Ultrasound-Responsive Nanodelivery System of GPC3-Targeting and Sonosensitizer for Visualized Hepatocellular Carcinoma Therapy.

Purpose: The incidence of hepatocellular carcinoma (HCC) is continuously increasing, and the mortality rate remains high. Thus, more effective strategies are needed to improve the treatment of HCC. Methods: In this study, we report the use of a visualized glypican-3 (GPC3)-targeting nanodelivery system (named GC-NBs) in combination with sonodynamic therapy (SDT) to enhance the therapeutic efficacy for treating HCC. The obtained nanodelivery system could actively target hepatocellular carcinoma cells and achieve ultrasound imaging through phase changes into nanobubbles under low-intensity ultrasound irradiation. Meanwhile, the released chlorine e6 (Ce6) after the nanobubbles collapse could lead to the generation of reactive oxygen species (ROS) under ultrasound irradiation to induce SDT. Results: Both in vitro and in vivo experiments have shown that GC-NBs can accumulate in tumour areas and achieve sonodynamic antitumour therapy under the navigation action of glypican-3-antibody (GPC3-Ab). Furthermore, in vitro and in vivo experiments did not show significant biological toxicity of the nanodelivery system. Moreover, GC-NBs can be imaged with ultrasound, providing personalized treatment monitoring. Conclusion: GC-NBs enable a visualized antitumour strategy from a targeted sonodynamic perspective by combining tumour-specific targeting and stimuli-responsive controlled release into a single system.

Advances in antitumor application of ROS enzyme-mimetic catalysts.

The rapid growth of research on enzyme-mimetic catalysts (Enz-Cats) is expected to promote further advances in nanomedicine for biological detection, diagnosis and treatment of disease, especially tumors. ROS-based nanomedicines present fascinating potential in antitumor therapy owing to the rapid development of nanotechnology. In this review, we focus on the applications of Enz-Cats based on ROS in antitumor therapy. Firstly, the definition and category of ROS are introduced, and the key factors enhancing ROS levels are carefully elucidated. Then, the rationally engineered Enz-Cats via different synthetic approaches with high ROS-producing efficiencies are comprehensively discussed. Subsequently, oncotherapy application of Enz-Cats is comprehensively discussed, which integrates diverse synergistic treatment modalities and exhibits high efficiency in ROS generation. Finally, the challenges and future research direction of this field are presented. This review is dedicated to unraveling the enigmas surrounding the interplay of nanomedicine and organisms.

Visualization of therapeutic intervention for acute liver injury using low-intensity pulsed ultrasound-responsive phase variant nanoparticles.

Acute liver injury (ALI) is a highly fatal condition characterized by sudden massive necrosis of liver cells, inflammation, and impaired coagulation function. Currently, the primary clinical approach for managing ALI involves symptom management based on the underlying causes. The association between excessive reactive oxygen species originating from macrophages and acute liver injury is noteworthy. Therefore, we designed a novel nanoscale phase variant contrast agent, denoted as PFP@CeO2@Lips, which effectively scavenges reactive oxygen species, and enables visualization through low intensity pulsed ultrasound activation. The efficacy of the nanoparticles in scavenging excess reactive oxygen species from RAW264.7 and protective AML12 cells has been demonstrated through in vitro and in vivo experiments. Additionally, these nanoparticles have shown a protective effect against LPS/D-GalN attack in C57BL/6J mice. Furthermore, when exposed to LIPUS irritation, the nanoparticles undergo liquid-gas phase transition and enable ultrasound imaging.

A giant head and neck hemangioma of the fetus: A case report.

RATIONALE: Hemangioma is a common benign disease in clinical practice, but it is rare to find a giant hemangioma in the fetal period. PATIENT CONCERNS: Here, we report a case of a giant hemangioma of the fetal head and neck measuring approximately 10.1 × 6.5 cm. DIAGNOSES: At first, only ultrasonography was used to diagnose the suspected hemangioma. The pregnant woman refused to undergo further testing and requested induction of labor, after which the tumor was finally sent for pathological examination to confirm hemangioma. INTERVENTIONS AND OUTCOMES: Additionally, the fetus developed severe edema (fluid accumulation in the thoracic, abdominal, and pericardial cavities), which can be fatal to the fetus. Finally, the mother refused to continue the pregnancy and underwent induction of labor with rivanol. LESSONS: Most hemangiomas are small and asymptomatic. Giant hemangiomas are rare and associated with a variety of maternal and fetal complications. Therefore, this article aims to summarize the knowledge related to hemangioma through this case, strengthen doctors' understanding of this disease, and bring the attention of pregnant women to this disease to ensure early diagnosis and treatment and prevent a poor prognosis.

Prenatal and postnatal diagnosis of congenital hymen prolapse: A case report.

RATIONALE: Female genital tract abnormalities are relatively uncommon and usually discovered accidentally. And hymen prolapse is even rarer, which is asymptomatic and is commonly found during the examination of the baby external genitals. PATIENT CONCERNS: Here, we report a case of fetal genital abnormality detected at 32 weeks of gestation. DIAGNOSES: At 32+1 weeks of pregnancy, ultrasound showed taht an iso-echoic mass of about 8 mm × 5 mm was protruding from the genitalia, and at 36 weeks, ultrasound showed that an iso-echoic mass of about 9 mm × 5 mm could be seen protruding from the genitalia, and its morphology was similar to the result of the 32-week data. At 39 weeks a baby girl was naturally delivered. Physical examination showed the female external genitalia, part of the hymen protruded into the vaginal orifice. Finally, the clinical diagnosis was hymen prolapse. INTERVENTIONS AND OUTCOMES: No treatment was carried out. Reexamination at 11 days after birth revealed a significantly smaller prolapse than before. Since the postpartum follow-up, the baby has been in good condition, the hymen has gradually returned, and the genitals are all normal. LESSONS: Regardless of the confidentiality of prenatal tests regarding the sex of the fetus, prenatal ultrasound should be used to fully evaluate the morphology and structure of each system including the reproductive system of the fetus when screening fetal malformations. The purpose of this case is to remind doctors of the rigorous degree of genital examination, increase the detection rate, and save the life of the fetus.

Prenatal ultrasound monitoring and diagnostic accuracy rates of fetal congenital heart disease: A meta-analysis.

Congenital heart disease (CHD) is the most common birth defect that is caused by genetic and acquired factors. Accurate prenatal diagnosis of congenital heart disease (CHD) can ensure proper delivery and in-time postpartum management, but the diagnostic rate is not clear. PubMed, CNKI, Web of Science, Wanfang, and VIP databases were searched for publications investigating CHD during prenatal ultrasound scans. Original studies with strict screening and diagnostic criteria were included. Fixed effect model or random effect model was used according to homogeneity statistical test. A total of 859 CHD cases were diagnosed by ultrasound, and 1394 cases were confirmed by induced labor autopsy or at birth. The heterogeneity of the analysis was 100% and the accuracy of CHD diagnosis using prenatal ultrasound was 76% (95%CI: 50.00%-102%). The diagnostic yield of fetal CHD screening using ultrasound alone is still not very high, which lower than the combined diagnostic yield of other studies. This suggests the need to combine other monitoring methods that do not harm fetal development. When economic conditions permit, the diagnosis of CHD can be recommended to use no less than two monitoring methods.

Uterine tumor resembling ovarian sex cord tumor: A rare case report.

RATIONALE: A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) is a clinically rare disease with an unclear origin and biological behavior. PATIENT CONCERNS: We present a case of UTROSCT in a 42-year-old woman who presented with abnormally increased menstrual volume for 2 years. DIAGNOSES: Initially, only ultrasound examination was performed to diagnose uterine fibroids, and then the tumor was surgically removed and sent for pathological examination. The patient was ultimately diagnosed with UTROSCT mainly based on pathological immunohistochemical examination and was further diagnosed with low malignant potential for recurrence based on genetic testing. INTERVENTIONS AND OUTCOMES: The patient underwent hysterectomy and bilateral adnexectomy, and no adjuvant radiotherapy or chemotherapy was performed after the surgery. Follow-up to date has indicated that she is in good condition. LESSONS: UTROSCT is a rare disease that requires pathological immunohistochemical examination to confirm the diagnosis and genetic testing when necessary so that a clear diagnosis can inform better decision-making regarding treatment measures.

Catheter-directed thrombolysis plus anticoagulation versus anticoagulation alone in the treatment of proximal deep vein thrombosis - a meta-analysis.

BACKGROUND: The aim of this meta-analysis was to compare the clinical outcomes of catheter-directed thrombolysis (CDT) plus anticoagulation with anticoagulation alone in patients with lower-extremity proximal deep vein thrombosis (DVT). PATIENTS AND METHODS: We systematically searched Pubmed, Embase, and the Cochrane Library from inception to October, 2014. All randomized controlled trials (RCTs) and non-randomized studies comparing the clinical outcomes between additional CDT and anticoagulation alone were included. The primary outcomes were postthrombotic syndrome and major bleeding complications. The secondary outcomes included the iliofemoral patency rate, deep venous function, mortality, pulmonary embolism, and recurrent DVT. RESULTS: Three RCTs and 3 non-randomized studies were included. Compared with standard anticoagulation treatment, additional CDT was associated with a significantly higher rate of complete lysis within 30 days (OR = 91; 95 % CI 19.28 to 429.46), a higher rate of 6-month patency (OR = 5.77; 95 % CI 1.99 to 16.73), a lower rate of postthrombotic syndrome (OR = 0.4; 95 % CI 0.19 to 0.96), and a lower rate of venous obstruction (OR = 0.20; 95 % CI 0.09 to 0.44). More major bleeding episodes occurred in the CDT group (Peto OR 2.0; 95 % CI 1.62 to 2.62). CDT was not found to reduce mortality, pulmonary embolism, or recurrent DVT. CONCLUSIONS: Additional CDT therapy appeared to be more effective than standard anticoagulation treatment in improving the venous patency and preventing venous obstruction and postthrombotic syndrome. Caution should be taken when performing CDT given the increased risk of major bleeding. However, no evidence supported benefits of CDT in reducing mortality, recurrent DVT, or pulmonary embolism.

[Anatomic characteristics and relationship of lingual artery and hypoglossal nerve with tongue base].

OBJECTIVE: To investigate the anatomic characteristics of lingual artery and hypoglossal nerve and relationship between lingual artery and hypoglossal nerve in tongue base, for the purpose of improving data with clinic and increasing safety in the operation of tongue base. METHOD: Twenty extraoral dissections of the submandibular region were performed on 10 human cadavers. The origin and distribution of lingual artery and hypoglossal nerve were observed: (1) The lingual artery was divided into four segments, length and adjacent organs were observed and measured; (2) The hypoglossal nerve length and adjacent organs were observed and measured; (3) The anatomic relationship of lingual artery and hypoglossal nerve was observed and measured. RESULT: The whole length of lingual artery was (9.73 +/- 0.83)cm. At points of foramen cecum of the tongue, 1 cm prior to foramen cecum, 1 cm behind foramen cecum and at adjacent part of foramen cecum to lateral tongue, hyoid, and distances between lingual artery and lateral of the tongue were separately measured. The distances were (2.34 +/- 0.20) cm, (2.48 +/- 0.14) cm, (2.43 +/- 0.26) cm, (2.53 +/- 0.33) cm, (2.14 +/- 0.16) cm, (1.11 +/- 0.09) cm, respectively. At points of foramen cecum of the tongue, 1 cm prior to foramen cecum, 1 cm behind foramen cecum and at adjacent part of hyoid, lateral tongue, and distance between hypoglossal nerve and midline of the inner mandible were separately measured. The distances were(2.28 +/- 0.14) cm, (2.36 +/- 0.16) cm, (2.34 +/- 0.21 ) cm, (1.25 +/- 0.42) cm, (1.86 +/- 0.32) cm, (2.64 +/- 0.28) cm, respectively. The position of the tongue base, lingual artery and hypoglossal nerve are significantly inferior and lateral, that is, 2 cm inferior and (1.11 +/- 0.09) cm lateral to the foramen cecum; (2.08 +/- 0.33) cm medial to the inner mandible. CONCLUSION: This inferior lateral location-'V' type- allows the potential for aggression tongue base resection without neurovascular bundle compromise. To ensure the operating safety, the depth and angle of radiofrequency of the tongue base for OSAHS should be controlled.