Fabrication of lidocaine-loaded polymer dissolving microneedles for rapid and prolonged local anesthesia.

There is an urgent need for research into effective interventions for pain management to improve patients' life quality. Traditional needle and syringe injection were used to administer the local anesthesia. However, it causes various discomforts, ranging from brief stings to trypanophobia and denial of medical operations. In this study, a dissolving microneedles (MNs) system made of composite matrix materials of polyvinylpyrrolidone (PVP), polyvinyl alcohol (PVA), and sodium hyaluronate (HA) was successfully developed for the loading of lidocaine hydrochloride (LidH). The morphology, size and mechanical properties of the MNs were also investigated. After the insertion of MNs into the skin, the matrix at the tip of the MNs was swelled and dissolved by absorption of interstitial fluid, leading to a rapid release of loaded LidH from MNs' tips. And the LidH in the back patching was diffused into deeper skin tissue through microchannels created by MNs insertion, forming a prolonged anesthesia effect. In addition, the back patching of MNs could be acted as a drug reservoir to form a prolonged local anesthesia effect. The results showed that LidH MNs provided a superior analgesia up to 8 h, exhibiting a rapid and long-lasting analgesic effects. Additionally, tissue sectioning and in vitro cytotoxicity tests indicated that the MNs patch we developed had a favorable biosafety profile.

Red blood cell membrane-coated functionalized Cu-doped metal organic framework nanoformulations as a biomimetic platform for improved chemo-/chemodynamic/photothermal synergistic therapy.

Nanoformulations for combining chemotherapy, chemodynamic therapy, and photothermal therapy have enormous potential in tumor treatment. Coating nanoformulations with cell membranes endows them with homologous cellular mimicry, enabling nanoformulations to acquire new functions and properties, including homologous targeting and long circulation in vivo, and can enhance internalization by homologous cancer cells. Herein, we fused multifunctional biomimetic nanoformulations based on Cu-doped zeolitic imidazolate framework-8 (ZIF-8). Hydroxycamptothecin (HCPT), a clinical anti-tumor drug, was encapsulated into ZIF-8, which was subsequently coated with polydopamine (PDA) and red blood cell membrane. The as-fabricated biomimetic nanoformulations showed an enhanced cell uptake in vitro and the potential to prolong blood circulation in vivo, producing effective synergistic chemotherapy, chemodynamic therapy, and photothermal therapy under the 808 nm laser irradiation. Together, the biomimetic nanoformulations showed a prolonged blood circulation and evasion of immune recognition in vivo to provide a bio-inspired strategy which may have the potential for the multi-synergistic therapy of breast cancer.

Red Blood Cell Membrane-Camouflaged Polydopamine and Bioactive Glass Composite Nanoformulation for Combined Chemo/Chemodynamic/Photothermal Therapy.

Combinations of different therapeutic strategies, including chemotherapy (CT), chemodynamic therapy (CDT), and photothermal therapy (PTT), are needed to effectively address evolving drug resistance and the adverse effects of traditional cancer treatment. Herein, a camouflage composite nanoformulation (TCBG@PR), an antitumor agent (tubercidin, Tub) loaded into Cu-doped bioactive glasses (CBGs) and subsequently camouflaged by polydopamine (PDA), and red blood cell membranes (RBCm), was successfully constructed for targeted and synergetic antitumor therapies by combining CT of Tub, CDT of doped copper ions, and PTT of PDA. In addition, the TCBG@PRs composite nanoformulation was camouflaged with a red blood cell membrane (RBCm) to improve biocompatibility, longer blood retention times, and excellent cellular uptake properties. It integrated with long circulation and multimodal synergistic treatment (CT, CDT, and PTT) with the benefit of RBCms to avoid immune clearance for efficient targeted delivery to tumor locations, producing an "all-in-one" nanoplatform. In vivo results showed that the TCBG@PRs composite nanoformulation prolonged blood circulation and improved tumor accumulation. The combination of CT, CDT, and PTT therapies enhanced the antitumor therapeutic activity, and light-triggered drug release reduced systematic toxicity and increased synergistic antitumor effects.

Separable Microneedles for Synergistic Chemo-Photothermal Therapy against Superficial Skin Tumors.

It is extremely important to develop a minimally invasive and efficient approach for treatment of superficial skin tumors (SSTs). In this work, a near-infrared (NIR)-triggered transdermal therapeutic system based on two-stage separable microneedles (MNs) has been proposed for synergistic chemo-photothermal therapy against SSTs. Lauric acid and polycaprolactone as phase-change materials have been used to prepare the arrowheads of the two-stage separable MNs in which an anticancer drug (doxorubicin, DOX) and photothermal agent (indocyanine green, ICG) were embedded. The arrowheads are capped on the dissolvable support bases that consisted of poly(vinyl alcohol)/polyvinyl pyrrolidone (PVA/PVP). After inserting into skin tissue, the PVA/PVP support bases can be dissolved quickly owing to the absorption of the interstitial fluid, leading the arrowheads to be left in the skin tissue. Under NIR irradiation, the arrowheads embedded in the skin can be ablated because of the photothermal conversion of the ICG, resulting in liberation and penetration of the DOX from the MNs into the tumor tissue. A mouse model of melanoma tumor has been established to evaluate the synergistic effect of two-stage separable MN phototherapy and chemotherapy in the treatment of skin cancer.

Fabrication of biodegradable composite microneedles based on calcium sulfate and gelatin for transdermal delivery of insulin.

To reduce the inconvenience and pain of subcutaneous needle injection, the calcium sulfate and gelatin biodegradable composite microneedle patches with high aspect-ratio microneedles (MNs) and a flexible substrate have been developed. The microneedles with an aspect-ratio approximate 6:1 exhibit excellent mechanical property which can achieve 0.4N for each needle. The cross-section views show the inside of microneedles that have abundant pores and channels which offer potential for different drug-release profiles. The preparation procedures, degradable property for the biodegradable composite microneedle patches are described in the paper. Insulin, the drug to control blood glucose levels in diabetic patients, has been embedded into the biodegradable composite MNs. The hypoglycemic effect for transdermal delivery of insulin is studied using diabetic Sprague-Dawley (SD) rats as models in vivo. After transdermal administration to the diabetic rats, the released insulin from biodegradable composite MNs exhibit an obvious and effective hypoglycemic effect for longer time compared with that of subcutaneous injection route. This work suggests that biodegradable composite MNs containing of insulin have a potential application in diabetes treatment via transdermal ingestion.

Efficacy and safety investigation of Kuntai capsule for the add-back therapy of gonadotropin releasing hormone agonist administration to endometriosis patients: a randomized, double-blind, blank- and tibolone-controlled study.

BACKGROUND: As a Chinese Traditional Medicine product, Kuntai capsule could improve the peri-menopausal symptoms in postmenopausal women. But it is still not clear whether Kuntai capsule has a good effect on alleviating peri-menopausal symptoms induced by gonadotropin releasing hormone agonist (GnRH-a) treatment. The purpose of this study was to investigate the clinical effectiveness and safety of Kuntai capsule, on peri-menopausal symptoms in endometriosis (EMS) patients, with postoperative GnRH-a treatment. METHODS: Ninety EMS ovarian cyst women with postoperative GnRH-a administration were enrolled in the study, and were randomly divided into Kuntai group, Tibolone group, or blank Control group. The therapeutic strategy in Kuntai group was 4 Kuntai capsules tid,po for 12 weeks after the first GnRH-a injection, while Tibolone 2.5 mg qd, po for 12 weeks in Tibolone group. There was no drug addition in Control group. Climacteric complaints were evaluated by Kupperman menopausal index (KMI) and hot flash/sweating score. Liver and renal functions, lipid profile, serum sex hormone levels and endometrial thickness were measured, and the frequency of adverse events in Kuntai and Tibolone groups was recorded. RESULTS: (1) Before GnRH-a therapy, the baseline parameter results were comparable in the three groups (P > 0.05). (2) After GnRH-a therapy, KMI and hot flash/sweating scores in all the three groups increased significantly (P < 0.05). At the 4 th week after GnRH-a therapy, KMI and hot flash/sweating score results were as follows: Control group > Kuntai group > Tibolone group (P < 0.05); at the 8 th and 12 th week after GnRH-a therapy, KMI and hot flash/sweating score in Control group were significantly higher than the other two groups (P < 0.05), and no significant difference was identified between Kuntai and Tibolone group (P > 0.05). (3) No statistical change took place in the liver and renal functions and lipid profile in all the three groups after the treatment (P > 0.05). (4) The posttherapeutic serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) level and endometrial thickness decreased significantly in all the three groups (P < 0.05). After therapy, serum E2 level in Tibolone group was obviously higher than the other two groups (P < 0.05), while FSH and LH levels were obviously lower (P < 0.05). (5) The incidence of vaginal bleeding, breast distending pain in Tibolne group was obviously higher than Kuntai group (P < 0. 05). CONCLUSIONS: Kuntai capsule is effective on the peri-menopausal symptoms induced by postoperative GnRH-a administration to EMS patients, although its clinical effect might be a few weeks later than Tibolone. Kuntai capsule might be a little safer than Tibolone tablet.

Efficacy and safety of remifemin on peri-menopausal symptoms induced by post-operative GnRH-a therapy for endometriosis: a randomized study versus tibolone.

BACKGROUND: The aim of this study was to investigate clinical efficacy and safety of Remifemin on peri-menopausal symptoms in endometriosis patients with a post-operative GnRH-a therapy. MATERIAL AND METHODS: We treated 116 women who had endometriosis with either Remifemin (n=56) 20 mg bid po or Tibolone (n=60) 2.5 mg qd po for 12 weeks after GnRH-a injection. The efficacy was evaluated by Kupperman menopausal index (KMI), and hot flash/sweating scores. The safety parameters such as liver and renal functions, lipid profile, endometrial thickness, and serum sex hormone level, as well as the incidence of adverse events were recorded. RESULTS: (1) After GnRH-a therapy, KMI and hot flash/sweating scores in both groups increased significantly (P<0.05) but we found no significant difference for KMI (2.87±1.40 for Remifemin and 2.70±1.26 for Tibolone) and hot flash/sweating scores (0.94±1.72 for Remifemin and 1.06±1.78 for Tibolone) between the 2 groups (P>0.05). (2) No statistical change was observed in liver or renal functions and lipid profile in both groups before and after the treatment (P>0.05). The post-therapeutic serum FSH, LH, and E2 level and endometrial thickness decreased remarkably in both groups (P<0.05). E2 level in the Remifemin group was obviously lower than that in the Tibolone group (P<0.05), and FSH and LH levels were strongly higher (P<0.05). No significant difference in thickness were found in either group (P>0.05). The Remifemin group had far fewer adverse events than the Tibolone group (P<0. 05). CONCLUSIONS: Compared with Tibolone, Remifemin had a similar clinical efficacy and was safer for the peri-menopausal symptoms induced by GnRH-a in endometriosis patients.

[Effects of Prostate Water Pellets on the number of colonies, NO concentration and NOS activity in the prostate tissue of CBP rats].

OBJECTIVE: To investigate the effects of Prostate Water Pellets (PWP) on the number of colonies, NO concentration and NOS activity in the prostate tissues of rats with chronic bacterial prostatitis (CBP). METHODS: A total of 120 healthy adult male Wistar rats weighing 250-300 g were equally randomized into 6 groups: blank control, model control, positive control, high-dose PWP, medium-dose PWP and low-dose PWP. The CBP rat models were established by injecting colibacilli (10(7)/ml) into the prostate. A month later, the high- , medium- and low-dose PWP groups were treated intragastrically with PWP at 4.4 g/kg, 2.2 g/kg and 1.1 g/kg per day respectively, the positive controls with levofloxacin at 0.018 g/kg per day, and the blank and model controls with normal saline, all for 35 days. Then the numbers of colonies in the prostate tissues were measured, and the changes in NO concentration and NOS activity detected by the nitrite reductase method. RESULTS: Compared with the model controls, the number of colonies, NO concentration and NOS activity were significantly reduced in the prostate tissues of the rats of the high- , medium- and low-dose PWP groups (P < 0.01). CONCLUSION: PWP was proved to be efficacious for CBP in rats, whose mechanism might be related with its inhibitory effect on bacterial growth and decreasing effect on NO concentration and NOS activity in the prostate tissues.

[Effects of electroacupuncture on expression of Abeta positive cells of the hippocampus and SOD activity in rats with streptozocin-Alzheimer's disease].

OBJECTIVE: To investigate the possible mechanism of the electroacupuncture for improvement of learning and memory in rats of Alzheimer's disease (AD). METHODS: Sixty Wistar rats were randomly divided into a normal group, a normal saline group, a model group, a western medication group and an electroacupuncture group, 12 rats in each group. The AD rat model was established by injecting Streptozocin (STZ) into lateral cerebral ventricle, except the rats in the normal saline group injecting Normal Saline with the same dose and in normal group with no injection. The western medication group was treated with intragastric administration of Memantine, and in the electroacupuncture group, the electroacupuncture was given at "Baihui" (GV 20), "Dazhui" (CV 14), "Taixi" (KI 3), "Shenshu" (BL 23), "Zusanli" (ST 36), once each day, 7 days for a course, and lasted for 4 courses. The other three groups were fed in routine way and without any treatment. The learning and memory ability was assessed by Morris water maze and the expression of Abeta positive cells of the hippocampus and superoxide dismutase (SOD) activity were determined by immunohistochemistry and visible spectrophotometer colorimetry. RESULTS: Compared with the normal group and the normal saline group, the Abeta protein expression was significantly increased in the model group (both P < 0.01), and the SOD activity was obviously decreased (both P < 0.01). After treatment, as compared with the model group, the Abeta protein expression was significantly decreased (both P < 0.01), and the SOD activity was obviously increased (both P < 0.01) in the electroacupuncture group and western medication group. CONCLUSION: Electroacupuncture treatment can reduce the Abeta protein expression and increase the SOD activity of the hippocampus so as to improve learning and memory ability in the AD rats.

[Study on needling depth of Fengfu (GV 16) with CT].

OBJECTIVE: To study on needling safe depth of Fengfu (GV 16) with CT, so as to provide reference for safe needling depth of Fengfu (GV 16) in clinical acupuncture treatment. METHODS: Forty-one adult volunteers were divided into 3 groups, a thin person group, a moderate person group and a fat person group according to Luo's indexes, and computer-aided tomography (CT) was used to measure the needling depth of Fengfu (GV 16). RESULTS: The safe depths of perpendicular needling of Fengfu (GV 16) were different for persons of different somatotypes. The safe needling depth was (27.73 +/- 3.45) mm for the thin person group, (30.78 +/- 2.90) mm for the moderate person group, and (33.39 +/- 4.27) mm for the fat person group. CONCLUSION: The safe needling depth < or = the dangerous depth x 75% can be used for reference for the safe needling depth of Fengfu (GV 16) for different somatotypes persons.