Preparation and Performance Evaluation of a Zinc Oxide-Graphene Oxideloaded Chitosan-Based Thermosensitive Gel.

This study aimed to develop and assess a chitosan biomedical antibacterial gel ZincOxide-GrapheneOxide/Chitosan/ß-Glycerophosphate (ZnO-GO/CS/ß-GP) loaded with nano-zinc oxide (ZnO) and graphene oxide (GO), known for its potent antibacterial properties, biocompatibility, and sustained drug release. ZnO nanoparticles (ZnO-NPs) were modified and integrated with GO sheets to create 1% and 3% ZnO-GO/CS/ß-GP thermo-sensitive hydrogels based on ZnO-GO to Chitosan (CS) mass ratio. Gelation time, pH, structural changes, and microscopic morphology were evaluated. The hydrogel's antibacterial efficacy against Porphyromonas gingivalis, biofilm biomass, and metabolic activity was examined alongside its impact (MC3T3-e1). The findings of this study revealed that both hydrogel formulations exhibited temperature sensitivity, maintaining a neutral pH. The ZnO-GO/CS/ß-GP formulation effectively inhibited P. gingivalis bacterial activity and biofilm formation, with a 3% ZnO-GO/CS/ß-GP antibacterial rate approaching 100%. MC3T3-e1 cells displayed good biocompatibility when cultured in the hydrogel extract.The ZnO-GO/CS/ß-GP thermo-sensitive hydrogel demonstrates favorable physical and chemical properties, effectively preventing P. gingivalis biofilm formation. It exhibits promising biocompatibility, suggesting its potential as an adjuvant therapy for managing and preventing peri-implantitis, subject to further clinical investigations.

MRI Directed Magnevist Effective to Study Toxicity of Gd-Doped Mesoporous Carbon Nanoparticles in Mice Model.

Purpose: Magnetic resonance imaging (MRI) has been a valuable and widely used examination technique in clinical diagnosis and prognostic efficacy evaluation. The introduction of MRI contrast agent (CA) improves its sensitivity obviously, particularly with the development of nano-CA, which presents higher contrast enhancement ability. However, systematical evaluation of their toxicity is still limited, hampering their further translation in clinics. Methods: In this paper, to systematically evaluate the toxicity of nano-CA, Gd-doped mesoporous carbon nanoparticles (Gd-MCNs) prepared by a one-step hard template method were introduced as a model and clinically used MRI CA, Magnevist (Gd-DTPA) as control. Their in vitro blood compatibility, cellular toxicity, DNA damage, oxidative stress, inflammation response as well as in vivo toxicity and MR imaging behaviors were studied and compared. Results: The experimental results showed that compared with Gd-DTPA, Gd-MCNs displayed negligible influence on the red blood cell shape, aggregation, BSA structure, macrophage morphology and mitochondrial function. Meanwhile, limited ROS and inflammatory cytokine production also illustrated the cellular compatibility of Gd-MCNs. For in vivo toxicity evaluation, Gd-MCNs presented acceptable in vivo biosafety even under 12 times injection for 12 weeks. More importantly, at the same concentration of Gd, Gd-MCNs displayed better contrast enhancement of tumor than Gd-DTPA, mainly coming from its high MRI relaxation rate which is nearly 9 times that of Gd-DTPA. Conclusion: In this paper, we focus on the toxicity evaluation of MRI nano-CA, Gd-MCNs from different angles. With Gd-DTPA as control, Gd-MCNs appeared to be highly biocompatible and safe nanoparticles that possessed promising potentials for the use of MRI nano-CA. In the future, more research on the long-term genotoxicity and the fate of nanoparticles after being swallowed should be performed.

Diagnosis value of 18F-Fluoro-D-glucose positron emission tomography-computed tomography in pulmonary hamartoma: a retrospective study and systematic review.

PURPOSE: The diagnosis of pulmonary hamartoma (PH) based on computed tomography (CT) is a challenge, especially in patients with atypical imaging characteristics. This study was aimed at summarizing the imaging characteristic of 18F-Fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) in PH and exploring the application value of PET-CT in the diagnosis of PH. DATA AND METHODS: Patients diagnosed with PH who had undergone PET-CT from literature pertaining were retrospectively analyzed, which were cases of publications from the Cochrane Library, PubMed, Excerpta Medica Database (EMBASE), China National Knowledge Infrastructure (CNKI) and Wanfang databases, from 2008 to June 2022. The other 20 cases of the collection were patients from our hospital from 2008 to June 2022. Patients' symptoms, imaging characteristics of chest CT, PET-CT characteristics, the reason for PET-CT and the complications were analyzed. RESULTS: In this retrospective study, a total of 216 patients were diagnosed with PH and had been examined by PET-CT. 20 of the cases were patients of our hospital from January 2008 to June 2022. The other cases were collected from the literature. The mean diameter of most PH lesions is 1.7 ± 1.0 cm. The mean maximum standardized uptake value (SUVmax) of the PH lesions was 1.2 ± 1.1. Most of their SUVmax were lower than internationally recognized cut-off value (SUVmax = 2.5). PET-CT was superior to CT in the diagnosis of PH but there was a correlation of between CT diagnosis and PET-CT diagnosis for the PH lesions. In order to draw the Receiver operating characteristic (ROC), we selected 29 patients with a clear SUVmax value of their PH lesion, and 29 lung cancer patients with clear SUVmax value in our hospital were collected as a control group. ROC curve analysis showed that the area under curve (AUC) of SUVmax was 0.899, and the optimal diagnostic threshold was SUVmax > 2.65. PET-CT could distinguish PH from malignant lesions with a sensitivity of 89.66% by applying a SUVmax of 2.65 as a cut-off in this study. CONCLUSION: PET-CT might be a useful tool to diagnose PH, which shows a better diagnostic sensitivity than CT. But PET-CT can not be used as a single diagnostic approach, which should be combined with other methods and the patients' history to make the most correct diagnosis.

Influencing factors of noninvasive positive pressure ventilation in the treatment of respiratory failure: a 10-year study in one single center.

BACKGROUND: The utilization of noninvasive positive pressure ventilation (NPPV) is becoming more and more common, especially in patients with acute or chronic respiratory failure. The purpose of our study is to analyze the factors that influence the efficacy of NPPV in the treatment of respiratory failure caused by a variety of etiology. METHODS: From May 2011 to April 2020, patients treated with NPPV during hospitalization in the First Affiliated Hospital of Soochow University were enrolled. According to the clinical outcome of NPPV treatment and whether converted to invasive mechanical ventilation, patients were divided into the success group and the failure group. The clinical data and the characteristics of NPPV application were compared between the two groups. RESULTS: A total of 3312 patients were enrolled, including 2025 patients in the success group and 1287 patients in the failure group. Univariate analysis suggested that there were no statistical differences in patients' age, gender, use of analgesia and/or sedation, complicated with barotrauma, inspiratory positive airway pressure and expiratory positive airway pressure between the success and failure groups (P > 0.05). However, there were statistically significant differences in serum albumin levels, Ca2+ concentration, blood glucose levels, duration of NPPV treatment and length of hospital stay between the success and failure groups (P < 0.05). Multivariate logistic regression analysis indicated that serum albumin levels and duration of NPPV treatment had statistical significance on the therapeutic effect of NPPV (P < 0.05). CONCLUSION: Serum albumin levels and duration of NPPV treatment were independent risk factors for the efficacy of NPPV treatment in respiratory failure.

The comparison of two exhaled nitric oxide analyzers: NIOX VERO and SUNVOU-CA2122.

As a marker of eosinophilic airway inflammation, fractional exhaled nitric oxide (FeNO) was widely used in clinical practice. NIOX VERO (VERO) and SUNVOU-CA2122 (CA2122) are two commonly used eNO analyzers in China. However, what's the difference and agreement between the two devices and whether the two types of devices can be replaced by each other in the application of common respiratory diseases have not been reported. The purpose of this study was to compare the two types of devices and to evaluate the difference between them in clinical use and whether they could be replaced. FeNO levels in 244 respiratory patients (including asthma, chronic obstructive pulmonary disease, chronic cough) were measured by CA2122 analyzer and VERO analyzer, respectively. The FeNO values obtained by the two devices were compared and the differences were analyzed. The success rate, the number of attempts and the total time required for a successful measurement by CA2122 and VERO were compared. The FeNO values measured by CA2122 online and offline were also compared. FeNO values obtained by CA2122 were slightly higher than those of VERO [median(range): 29.0(9-271) parts per billion (ppb) vs 25.5 (5-263) ppb,P= 0.000]. There was a high correlation between FeNO values measured by the two types of devices (r= 0.964,P= 0.000). By comparison, there was a high degree of agreement between the FeNO values measured by two devices, in all patients with different respiratory diseases. FeNO values measured online and offline by CA2122 were highly correlated and there was a high degree of agreement between online and offline methods. The success rate of CA2122 was higher than VERO, and the number of attempts (2.1 vs 2.4) and the total time (110.5 ± 35.7 vs 117.5 ± 48.1 s) required for a successful measurement by CA2122 were lower than those of VERO. CA2122 and VERO can be replaced by each other, and FeNO values can be converted if necessary. CA2122 has some advantages in success rate, the mean attempts and time required for successful measurement of FeNO.

Alkalescent soda beverage caused the disappearance of gefitinib-induced rashes and decreased efficacy in a non-small-cell lung cancer patient treated with gefitinib: A case report.

Oral anticancer drugs have the advantages of convenient and flexible administration, however, they also face some new problems related to their oral preparation. Herein we describe a case of advanced non-small-cell lung cancer patient treated with gefitinib who had long-term adverse reactions of rashes and diarrhea, and his rashes disappeared after taking alkaline soda, and then reappeared after stopping drinking it. Imaging progress was also observed. To our knowledge, this is the first report on the effect of alkaline food on gefitinib-induced rashes dynamic change. In this case, the rash acted as a signal of therapeutic efficacy. Clinicians and pharmacists should be aware of potential and common factors that affect drug efficacy and strive to achieve the best therapeutic results.

A case of torsades de pointes induced by the third-generation EGFR-TKI, osimertinib combined with moxifloxacin.

BACKGROUND: Torsade de pointes (TdP) is a malignant arrhythmia that can be induced by QT internal prolongation due to a variety of factors. Here we report an elderly patient with advanced non-small cell lung cancer (NSCLC) had sudden TdP during hospitalization, which was caused by multiple factors such as osimertinib, moxifloxacin and patient self-factors. CASE PRESENTATION: An 85-year-old man with advanced NSCLC with brain andbone metastasis was initially treated with gefitinib targeted therapy. After 4 months treatment, the patient developed drug resistance and a second genetic testing revealed that the T790M mutation was positive. And the patient was then changed to targeted therapy with osimertinib, followed by adverse reactions of varying severity such as diarrhea, electrolyte imbalance, decreased cardiac function, leukopenia, and prolonged QTc interval. Six months after the administration of osimertinib, the patient was admitted to the hospital, chest CT showed the lesion progressed again, and during which hospital-acquired infection occurred. After concomitant use of moxifloxacin, the patient had sudden TdP, and finally died of this cardiac event. CONCLUSIONS: It is suggested that clinicians need to identify patients with high risk factors of TdP, and consider comprehensively in concomitant medication to avoid such events to the greatest extent.

Complete chloroplast genome sequence of Dryopteris fragrans (L.) Schott and the repeat structures against the thermal environment.

Dryopteris fragrans (L.) Schott is a fern growing on the surface of hot rocks and lava. It is exposed to sunlight directly and bears local hot environment. We sequenced the complete nucleotide sequence of its chloroplast (cp) genome. The cp genome was 151,978 bp in length, consisting of a large single-copy region (85,332 bp), a small single-copy region (31,947 bp) and a pair of inverted repeats (17,314 bp). The cp genome contained 112 genes and 345 RNA editing sites in protein-coding genes. Simple sequence repeats (SSRs) and long repeat structure pairs (30-55 bp) were identified. The number and percent of repeat structures are extremely high in ferns. Thermal denaturation experiments showed its cp genome to have numerous, dispersed and high GC percent repeat structures, which conferred the strongest thermal stability. This repeat-heavy genome may provide the molecular basis of how D. fragrans cp survives its hot environment.

Retrospective study of arsenic trioxide for childhood acute promyelocytic leukemia in China: a single-center experience.

There are very limited reports about childhood acute promyelocytic leukemia (APL), especially about arsenic trioxide (ATO) treatment in both induction and post-remission regimens. 35 newly diagnosed APL patients received ATO treatment in our center and the clinical course as well as the outcome of them was investigated. The dose of intravenous ATO was 0.15-0.17 mg/kg per day, only one patient got 0.33 mg/kg per day, maximum dose was 10 mg per day in induction therapy with minimal chemotherapy treatment (CT) for hyperleukocytosis. Anthracycline or anthracycline-based CT was used for consolidation therapy and followed by 0.10-0.15 mg/kg per day ATO treatment in maintenance therapy. The continuous detection for morphology of bone marrow and PML-RARa were necessary for administrating CT or not. 3 patients died during induction therapy for intracranial hemorrhage, leukocytosis and septic shock. Total of 30 patients achieved complete remission (CR) and were followed-up for 10-108 months. The overall survival (OS) for all patients was 82.7%, whereas the OS for patients obtained CR was 95.8%. The event-free survival for 5 years was 80.3%. Disseminated intravascular coagulation could be under control to reduce induction mortality with adequate supportive care, especially in the first 2 weeks. The side effects of ATO were mild and transient. This regimen of ATO treatment both in induction and post-remission therapy was effective and safe for childhood APL to get long-term survival.