reaction.

Membrane-Anchoring Photosensitizer with Aggregation-Induced Emission Characteristics for Combating Multidrug-Resistant Bacteria.

Traditional photosensitizers (PSs) show reduced singlet oxygen (1 O2 ) production and quenched fluorescence upon aggregation in aqueous media, which greatly affect their efficiency in photodynamic therapy (PDT). Meanwhile, non-targeting PSs generally yield low efficiency in antibacterial performance due to their short lifetimes and small effective working radii. Herein, a water-dispersible membrane anchor (TBD-anchor) PS with aggregation-induced emission is designed and synthesized to generate 1 O2 on the bacterial membrane. TBD-anchor showed efficient antibacterial performance towards both Gram-negative (Escherichia coli) and Gram-positive bacteria (Staphylococcus aureus). Over 99.8 % killing efficiency was obtained for methicillin-resistant S. aureus (MRSA) when they were exposed to 0.8 µm of TBD-anchor at a low white light dose (25 mW cm-2 ) for 10 minutes. TBD-anchor thus shows great promise as an effective antimicrobial agent to combat the menace of multidrug-resistant bacteria.

MicroRNA-133a Inhibits Osteosarcoma Cells Proliferation and Invasion via Targeting IGF-1R.

BACKGROUND/AIMS: MicroRNAs (miRNAs) are a class of small noncoding RNAs that regulate gene expression by repressing translation or cleaving RNA transcripts in a sequence-specific manner. Downregulated microRNAs and their roles in cancer development have attracted much attention. A growing body of evidence showed that microRNA-133a (miR-133a) has inhibitory effects on cell proliferation, migration, invasion, and metastasis of osteosarcoma. METHODS: MiR-133a expression in human osteosarcoma cell lines and human normal osteoblastic cell line hFOB was investigated by real-time PCR (RT-PCR). The role of miR-133a in human osteosarcoma growth and invasion was assessed in cell lines in vitro and in vivo. Then, luciferase reporter assay validated IGF-1R as a downstream and functional target of miR-133a, and functional studies revealed that the anti-tumor effect of miR-133a was probably due to targeting and repressing of IGF-1R expression. RESULTS: MiR-133a was lower expressed in human osteosarcoma cell lines than human normal osteoblastic cell line hFOB and its effect on inhibiting proliferation, invasion and metastasis is mediated by its direct interaction with the IGF-1R. Furthermore, the tumour-suppressive function of miR-133a probably contributed to inhibiting the activation AKT and ERK signaling pathway. CONCLUSION: MiR-133a suppresses osteosarcoma progression and metastasis by targeting IGF-1R in human osteosarcoma cells, providing a novel candidate prognostic factor and a potential anti-metastasis therapeutic target in osteosarcoma.

[Clinical diagnosis and treatment of adrenocortical adenoma in patients aged 60 years or above].

OBJECTIVE: To investigate the clinical features of adrenocortical adenoma's diagnosis and treatment in patients aged 60 years or above. METHODS: A retrospective study was performed with a total of 249 patients aged 60 years or above who suffered from adrenocortical adenoma and treated in Peking Union Medical College Hospital from January 2004 to January 2014.The clinical features, treatments and prognosis of the 249 patients aged 60 years or above were compared with another 249 patients which were randomly selected during the same period aged from 30 to 50 years.t-test or χ(2) test was used to analyze the data between the two groups. RESULTS: Endocrine examinations were performed in all 249 patients aged 60 years or above.There were 144 patients diagnosed as non-functional adrenocortical adenoma, 94 cases as aldosterone-producing adenoma and 11 cases as Cushing adenoma.For the patients aged 60 years or above, the rate of cardio-cerebral vascular incident in non-functional adrenocortical adenoma group was 26.4%(38/144), which was significantly lower than that of the aldosterone-producing adenoma and Cushing adenoma group(54.3%, 57/105)(χ(2)=20.027, P=0.000). There were 91.5%(65/71) of the patients aged 60 years or above who got a relief in low blood potassium symptoms after the operation.Forty-nine point one percent(53/108) of the non-functional adrenocortical adenoma patients aged 60 years or above had a better control of their blood pressure level, while functional adrenocortical adenoma group were 64.0%(48/75) which indicated that the functional adrenocortical adenoma patients have a better control of their blood pressure then the non-functional adrenocortical adenoma patients after the operation(χ(2)=3.987, P=0.046). There were 37.1% of the patients aged 60 years or above whose fasting blood-glucose was higher than 7.1 mmol/L, while the patients aged from 30 to 50 years was 14.1%(χ(2)=22.02, P=0.000). The differences in plasma aldosterone and blood potassium between the patients aged 60 years or above and the patients aged from 30 to 50 years had statistical significance(t=10.48, -2.58; P=0.00, 0.01). CONCLUSIONS: Most of the adrenocortical adenoma in patients aged 60 years or above is non-functional adrenocortical adenoma.Among who, patients with aldosterone-producing adenoma tend to have lower plasma aldosterone concentration and higher blood potassium level then the patients aged from 30 to 50 years.The patients aged 60 years or above with functional adrenocortical adenoma are tend to have severe cardio-cerebral vascular incidence.A few of non-functional adrenocortical adenoma patients who combine with hypertension can benefit for the operation.

BMI levels with MS Bone mineral density levels in adults with multiple sclerosis: a meta-analysis.

INTRODUCTION: Multiple sclerosis (MS) and osteoporosis (OP) affect a substantial proportion of the population. Accumulating evidence suggests that MS patients are at high risk for OP. We performed a meta-analysis to identify risk factors for lowered bone mineral density (BMD) in MS patients. METHODS: We searched for articles within the Medline, Embase and Cochrane Library databases, published up to March 2014, pertaining to associations between MS and BMD. A total of 11 studies was included in the meta-analysis. RESULTS: The analysis indicated that MS patients have reduced lumbar spine, femur neck, and hip BMD compared with healthy controls (lumbar spine, standardized mean difference (SMD) = -0.76, 95% CI: -1.07, -0.45; femur neck, SMD = -0.56, 95% CI: -0.84, -0.29; and hip, SMD = -0.62, 95% CI: -0.96, -0.29). Further subgroup analysis revealed that a disease duration of >7 years, total steroid dose during the disease of >15 g, and an Expanded Disability Status Scale (EDSS) score of > 3, increased the risk of reduced BMD in the lumbar spine and femoral neck, but not in the hip. Meta-regression analysis did not explain the heterogeneity in the clinical characteristics or outcome definitions. CONCLUSIONS: Our meta-analysis suggests that MS patients have reduced overall BMD compared with healthy controls. Furthermore, disease duration (>7 years), total steroid dose (>15 g), and EDSS score (>3) are risk factors for reduced BMD in MS patients.

[The incidence and risk factors of male urinary tract infection following invasive urodynamic investigation].

OBJECTIVE: To assess the prevalence of male urinary tract infection (UTI) after invasive urodynamic studies and to determinate the risk factors by evaluating the clinical characteristics and urodynamic parameters of patients. METHODS: Six hundred and seventy-one consecutive men were recruited. All patients accepted urine routine tests and(or)urine culture three times. The first culture and routine tests were carried out in the 2 to 4 weeks before urodynamic studies by using clean-catch midstream urine (MSU) or catheter urine specimen. The second urine routine test was carried out at the start of examinations and the last urine culture were carried out in 48-72 hours after the investigations. Male patients with negative results (leucocytes <15 cells/ul and <10(5) colony-forming units per milliliter [cfu/ml]) in 1(st) and 2(nd) time received a standard urodynamic investigation. The investigations of the remaining patients were postponed until the urinary tract infection had been treated. RESULTS: The prevalence of urinary tract infection before urodynamic investigation (with positive results in 1(st) and 2(nd) urine test) was 7.3%, and the prevalence after the investigation in patients without UTI before examination was 10.3%. Bladder outlet obstruction (BOO), age ≥ 65 years, and diabetes were the risk factors for UTI after urodynamic investigation. The most common uropathogens in the urinary tract infections after the urodynamic investigation were Escherichia coli (53.1%, 34/64) and Enterococcus faecalis (17.2%, 11/64). CONCLUSION: Despite a stringent standard operation protocol, the prevalence of UTI in male patients caused by urodynamic examination is about 10%. For the high-risk patients with BOO, older age, and diabetes, prophylactic antibiotic treatment before or after procedure may be necessary.

[Clinical analysis of renal cell carcinoma with brain metastases (report of 10 cases)].

OBJECTIVE: To investigate the optimal treatment and prognostic factors of renal cell carcinoma with brain metastases (RCCBM) by the analysis of clinical features. METHODS: The clinical data of 10 patients with RCCBM in our hospital from Jul. 2003 to Aug. 2011 were analyzed retrospectively. The age range of the patients was 48-80 years, and the mean age was 64 years old. Nine patients were male and one patient was female. Six patients had neurological symptoms. Brain metastasis and kidney cancer were found in the same period in 7 patients. Two patients had brain metastases alone, and 8 patients had metastasis in brain and other parts. There were 4 patients had more than 3 brain metastatic foci. Brain metastatic foci located in: frontal lobe in 6 patients, parietal lobe in 2 patients, occipital lobe in 2 patients, cerebellum in 2 patients, temporal lobe in 1 patient, thalamus and basal ganglia in 1 patient. RESULTS: The overall survival (OS) of 10 patients with RCCBM was 0.8 to 62.6 months, with an average OS of 12.7 months. Two patients refused therapy and those average OS is only 1.4 months. Three patients were performed stereotactic radiotherapy (SRS). The tumor volume of 1 patient reduced >25% and 2 patients showed no progression in magnetic resonance images at 2-months after SRS. Two patients accepted sorafenib treatment and the average OS was 16.7 months. Patients with 3 or more brain metastases had an average OS of 1.9 months, and the average OS of those with less than 3 brain metastases was 20 months. Patients with synchronous or metachronous brain metastases of renal cell carcinoma had an average OS of 6.8 or 26.5 months, respectively. Patients with or without neurological symptoms had an average OS of 17.9 or 4.9 months, respectively. CONCLUSIONS: For RCCBM patients, SRS could effectively control the local brain metastases while sorafenib could extend the overall survival. With 3 or more metastases, synchronous brain metastases and no neurological symptoms were the adverse prognostic factors of RCCBM.

[Diagnosis and treatment of adrenal medullary hyperplasia].

OBJECTIVE: To explore the clinical characters of adrenal medullary hyperplasia (AMH). METHODS: The clinical data of 7 cases of AMH admitted from 1996 to 2013 were analyzed with a review of literature. RESULTS: There were 3 males and 4 females with a median age of 36 (23-69) years. All had hypertension at first diagnosis and 2 were paroxysmal. Computed tomography (CT) scan revealed unilateral adrenal nodule in all cases, including left (n = 5) and right (n = 2) side. The diameter of nodules was 0.9 cm to 3.0 cm.Hypokalemia was found in 2 cases. And 24-hour output of urine catecholamine was higher than normal level in 2 cases. An abnormal rise of 24-hour output of urine free cortisol was found in 1 case with a lower level of adrenocorticotropic hormone (ACTH) simultaneously while a lower level of plasma renin activity in vertical position was found in another case. Three patients received (131)I-meta-iodobenzylguanidine scan and one had positive result. Pre-operative diagnosis included pheochromocytoma (n = 2), adrenocortical adenoma (n = 3) (2 aldosterone-producing adenomas, 1 Cushing adenoma) and undetermined adrenal tumor (n = 2). All underwent surgery, including unilateral adrenalectomy (n = 4) and resection of adrenal disease (n = 3). All cases had a pathologic diagnosis of AMH. One had concurrent Cushing adenoma while another with cortical hyperplasia.One case achieved normotension postoperatively while others showed varying decreases of blood pressure, but remained hypertensive. CONCLUSION: With a common feature of hypertension, AMH is difficult to diagnose preoperatively. CT scan has a certain diagnostic significance and a definite diagnosis depends on pathological examination; because of inaccurate preoperative and intraoperative diagnosis, the extent of surgery may be incomplete and results in unsatisfied outcomes.

[Clinical analyses of bilateral renal angiomyolipomas associated with tuberous sclerosis complex].

OBJECTIVE: To explore the clinical characteristics, diagnosis, treatment and outcomes of renal angiomyolipoma (RAML) associated with tuberous sclerosis complex (TSC). METHODS: The clinical data were analyzed for 10 cases of renal angiomyolipomas associated with tuberous sclerosis. There were 4 males and 6 females with a mean age of 23.5 (9-44) years.Five patients were admitted for flank pain or hematuria.RAML was found by TSC associated imaging examinations for those with extra renal organ involvement. RESULTS: Bilateral multiple renal angiomyolipomas were all confirmed on imaging tests and consistent with clinical TSC. The maximal diameter of RAMLs was from 2 to 15(7.3 ± 3.5) cm.Six patients of tumor hemorrhage had an average maximal diameter of 9.2 cm.Selective arterial embolization (SAE) (n = 4) and homeostasis, anti inflammation and immobilization therapy (n = 2) were performed.Four asymptomatic cases accepted close observation. During a follow-up period of 9-116 months, one of 4 SAE cases underwent secondary SAE due to rebleeding 12 months later while there was no recurrence of flank pain in other 3 cases. The mean enlargement of maximal diameter was 1.5 cm/year and serum creatinine elevated by 3.1 µmol/L/year.Six cases on conservative medical therapy or under observation had a mean enlargement of maximal diameter of 0.7 cm/year and serum creatinine elevated by 2.2 µmol/L/year. Three cases remained asymptomatic, one died of respiratory failure from TSC-associated pulmonary lymphangioleiomyomatosis, two had flank pain at 16 and 40 months respectively, one underwent secondary SAE and another received rapamycin with marked tumor regression. CONCLUSIONS: Bilateral multiple RAMLs occur in most TSC patients. After excluding malignancy, SAE becomes an important choice for its mini-invasiveness, efficacy and chances of re-embolization. And rapamycin provides ameliorative treatment for TSC patients.

Ultra-efficient delivery of CRISPR/Cas9 using ionic liquid conjugated polymers for genome editing-based tumor therapy.

Emerging CRISPR-Cas9 systems can rebuild DNA sequences in the genome in a spatiotemporal manner, offering a magic tool for biological research, drug discovery, and gene therapy. However, low delivery efficiency remains a major roadblock hampering the wide application of CRISPR-Cas9 gene editing talent. Herein, ionic liquid-conjugated polymers (IL-CPs) are explored as efficient platforms for CRISPR-Cas9 plasmid delivery and in vivo genome editing-based tumor therapy. Via molecular screening of IL-CPs, IL-CPs integrated with fluorination monomers (PBF) can encapsulate plasmids into hybrid nanoparticles and achieve over 90% delivery efficiency in various cells regardless of serum interference. In vitro and in vivo experiments demonstrate that PBF can mediate Cas9/PLK1 plasmids for intracellular delivery and therapeutic genome editing in tumor, achieving efficient tumor suppression. This work provides a new tool for safe and efficient CRISPR-Cas9 delivery and therapeutic genome editing, thus opening a new avenue for the development of ionic liquid polymeric vectors for genome editing and therapy.

Investigating the efficacy and mechanisms of Jinfu'an decoction in treating non-small cell lung cancer using network pharmacology and in vitro and in vivo experiments.

ETHNOPHARMACOLOGICAL RELEVANCE: Jinfu'an Decoction (JFAD) is a traditional Chinese decoction used in lung cancer treatment to improve patient quality of life and survival. Previous research has established that JFAD has a significant therapeutic effect on non-small cell lung cancer (NSCLC), although the underlying molecular mechanisms have not been largely underexplored. AIM OF THE STUDY: We used network pharmacology to identify the putative active ingredients of JFAD and conducted experimental studies to determine the potential molecular mechanism of JFAD in NSCLC treatment. MATERIALS AND METHODS: The herbal components in JFAD-containing serum were identified by ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS), and targets associated with the anti-lung cancer metastasis effects of JFAD were retrieved from various databases. The Database for Annotation, Visualization and Integrated Discovery (DAVID) was used to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Next, the protein-protein interactions network and the "JFAD-Chemical Component-Target-KEGG Pathway" network were constructed. The network pharmacology findings were confirmed by in vitro and in vivo experiments. In vitro experiments were conducted to assess cell viability by CCK8 assay, cell cycle analysis by propidium iodide (PI) assay, and migration and invasion ability of cells by the transwell assay. In vivo experiments were performed to assess the efficacy of JFAD on the tumor by observing the growth of transplanted tumor models in nude mice and evaluated by in vivo bioluminescence imaging. Moreover, we assessed the effect of JFAD on the PI3K/Akt signaling pathway and proteins of Lumican, p120ctn, and specific RhoGTP enzyme family members (RhoA, Rac1, and RhoC) by Western Blot and immunohistochemistry. RESULTS: 32 herbal components were identified in the JFAD-containing serum, which potentially acted on 229 targets related to lung cancer metastasis. Network pharmacology results suggested that JFAD may treat lung cancer metastasis by targeting the PI3K/Akt pathway via regulating multiple core targets. Our experiments showed that JFAD suppressed the proliferation of A549 cells in vitro, induced cell cycle arrest, and reduced the migration and invasion ability of A549 cells. Our in vivo study revealed that JFAD inhibited tumor growth in a nude mouse model. Additionally, we found that JFAD could downregulate the expression of the PI3K/Akt pathway and affect the expression of Lumican, p120ctn, and specific RhoGTPase family members. CONCLUSIONS: In conclusion, through network pharmacology, we have unveiled the underlying mechanisms that link the various components, targets, and pathways influenced by JFAD in the context of lung cancer metastasis. Our experimental results suggest that the oncostatic effects of JFAD may be achieved by upregulating the expression of Lumican/p120ctn and downregulating the levels of specific RhoGTPase family members, which in turn block the PI3K/Akt signaling pathway.