The Convergence of Sonodynamic Therapy and Cuproptosis in the Dual-Responsive Biomimetic CytoNano for Precision Mitochondrial Intervention in Cancer Treatment.

The integration of sonodynamic therapy (SDT) with cuproptosis for targeted cancer treatment epitomizes a significant advancement in oncology. Herein, we present a dual-responsive therapeutic system, "CytoNano", which combines a cationic liposome infused with copper-nitride nanoparticles and oxygen-rich perfluorocarbon (Lip@Cu3N/PFC-O2), all enveloped in a biomimetic coating of neutrophil membrane and acid-responsive carboxymethylcellulose. CytoNano leverages the cellular mimicry of neutrophils and acid-responsive materials, enabling precise targeting of tumors and their acidic microenvironment. This strategic design facilitates the targeted release of Lip@Cu3N/PFC-O2 within the tumor, enhancing cancer cell uptake and mitochondrial localization. Consequently, it amplifies the therapeutic efficacy of both Cu3N-driven SDT and cuproptosis while preserving healthy tissues. Additionally, CytoNano's ultrasound responsiveness enhances intratumoral oxygenation, overcoming physiological barriers and initiating a combined sonodynamic-cuproptotic effect that induces multiple cell death pathways. Thus, we pioneer a biomimetic approach in precise sonodynamic cuproptosis, revolutionizing cancer therapy.

Efficacy and safety of thermal ablation modalities for the treatment of papillary thyroid microcarcinoma: Systematic Review and network meta-analysis.

Background: Thermal ablation (TA) modalities such as radiofrequency ablation (RFA), microwave ablation (MWA), and laser ablation (LA) have been widely used in the treatment of papillary thyroid microcarcinoma (PTMC) patients. Based on previous small-sample meta-analyses, this network meta was designed to further compare the efficacy and safety of these thermal ablation methods in PTMC patients. Methods: China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Embase, and the Cochrane Library databases were searched to retrieve relevant studies published before May 2022. The efficacy outcomes was recurrence and lymph node metastasis (LNM), the safety outcome included operation time, intra-operative blood loss, hospital stays and complications. The Newcastle-Ottawa Scale (NOS) was selected for the risk of bias assessment. Stata 14.0 was used for statistical analysis. Results: Twenty-nine articles were included. Based on as least 6 months follow up, our analysis discovered no significant statistical differences in all efficacy and safety outcomes between MWA, RFA, and LA groups. Moreover, three TA treatments all produced significant least operation time, hospital stays, and complications than surgery group. Additionally, our study found that RFA showed relatively less complications, LNM, operation time and intra-operative blood loss, compared with other TA treatments. MWA indicated the lowest probability of recurrence, LA showed the longest hospital stays. Conclusions: MWA, RFA, and LA are all effective treatment strategies for patients with PTMC, but could not completely replace conventional surgical treatment.

Estimation of left ventricular functions in patients with subclinical hypothyroidism: a meta-analysis.

Objective: To evaluate left ventricular (LV) function in patients with subclinical hypothyroidism (ScH) compared to healthy individuals and to provide clinical hints for practitioners. Methods: PubMed, Embase, Cochrane Library, and Web of Science were systematically searched in this meta-analysis. Studies evaluating LV function in ScH patients were included. Standardized mean difference (SMD) and the 95% confidence intervals (CIs) were calculated as effect size. Heterogeneity and risks of bias of included studies were assessed. Results: A total of 9 studies were identified as eligible. The SMD for fractional shortening (FS, %) was -0.21 (95% CI: -0.60, 0.17; z = -1.08, p = 0.2788). The pooled SMD for systemic vascular resistance (SVR, dynes/sec·cm-5) was -0.41 (95% CI: -1.31, 0.49; z = -0.89, p = 0.3744). The pooled SMD for early diastolic mitral flow velocity/late diastolic mitral flow velocity (E/A) ratio was -0.74 (95% CI: -1.09, -0.39; z = -4.13, p < 0.001). The pooled SMD for ejection fraction (EF, %) was -0.35 (95% CI: -0.59, -0.12; z = -2.95, p = 0.0032). Conclusion: ScH patients had significantly worse LV function parameters than healthy controls. These changes in LV function may be involved in the management of ScH.

Ultrasound-guided microwave, radiofrequency, and high intensity focused ultrasound (HIFU) ablation in treating uterine leiomyoma: A systemic review and meta-analysis of retrospective studies.

To retrospectively evaluate the efficacy and safety of ultrasound-guided microwave (MWA), radiofrequency (RF), and high-intensity focused ultrasound (HIFU) ablation in the treatment of uterine leiomyoma and to provide a suggestion for the selection of clinical treatment of uterine leiomyoma. The retrospective cohort studies on the efficacy of high-intensity focused ultrasound in treating uterine leiomyoma was collected through a literature search in Pubmed, Embase, Cochrane library, Scopus, and Web of Science, and selected according to the specified inclusion criteria and exclusion criteria. Evaluate the study quality, extract relevant data, and RevMan 5.4.1 was used to conduct this meta-analysis. Compared with HIFU therapy, the complete or partial ablation rate and recurrence rate of uterine leiomyoma treated with RFA/MWA were statistically different (P < 0.05). Compared with RF, the overall efficacy of HIFU in treating uterine leiomyoma was not as good as that of RF. There was no significant difference between the RFA therapy and the MWA. HIFU still has mild and short-term complications, such as abdominal pain, bloody vaginal discharge, sacral pain, and fever. Although myomectomy is usually the first choice for uterine preservation, RFA/MWA and HIFU have also been shown to relieve clinical symptoms significantly, shorten treatment time, reduce complications, and improve prognosis.

Investigating Changes in Cardiac Function and Structure of Left Ventricle by Speckle-Tracking Echocardiography in Patients With Hyperthyroidism and Graves' Disease.

Subclinical hyperthyroidism is a common thyroid dysfunction that can lead to cardiovascular complications. It is necessary to understand the treatment strategy in clinical practice. This study aimed to investigate the changes in cardiac function and left ventricular (LV) structure by speckle-tracking echocardiography in patients with hyperthyroidism and Graves' disease. PubMed, Medline, Cochrane Library, Embase, and SinoMed were searched for targeted articles, from inception till November 26, 2020, without any language restriction. All studies that evaluated changes in cardiac function and LV structure by speckle-tracking echocardiography in patients with hyperthyroidism and Graves' disease were screened. Included studies met the following inclusion criteria: (1) study population diagnosed with hyperthyroidism or Graves' disease; (2) patients without treatment and are undergoing speckle-tracking echocardiography; (3) necessary data could be extracted from original studies; (4) studies published in English or Chinese; and (5) if the study population was duplicated, only one study from the same institution that provided detailed information or newly published article was selected. All relevant articles from the above databases were screened and assessed according to the inclusion criteria by two reviews independently. Inverse variance methods with random-effects were employed to pool the mean differences (MDs) and the corresponding 95% confidence intervals (CIs). Ten studies with 483 patients and 434 healthy controls were included for data extraction and meta-analysis. On comparing patients with healthy controls, two-dimensional echocardiography revealed significant differences in several parameters including interventricular septal thickness (IVST) [mean difference (MD): 0.43, 95% CI = 0.12-0.73, P < 0.05] and left ventricular end systolic diameter (LVESD) (MD: 1.42, 95% CI = 0.33-2.52, P < 0.05). Moreover, there were significant differences in left ventricular ejection fraction (LVEF) (P < 0.05), global longitudinal strain (P < 0.05), and global circumferential strain (P < 0.05) demonstrated by three-dimensional echocardiography. These findings suggested that left ventricle (LV) function evaluated by speckle-tracking echocardiography showed significant impairment in patients with hyperthyroidism. However, additional original studies and meta-analyses are warranted for an in-depth investigation.

The use of glyburide in the management of gestational diabetes mellitus: a meta-analysis.

PURPOSE: Glyburide has been used for managing gestational diabetes mellitus (GDM) in a number of countries. It is rather inexpensive. However, its efficacy and safety remain controversial. With this meta-analysis, we evaluated glyburide in comparison with insulin. MATERIAL/METHODS: With a systematic literature search strategy, a total of 93 randomized controlled trials (RCTs) with insulin and glyburide comparison were identified. Based on the revised Consolidated Standards of Reporting Trials (CONSORT) checklist, five of them met the inclusion criteria and were included in this meta-analysis. RESULTS: Six hundred and seventy four subjects were included in these five RCTs. When compared with insulin, glyburide had an increased relative risk (RR) for neonatal hypoglycemia (RR: 1.98; 95% confidence interval [CI]: 1.17, 3.36). Estimation of standard mean differences (SMD) showed that both fetal birth weight and incidence of macrosomia were higher in subjects receiving glyburide than in those receiving insulin (SMD: 0.21; 95% CI: 0.06, 0.36; RR: 2.22; 95% CI: 1.07, 4.61 respectively). There were no significant differences in maternal glucose control, glycated hemoglobin, the rate of Cesarean section, large-for-gestational age, neonatal hypocalcemia, length of stay for neonatal ICU admissions, preterm birth, or congenital anomalies. CONCLUSIONS: Our study suggested that in women with GDM, glyburide is as effective as insulin, but the risks of neonatal hypoglycemia, high fetal birth weight, and macrosomia were higher.