Exosome-based delivery strategies for tumor therapy: an update on modification, loading, and clinical application.

Malignancy is a major public health problem and among the leading lethal diseases worldwide. Although the current tumor treatment methods have therapeutic effect to a certain extent, they still have some shortcomings such as poor water solubility, short half-life, local and systemic toxicity. Therefore, how to deliver therapeutic agent so as to realize safe and effective anti-tumor therapy become a problem urgently to be solved in this field. As a medium of information exchange and material transport between cells, exosomes are considered to be a promising drug delivery carrier due to their nano-size, good biocompatibility, natural targeting, and easy modification. In this review, we summarize recent advances in the isolation, identification, drug loading, and modification of exosomes as drug carriers for tumor therapy alongside their application in tumor therapy. Basic knowledge of exosomes, such as their biogenesis, sources, and characterization methods, is also introduced herein. In addition, challenges related to the use of exosomes as drug delivery vehicles are discussed, along with future trends. This review provides a scientific basis for the application of exosome delivery systems in oncological therapy.

Time-Dependent Factors Influencing Cardiocerebral Vascular Events in Chronic Hemodialysis Patients: Insights from a Longitudinal Study.

BACKGROUND Cardiocerebral vascular events (CVCs) are significant complications in patients undergoing hemodialysis (HD). Given the increased morbidity and mortality associated with CVCs in this population, understanding the factors influencing CVC occurrence over time is crucial. This study aimed to investigate these time-dependent factors in HD patients. MATERIAL AND METHODS A total of 228 HD patients from 2 dialysis centers, with at least 3 months of treatment between 2017 and 2021, were included. Annual clinical data were collected, and patients were monitored until CVC development. Kaplan-Meier analysis and a time-dependent Cox regression model were used for data analysis. RESULTS The mean age of 228 patients was 55.0±15.0 years, and 64.76% were male. For 5 years of monitoring, the mean follow-up interval was 3.1±1.0 years for patients to develop CVCs. The 1-year, 3-year, and 5-year CVC-free rates were 97.47%, 81.31%, and 70.71%, respectively. Time-dependent Cox regression revealed that C-reactive protein was an independent time-dependent risk factor in HD patients and blood flow rate was an independent time-dependent protective factor. The male subgroup and non-diabetic subgroup had these same results. The following were was the independent time-dependent risk factors: white blood cell count for the female subgroup; blood flow rate for the non-elderly subgroup; and C-reactive protein for the diabetic subgroup. None were risk factors for the elderly subgroup. CONCLUSIONS It took an average of 3.1±1.0 years for patients with HD to develop CVCs. C-reactive protein and blood flow rate emerged as key time-dependent influencing factors for CVCs in this population.

[Preliminary Study on Drug-Loaded Chondroitin Sulfate-Modified Micelles Targeting Golgi Apparatus in Tumor Cells for the Treatment of Tumor Metastasis].

Objective: To make preliminary exploration into the Golgi apparatus targeting of chondroitin sulfate-modified micelles (CSmicelles) co-loaded with pirarubicin (THP) and vinorelbine (VRL) in tumor cells, as well as their in vitro anti-tumor metastasis effect. Methods: The cellular uptake efficiency and internalization mechanism of CSmicelles in 4T1 mouse breast cancer cell line were investigated by flow cytometry. Preliminary study of the Golgi apparatus targeting CSmicelles in tumor cells was conducted by co-localization experiment. Then, the effect of CSmicelles co-loaded with THP and VRL (THP+VTL-CSmicelles) on the structure of Golgi apparatus was investigated by GM130 immunofluorescence experiment. Finally, the i n vitro anti-tumor metastasis ability of THP+VTL-CSmicelles was evaluated by wound healing assay and Transwell migration/invasion assay. Results: It was found that CSmicelles could significantly increase cellular uptake of drugs. CSmicelles were internalized into cells through clathrin-mediated and caveolin-mediated endocytosis, which was energy-dependent active transport and exhibited substantial ability of targeting Golgi apparatus in tumor cells. THP+VTL-CSmicelles could break down the structure of Golgi apparatus and significantly inhibit the migration and invasion of tumor cells. Conclusion: THP+VTL-CSmicelles demonstrate high affinity towards Golgi apparatus in tumor cells, exert targeted effects and inhibit tumor cell metastasis, which provides a novel idea and method for the treatment of cancer metastasis.

Cochlear implantation in prelingually deafened patients: Evaluation in hearing, speech ability, and quality of life. / äººå·¥è€³èœ—æ¤å ¥æœ¯æé«˜è¯­å‰è‹æ‚£è€ å¬è§‰è¨€è¯­èƒ½åŠ›åŠç”Ÿæ´»è´¨é‡.

OBJECTIVES: The main purpose of cochlear implantation for prelingual deafness is to restore the deaf children's auditory function, obtain normal speech development, learning and social ability, and improve the quality of life. Previous studies mostly focused on the improvement of simple hearing or speech ability. This study aims to evaluate the changes of hearing and speech ability and family life quality of patients after cochlear implantation, and to explore the effect of cochlear implantation on hearing and speech rehabilitation of patients. METHODS: In February 2021, using the convenient sampling method, 171 patients who have completed cochlear implantation were selected from the database of cochlear implantation follow-up center of a class III Tertiary hospital in Hunan Province. Questionnaires were used to investigate the patients' parents, which were Categories of Auditory Performance (CAP), Speech/Spatial and Qualities of Hearing Scale-Parents' Version (SSQ-P), and Children using Hearing Implants Quality of Life (CuHI-QoL). T-test and analysis of variance were used to explore the postoperative auditory and speech ability of patients at different ages in different periods (<2.5-year group, 2.5-4.5-year group and >4.5-year group), and Pearson correlation analysis was used to explore the correlation. Multiple linear regression was used to explore the relationship between the dimension of patients' quality of life and the scores of scale for evaluating auditory ability (CAP, speech perception, spatial hearing, and other hearing characteristics). RESULTS: The values of CAP and SSQ-P in the <2.5-year group were lower than those in the 2.5-4.5-year and >4.5-year groups (all P<0.05). Pearson correlation analysis showed that postoperative years and CuHI-QoL scores (parental expectations and patients' quality of life) were positively correlated with score of CAP, SSQ-P and its dimension, respectively (all P<0.05). The results of multiple linear regression analysis showed the CAP scores and speech perception were the influencing factors for the quality of life (R2=0.170, P<0.01). CONCLUSIONS: Two and a half years after operation is the rapid growth period of patients' hearing and language ability, and the growth rate becomes slow after stabilization. With the extension of postoperative years, the patients' hearing and speech ability becomes stronger, and the quality of life is better.

MicroRNA-342-5p protects against myocardial ischemia-reperfusion injury by targeting the GPRC5A pathway.

Myocardial ischemia/reperfusion (MI/R) injury usually occurs in patients with cardiovascular disease. However, myocardial reperfusion insult often induces apoptosis. It is assumed that that microRNAs (miRNAs) are involved in the pathological and physiological processes associated with myocardial ischemia/reperfusion (MI/R). In the present study, we found decreased expression of miR-342-5p in hypoxia/reoxygenation (H/R) cardiomyocyte model (H9C2 cells) and MI/R mouse model. Alternatively, overexpression of miR-342-5p was found to ameliorate myocardial cell damage in both in vivo and in vitro. In addition, G protein-coupled receptor, family C, group 5, member A (GPRC5A) was identified as a direct target of miR-342-5p. The up-regulation of GPRC5A functioned to inhibit the previously observed protective effect of miR-342-5p in the H9C2 H/R model. Our results revealed that miR-342-5p may be a potential target for MI/R injury prevention and therapy of MI/R injury.

Direct diabatization and analytic representation of coupled potential energy surfaces and couplings for the reactive quenching of the excited 2Σ+ state of OH by molecular hydrogen.

We have employed extended multiconfiguration quasidegenerate perturbation theory, fourfold-way diabatic molecular orbitals, and configurational uniformity to develop a global three-state diabatic representation of the potential energy surfaces and their couplings for the electronically nonadiabatic reaction OH* + H2 → H2O + H, where * denotes electronic excitation to the A 2Σ+ state. To achieve sign consistency of the computed diabatic couplings, we developed a graphics processing unit-accelerated algorithm called the cluster-growing algorithm. Having obtained consistent signs of the diabatic couplings, we fit the diabatic matrix elements (which consist of the diabatic potentials and the diabatic couplings) to analytic representations. Adiabatic potential energy surfaces are generated by diagonalizing the 3 × 3 diabatic potential energy matrix. The comparisons between the fitted and computed diabatic matrix elements and between the originally computed adiabatic potential energy surfaces and those generated from the fits indicate that the current fit is accurate enough for dynamical studies, and it may be used for quantal or semiclassical dynamics calculations.

Full-dimensional ground- and excited-state potential energy surfaces and state couplings for photodissociation of thioanisole.

Analytic potential energy surfaces (PESs) and state couplings of the ground and two lowest singlet excited states of thioanisole (C6H5SCH3) are constructed in a diabatic representation based on electronic structure calculations including dynamic correlation. They cover all 42 internal degrees of freedom and a wide range of geometries including the Franck-Condon region and the reaction valley along the breaking S-CH3 bond with the full ranges of the torsion angles. The parameters in the PESs and couplings are fitted to the results of smooth diabatic electronic structure calculations including dynamic electron correlation by the extended multi-configurational quasi-degenerate perturbation theory method for the adiabatic state energies followed by diabatization by the fourfold way. The fit is accomplished by the anchor points reactive potential method with two reactive coordinates and 40 nonreactive degrees of freedom, where the anchor-point force fields are obtained with a locally modified version of the QuickFF package. The PESs and couplings are suitable for study of the topography of the trilayer potential energy landscape and for electronically nonadiabatic molecular dynamics simulations of the photodissociation of the S-CH3 bond.

Full-dimensional multi-state simulation of the photodissociation of thioanisole.

The photodissociation of thioanisole is very interesting because the experiments of Lim and Kim provide evidence for mode-specific effects on the product distribution. They showed that, with a specific S-CH3 stretching mode being excited as the reagent is excited to the S1 electronic state, there is a sharp increase in the proportion of the ground-state product to the excited-state product. In the present work, we report 78 011 full-dimensional semiclassical multi-state trajectories of the photodissociation process using the coherent switching with decay of mixing dynamics method. The potential surfaces and couplings are based on electronic structure calculations that include dynamic correlation through second order perturbation theory. We report results for four sets of initial conditions, one corresponding roughly to 0-0 excitation and three corresponding to exciting one vibrational mode, to look for mode-specific effects. The simulations show no significant mode-specific effect on the product energy distributions, but they do show an effect on the distribution of minimum-energy gaps in the trajectories and on the lifetime for dissociation. In particular, excitation of the S-CH3 stretching mode leads to trajectories passing closer to the S1-S2 conical intersection and to shorter lifetimes. This provides a possible explanation of why experimental results are different for excitation of this vibration.

Perspective: Kohn-Sham density functional theory descending a staircase.

This article presents a perspective on Kohn-Sham density functional theory (KS-DFT) for electronic structure calculations in chemical physics. This theory is in widespread use for applications to both molecules and solids. We pay special attention to several aspects where there are both concerns and progress toward solutions. These include: 1. The treatment of open-shell and inherently multiconfigurational systems (the latter are often called multireference systems and are variously classified as having strong correlation, near-degeneracy correlation, or high static correlation; KS-DFT must treat these systems with broken-symmetry determinants). 2. The treatment of noncovalent interactions. 3. The choice between developing new functionals by parametrization, by theoretical constraints, or by a combination. 4. The ingredients of the exchange-correlation functionals used by KS-DFT, including spin densities, the magnitudes of their gradients, spin-specific kinetic energy densities, nonlocal exchange (Hartree-Fock exchange), nonlocal correlation, and subshell-dependent corrections (DFT+U). 5. The quest for a universal functional, where we summarize some of the success of the latest Minnesota functionals, namely MN15-L and MN15, which were obtained by optimization against diverse databases. 6. Time-dependent density functional theory, which is an extension of DFT to treat time-dependent problems and excited states. The review is a snapshot of a rapidly moving field, and-like Marcel Duchamp-we hope to convey progress in a stimulating way.

Computational simulation and interpretation of the low-lying excited electronic states and electronic spectrum of thioanisole.

Three singlet states, namely a closed-shell ground state and two excited states with (1)ππ* and (1)nσ* character, have been suggested to be responsible for the radiationless decay or photochemical reaction of photoexcited thioanisole. The correct interpretation of the electronic spectrum is critical for understanding the character of these low-lying excited states, but the experimental spectrum is yet to be fully interpreted. In the work reported here, we investigated the nature of those three states and a fourth singlet state of thioanisole using electronic structure calculations by multireference perturbation theory, by completely-renormalized equation-of-motion coupled cluster theory with single and double excitations and noniterative inclusion of connected triples (CR-EOM-CCSD(T)), and by linear-response time-dependent density functional theory (TDDFT). We clarified the assignment of the electronic spectrum by simulating it using a normal-mode sampling approach combined with TDDFT in the Tamm-Dancoff approximation (TDA). The understanding of the electronic states and of the accuracy of the electronic structure methods lays the foundation of our future work of constructing potential energy surfaces.

Model space diabatization for quantum photochemistry.

Diabatization is a procedure that transforms multiple adiabatic electronic states to a new representation in which the potential energy surfaces and the couplings between states due to the electronic Hamiltonian operator are smooth, and the couplings due to nuclear momentum are negligible. In this work, we propose a simple and general diabatization strategy, called model space diabatization, that is applicable to multi-configuration quasidegenerate perturbation theory (MC-QDPT) or its extended version (XMC-QDPT). An advantage over previous diabatization schemes is that dynamical correlation calculations are based on standard post-multi-configurational self-consistent field (MCSCF) multi-state methods even though the diabatization is based on state-averaged MCSCF results. The strategy is illustrated here by applications to LiH, LiF, and thioanisole, with the fourfold-way diabatization and XMC-QDPT, and the results illustrate its validity.

Testing time-dependent density functional theory with depopulated molecular orbitals for predicting electronic excitation energies of valence, Rydberg, and charge-transfer states and potential energies near a conical intersection.

Kohn-Sham (KS) time-dependent density functional theory (TDDFT) with most exchange-correlation functionals is well known to systematically underestimate the excitation energies of Rydberg and charge-transfer excited states of atomic and molecular systems. To improve the description of Rydberg states within the KS TDDFT framework, Gaiduk et al. [Phys. Rev. Lett. 108, 253005 (2012)] proposed a scheme that may be called HOMO depopulation. In this study, we tested this scheme on an extensive dataset of valence and Rydberg excitation energies of various atoms, ions, and molecules. It is also tested on a charge-transfer excitation of NH3-F2 and on the potential energy curves of NH3 near a conical intersection. We found that the method can indeed significantly improve the accuracy of predicted Rydberg excitation energies while preserving reasonable accuracy for valence excitation energies. However, it does not appear to improve the description of charge-transfer excitations that are severely underestimated by standard KS TDDFT with conventional exchange-correlation functionals, nor does it perform appreciably better than standard TDDFT for the calculation of potential energy surfaces.

Current state of research on exercise for the treatment of myasthenia gravis: A scoping review.

OBJECTIVE: To provide a comprehensive overview of existing evidence, research gaps, and future research priorities concerning the treatment of myasthenia gravis (MG) using exercise therapies. METHOD: Clinical studies on exercise treatment for MG were searched in nine databases to conduct a scoping review. Two independent researchers screened the literature and comprehensively analyzed the characteristics and limitations of the included articles. RESULTS: A total of 5725 studies were retrieved, of which 24 were included. The included studies were conducted in 16 different countries/regions and 456 patients were enrolled. Study designs included both interventional and observational studies. Exercise interventions included aerobic exercise, resistance exercise, balance training, and stretch training, and are typically administered in conjunction with medication, usual care, or some other interventions. The intensity, frequency, and duration of exercise interventions varied hugely among studies. Six-minute walk test, adverse events, muscle strength, MG quality of life-15 scale, forced vital capacity, quantitative MG scale, and MG activities of daily living scale were the most frequently used outcomes. All studies reported results in favor of the efficacy and safety of exercise in MG, and exercise-related adverse events were reported in two studies. CONCLUSION: This scoping review provides an overview of the evidence concerning exercise treatment for MG. Key gaps in evidence include a limited number of participants, complex interventions, variability in outcome selection, and insufficient reporting in publications. The promotion of exercise treatment for MG still encounters several obstacles. A larger population, rigorous study design and conduction, standardized interventions and outcomes, and standardized reporting are essential.

Mapping current trends and hotspots in myasthenia gravis from 2003 to 2022: a bibliometric analysis.

Introduction: Research on myasthenia gravis (MG) has undergone rapid development in recent years. This article aimed to elucidate the characteristics of MG publications over the past 20 years and analyze emerging trends using bibliometric methods. Methods: Information on MG articles was obtained from the Web of Science Core Collection and stored in Excel for quantitative analyses. Bibliometric analyses were performed using CiteSpace and VOSviewer to visualize publications according to countries/regions, institutions, journals, and authors. Results: A total of 3,610 publications were included in the analysis. The USA had the highest number of publications (NP) and H-index. Among the institutions, the University of Oxford had the highest NP, followed by the University of Toronto and Duke University. Close cooperation was observed among countries and institutions. The most productive author was Renato Mantegazza, followed by Jan J. Verschuuren, and Amelia Evoli. Muscle & Nerve published the most articles on MG, followed by the Journal of Neuroimmunology and Neuromuscular Disorders. The keyword with the highest strength is "neuromuscular transmission," followed by "safety" and "rituximab." Co-citation analysis includes 103 publications cited at least 65 times, categorized into four clusters. Additionally, 123 keywords cited more than 40 times were analyzed and divided into five clusters. Conclusion: This bibliometric analysis shows the framework of research over the past 20 years by mapping the scholarly contributions of various countries or regions, institutions, journals, and authors in MG. The analysis also explores future trends and prospective directions, emphasizing individualized treatment based on subtypes, novel immunotherapeutic approaches, and thymectomy.

Near-field for electrodynamics at sub-wavelength scales: generalizing to an arbitrary number of dielectrics.

We extend the recently developed near-field (NF) method to include an arbitrary number of dielectrics. NF assumes that the dipoles and fields respond instantaneously to the density, without retardation. The central task in NF is the solution of the Poisson equation for every time step, which is here done by a conjugate gradient method which handles any dielectric distribution. The optical response of any metal-dielectric system can now be studied very efficiently in the near field region. The improved NF method is first applied to simple benchmark systems: a gold nanoparticle in vacuum and embedded in silica. The surface plasmons in these systems and their dependence on the dielectrics are reproduced in the new NF approach. As a further application, we study a silver nanoparticle-based structure for the optical detection of a "lipid" (i.e., dielectric) layer in water, where the layer is wrapping around part of the metallic nanostructure. We show the ~0.1-0.15 eV shift in the spectrum due to the presence of the layer, for both spherical and non-spherical (sphere+rod) systems with various polarizations.

[Study on quality evaluation of Angelica sinensis by grey incidence degree method].

OBJECTIVE: To evaluate the quality of Angelica sinensis based on Grey incidence degree method. METHODS: Grey model was set up by determining four main compositions contained in the samples. RESULTS: The result of quality evaluation on 21 samples by this model was as same as that of genuine medicinal materials. CONCLUSION: Grey incidence degree method and the model can be used to evaluate the quality of Angelica sinensis.

Current state of research on acupuncture for the treatment of amyotrophic lateral sclerosis: A scoping review.

Objective: To provide an overview of the range and characteristics of existing evidence, research gaps, and future research priorities in treating amyotrophic lateral sclerosis (ALS) with acupuncture. Method: Clinical studies on acupuncture treatment for ALS were searched in 9 databases and two websites. Two independent researchers screened the literature according to the inclusion and exclusion criteria; extracted the demographic data, interventions, and significant findings of the studies; and comprehensively analyzed the characteristics and limitations of the included articles. Results: A total of 2,326 studies were retrieved, of which 92 were included. Most of the studies were conducted in China, with the number increasing over time. Study designs included case reports, case series, randomized controlled trials (RCTs), and before-and-after studies, among which case reports were the most frequently used. A total of 1,388 patients were enrolled, of whom 1,031 had ALS, 274 had progressive bulbar palsy (PBP), 60 had progressive muscle atrophy (PMA), and 23 had primary lateral sclerosis (PLS). Acupuncture interventions included body acupuncture, electroacupuncture, acupoint injection, scalp acupuncture, acupoint massage, Sa-am acupuncture, needle-embedding therapy, auricular acupuncture, venom pharmacopuncture therapy, plum blossom needling, acupoint paste, electroacupuncture, and needle warming through moxibustion. The most frequently used acupoints were ST36, LI4, SP6, and LI11. Acupuncture is often applied in combination with other treatments, such as herbal or Western medicine. The frequency of treatment ranged from once a month to three times a day, and the duration of treatment ranged from 5 days to 3 years. Clinical symptoms, muscle strength, and effective rates were the most frequently used outcomes. Most studies reported significant efficacy, and only a few studies reported adverse events explicitly. Conclusion: Evidence gaps include poor study design, complex interventions, limited significance of the selected outcomes, and limited study reporting. The promotion of acupuncture treatment for ALS still faces several obstacles. Rigorous study design and conduct, standardized intervention and outcome measurements, and normative reporting are needed to investigate the efficacy and safety of acupuncture treatment for ALS.

Herbal medicine and acupuncture relieved progressive bulbar palsy for more than 3 years: A case report.

RATIONALE: Progressive bulbar palsy (PBP) is a type of motor neuron disease (MND). The main symptoms include dysarthria, dysphagia, tongue muscle atrophy and fasciculations. This disease is generally severe and develops rapidly. Due to the lack of effective treatment, many patients with MND in China turn to traditional Chinese medicine treatment for help. We successfully relieved dysphagia and sialorrhea in a patient with PBP for 3 years with herbal medicine and acupuncture. PATIENT CONCERNS: The patient was a 68-years-old woman with PBP and suffered from severe dysphagia and sialorrhea. DIAGNOSES: Progressive bulbar palsy. INTERVENTIONS: Chinese herbal medicine and acupuncture. OUTCOMES: After 4 months of herbal medicine and acupuncture treatment, dysphagia and sialorrhea were relieved considerably. The patient's condition has been stable for more than 3 years and continues to be treated with Chinese herbal medicine and acupuncture. LESSONS: Our case suggests that alternative therapies such as herbal medicine and acupuncture may be effective in alleviating the symptoms of MND/PBP. However, standardized clinical studies are still required to verify the effectiveness and safety.

The safety of COVID-19 vaccines in patients with myasthenia gravis: A scoping review.

Background: COVID-19 vaccines are required for individuals with myasthenia gravis (MG), as these patients are more likely to experience severe pneumonia, myasthenia crises, and higher mortality rate. However, direct data on the safety of COVID-19 vaccines in patients with MG are lacking, which results in hesitation in vaccination. This scoping was conducted to collect and summarize the existing evidence on this issue. Methods: PubMed, Cochrane Library, and Web of Science were searched for studies using inclusion and exclusion criteria. Article titles, authors, study designs, demographics of patients, vaccination information, adverse events (AEs), significant findings, and conclusions of included studies were recorded and summarized. Results: Twenty-nine studies conducted in 16 different countries in 2021 and 2022 were included. Study designs included case report, case series, cohort study, cross-sectional study, survey-based study, chart review, and systemic review. A total of 1347 patients were included. The vaccines used included BNT162b2, mRNA-1273, ChAdOx1 nCoV-19, inactivated vaccines, and recombinant subunit vaccines. Fifteen case studies included 48 patients reported that 23 experienced new-onset, and five patients experienced flare of symptoms. Eleven other types of studies included 1299 patients reported that nine patients experienced new-onset, and 60 participants experienced flare of symptoms. Common AEs included local pain, fatigue, asthenia, cephalalgia, fever, and myalgia. Most patients responded well to treatment without severe sequelae. Evidence gaps include limited strength of study designs, type and dose of vaccines varied, inconsistent window of risk and exacerbation criteria, limited number of participants, and lack of efficacy evaluation. Conclusion: COVID-19 vaccines may cause new-onset or worsening of MG in a small proportion of population. Large-scale, multicenter, prospective, and rigorous studies are required to verify their safety.