Injectable and thermoresponsive self-assembled nanocomposite hydrogel for long-term anticancer drug delivery.

The purpose of this study is to develop an injectable thermoresponsive hydrogel system that can undergo sol-gel phase transition by the stimulation of body temperature with improved mechanical stability and biocompatibility as a controlled drug delivery carrier for cancer therapy. Hexamethylene diisocyanate (HDI) was introduced into Pluronic F127 as a chain extender to improve the mechanical stability. HDI-Pluronic F127 copolymer was then incorporated with hyaluronic acid to develop a thermoresponsive nanocomposite hydrogel system. The physiochemical properties were characterized. The anticancer drug release profile and effect to inhibit tumor cells growth were analyzed in vitro and in vivo. The results showed that HDI-Pluronic F127/hyaluronic acid thermoresponsive hydrogel could undergo sol-gel transition as temperature increased to 37 °C. The nanocomposite polymer can spontaneously self-assemble into micellar structure with size of 100-200 nm. The release of doxorubicin (DOX) from HDI-PF127/HA composite hydrogel was a zero-order profile and maintained sustained release for over 28 days. The viability of tumor cells and size of tumor significantly decreased with incubation time, indicating the potential to have a therapeutic effect for cancer therapy. The injectable thermoresponsive nanocomposite hydrogel system was biocompatible and degradable and had the slow controlled release property for anticancer drugs with potential applications in the field of drug delivery.

Coprescription Trends in Western Medicine, Chinese Herbal Medicine and Dental Medicine among Older Adults in Taiwan from 1997 to 2013.

BACKGROUND: Coprescription is a potential medical problem for older adults that could induce polypharmacy and subsequent complications. In Taiwan, Chinese herbal medicine (CHM) is popular among the older adults. Investigating the coprescription trends in Western medicine, CHM and dental medicine is important to avoid possible polypharmacy. METHODS: We analyzed data from the Longitudinal Health Insurance Database 2000 (LHID 2000) in Taiwan. Patients ≥ 60 years old who received coprescription of Western medicine, CHM and drugs for dental care from 1997 to 2013 were included. The odds ratio (OR) and 95% confidence interval (95% CI) were estimated by a logistic regression model for evaluating the correlation between baseline characteristics and coprescription. RESULTS: A total of 266,034 patients were included for the analysis. Most patients receiving coprescriptions lived in the northern Taiwan and with a monthly income lower than 20,000 new Taiwan dollars. The trends in older adults using Western medicine alone or CHM alone decreased over time, but the cohort using dental medicine alone had the opposite result. Decreased trends in coprescription with age were noted. The trends in the proportion of coprescription and the number of days of coprescription increased with the calendar year. Increased trends in the proportion of patients with coprescription were also found, except for the cohort of patients who used both Western medicine and CHM. Patients who were female, and aged 70-79 years were prone to receive coprescription. CONCLUSIONS: Coprescription in older patients is not uncommon in Taiwan. Healthcare providers and policymakers should be aware of the complex coprescription pattern in the older adults.

Investigating tooth loss and associated factors among older Taiwanese adults.

The aim of this study was to evaluate factors associated with tooth loss in older Taiwanese adults with different numbers of remaining teeth. This study evaluated oral health status and tooth loss among 2286 adults aged over 65. Subjects were classified according to number of teeth (Group 1 <20 teeth vs. Group 2 ≥20 teeth). Tooth loss and oral health data were collected from the National Health Interview Survey (NHIS), compared between groups and analyzed by multivariate modeling. Group 1 subjects were older and had more partial dentures. Tooth loss was associated with self-limited food choices due to oral health status, and malnutrition. Tooth loss in Group 2 subjects was significantly associated with lower mental status. Tooth loss may predict cognitive status (odds ratio (OR) 1.30) and physical-disability (OR 1.79). Our results suggested that tooth loss was associated with age, more partial dentures, self-limited food choices, malnutrition, and lower mental and cognitive status and physical disability.