Generalized Multifunctional Coating Strategies Based on Polyphenol-Amine-Inspired Chemistry and Layer-by-Layer Deposition for Blood Contact Catheters.

Blood-contacting catheters play a pivotal role in contemporary medical treatments, particularly in the management of cardiovascular diseases. However, these catheters exhibit inappropriate wettability and lack antimicrobial characteristics, which often lead to catheter-related infections and thrombosis. Therefore, there is an urgent need for blood contact catheters with antimicrobial and anticoagulant properties. In this study, we employed tannic acid (TA) and 3-aminopropyltriethoxysilane (APTES) to create a stable hydrophilic coating under mild conditions. Heparin (Hep) and poly(lysine) (PL) were then modified on the TA-APTES coating surface using the layer-by-layer (LBL) technique to create a superhydrophilic TA/APTES/(LBL)4 coating on silicone rubber (SR) catheters. Leveraging the superhydrophilic nature of this coating, it can be effectively applied to blood-contacting catheters to impart antibacterial, antiprotein adsorption, and anticoagulant properties. Due to Hep's anticoagulant attributes, the activated partial thromboplastin time and thrombin time tests conducted on SR/TA-APTES/(LBL)4 catheters revealed remarkable extensions of 276 and 103%, respectively, when compared to uncoated commercial SR catheters. Furthermore, the synergistic interaction between PL and TA serves to enhance the resistance of SR/TA-APTES/(LBL)4 catheters against bacterial adherence, reducing it by up to 99.9% compared to uncoated commercial SR catheters. Remarkably, the SR/TA-APTES/(LBL)4 catheter exhibits good biocompatibility with human umbilical vein endothelial cells in culture, positioning it as a promising solution to address the current challenges associated with blood-contact catheters.

Unveiling Confinement Engineering for Achieving High-Performance Rechargeable Batteries.

The confinement effect, restricting materials within nano/sub-nano spaces, has emerged as an innovative approach for fundamental research in diverse application fields, including chemical engineering, membrane separation, and catalysis. This confinement principle recently presents fresh perspectives on addressing critical challenges in rechargeable batteries. Within spatial confinement, novel microstructures and physiochemical properties have been raised to promote the battery performance. Nevertheless, few clear definitions and specific reviews are available to offer a comprehensive understanding and guide for utilizing the confinement effect in batteries. This review aims to fill this gap by primarily summarizing the categorization of confinement effects across various scales and dimensions within battery systems. Subsequently, the strategic design of confinement environments is proposed to address existing challenges in rechargeable batteries. These solutions involve the manipulation of the physicochemical properties of electrolytes, the regulation of electrochemical activity, and stability of electrodes, and insights into ion transfer mechanisms. Furthermore, specific perspectives are provided to deepen the foundational understanding of the confinement effect for achieving high-performance rechargeable batteries. Overall, this review emphasizes the transformative potential of confinement effects in tailoring the microstructure and physiochemical properties of electrode materials, highlighting their crucial role in designing novel energy storage devices.

Injectable Hydrogels with Integrated Ph Probes and Ultrasound-Responsive Microcapsules as Smart Wound Dressings for Visual Monitoring and On-Demand Treatment of Chronic Wounds.

Hydrogel dressings capable of infection monitoring and precise treatment administration show promise for advanced wound care. Existing methods involve embedd ingorganic dyes or flexible electronics into preformed hydrogels, which raise safety issues and adaptability challenges. In this study, an injectable hydrogel based smart wound dressing is developed by integrating food-derived anthocyanidin as a visual pH probe for infection monitoring and poly(L-lactic acid) microcapsules as ultrasound-responsive delivery systems for antibiotics into a poly(ethylene glycol) hydrogel. This straightforwardly prepared hydrogel dressing maintains its favorable properties for wound repair, including porous morphology and excellent biocompatibility. In vitro experiments demonstrated that the hydrogel enabled visual assessment of pH within the range of 5 âˆ¼ 9.Meanwhile, the release of antibiotics could be triggered and controlled by ultrasound. In vivo evaluations using infected wounds and diabetic wounds revealed that the wound dressing effectively detected wound infection by monitoring pH levels and achieved antibacterial effects through ultrasound-triggered drug release. This led to significantly enhanced wound healing, as validated by histological analysis and the measurement of inflammatory cytokine levels. This injectable hydrogel-based smart wound dressing holds great potential for use in clinical settings to inform timely and precise clinical intervention and in community to improve wound care management.

Construction and mechanism study of lignin-based polyurethane with high strength and high self-healing properties.

Lignin is a natural polymer with abundant functional groups with great application prospects in lignin-based polyurethane elastomers with self-healing abilities. In this study, a lignin self-healing polyurethane (PUDA-L) was specially designed using lignin as the raw material of polyurethane, combining lignin with Diels-Alder (DA) bond and hydrogen bonds. The experimental results showed that PUDA-L was prepared with good thermal stability, fatigue resistance, shape memory effect, excellent mechanical strength, and self-healing ability by partially replacing the crosslinking agents with bio-based lignin and hydroxylated modified lignin to increase the hydroxyl content. Polyurethane has a tensile strength of up to 29 MPa and an elongation at break of up to 500 %. The excellent self-healing ability of PUDA-L originates from the internal DA bonds and cross-linked hydrogen bonds. After the dumbbell sample was fused and heated at 130 °C for 4 h, the elastomer could be completely healed, the tensile strength was restored to 29 MPa, and the self-healing efficiency was up to 100 %. The developed PUDA-L elastomer has promising applications in sensors and smart skins.

Cerebral cortical hemodynamic metrics to aid in assessing pain levels? A pilot study of functional near-infrared spectroscopy.

Introduction: Establishing an accurate way to quantify pain is one of the most formidable tasks in neuroscience and medical practice. Functional near-infrared spectroscopy (fNIRS) can be utilized to detect the brain's reaction to pain. The study sought to assess the neural mechanisms of the wrist-ankle acupuncture transcutaneous electrical nerve stimulation analgesic bracelet (E-WAA) in providing pain relief and altering cerebral blood volume dynamics, and to ascertain the reliability of cortical activation patterns as a means of objectively measuring pain. Methods: The participants (mean age 36.6 ± 7.2 years) with the cervical-shoulder syndrome (CSS) underwent pain testing prior to, 1 min following, and 30 min after the left point Jianyu treatment. The E-WAA was used to administer an electrical stimulation therapy that lasted for 5 min. A 24-channel fNIRS system was utilized to monitor brain oxyhemoglobin (HbO) levels, and changes in HbO concentrations, cortical activation areas, and subjective pain assessment scales were documented. Results: We discovered that HbO concentrations in the prefrontal cortex significantly increased when CSS patients were exposed to painful stimuli at the cerebral cortex level. The second pain test saw a considerable decrease in the average HbO change amount in the prefrontal cortex when E-WAA was applied, which in turn led to a reduction in the amount of activation and the size of the activated area in the cortex. Discussion: This study revealed that the frontal polar (FP) and dorsolateral prefrontal cortex (DLPFC) were linked to the analgesic modulation activated by the E-WAA.

Engineered procyanidin-Fe nanoparticle alleviates intestinal inflammation through scavenging ROS and altering gut microbiome in colitis mice.

Inflammatory bowel disease (IBD) is an idiopathic chronic inflammatory bowel disease characterized by inflammation, intestinal barrier injury, and imbalance of gut microbiota. Excess accumulation of reactive oxygen species (ROS) is closely correlated with the development and reoccurrence of IBD. Previous researches demonstrate that procyanidin, as a natural antioxidant, exhibits strong ability of eliminating ROS, thus showing good therapeutic effects in the inflammation-related diseases. Non-etheless, its poor stability and solubility always limits the therapeutic outcomes. Here, we typically designed an antioxidant coordination polymer nanoparticle using the engineering of procyanidin (Pc) and free iron (Fe), named Pc-Fe nanozyme, for effectively scavenging ROS and further inhibiting inflammation while altering the gut microbiome for the treatment of colitis. Furthermore, in vitro experiments uncover that Pc-Fe nanoparticles exert strong multi biomimic activities, including peroxidase, and glutathione peroxidase, for the scavenging of ROS and protecting cells from oxidative injury. In addition, the colon accumulation of Pc-Fe nanozyme effectively protects the intestinal mucosa from oxidative damage while significantly downregulates pro-inflammatory factors, repairs the intestinal barriers and alternates gut microbiome after orally administrated in sodium dextran sulfate (DSS) induced colitis mice. The results collectively illustrate that the multienzyme mimicking Pc-Fe nanozyme owns high potential for treating IBD through scavenging ROS, inhibiting inflammation, repairing gut barriers and alternating gut microbiome, which further promising its clinical translation on IBD treatment and other ROS induced intestinal diseases.

An Efficient Federated Learning Framework for Machinery Fault Diagnosis With Improved Model Aggregation and Local Model Training.

Due to device operating environment limitations and data privacy protection, it is frequently difficult to obtain sufficient high-quality labeled data from devices, resulting in an insufficient generalization ability of fault diagnosis model. Therefore, a high-performance federated learning framework is proposed in this work, which makes improvements in the procedure of model aggregation and local model training. In the model aggregation of central server, an optimization aggregation strategy in which forgetting Kalman filter (FKF) is combined with cubic exponential smoothing (CES) is proposed to improve the efficiency of federated learning. In the local model training of multiclient, a deep learning network combined with multiscale convolution, attention mechanism, and multistage residual connection is proposed, which is able to fully extract multiclient data features simultaneously. Meanwhile, experiments on two machinery fault datasets show that the proposed framework is capable of achieving high accuracy and strong generalization of fault diagnosis on the premise of protecting data privacy in actual industrial situations.

FexO4-enhanced degradation of bisphenol A in visible light/peroxydisulfate system: production of singlet state oxygen.

In this study, ferrous composites (FexO4) were prepared by microreactor to activate peroxydisulfate (PDS) for the degradation of bisphenol A (BPA) with visible (Vis) light irradiation. X-ray diffraction (XRD), energy-dispersive spectrometry (EDS), X-ray photoelectron spectroscopy (XPS), and scanning electron microscope (SEM) were used to characterize the morphology and crystal phase of FeXO4. Photoluminescence (PL) spectroscopy combined with amperometric tests were used to determine the role of PDS on the performance of photocatalytic reaction. The main reactive species and intermediates for BPA removal were determined by electron paramagnetic resonance (EPR) measurement and quenching experiments. The result indicated that singlet state oxygen (1O2) contributed more to the BPA degradation than that of other reactive radicals (·OH, SO4·- and ·O2-); these reactive radicals and 1O2 formed by the reaction between photo-generated electrons (e-) and holes (h+) of FexO4 and PDS. During this process, the consumption of e- and h+ also improved their separation efficiency and thus enhanced the degradation of BPA. In addition, the photocatalytic activity of FexO4 in Vis/FexO4/PDS system was 3.2-fold and 6.6-fold higher than that of single FexO4 and PDS under Vis light, respectively. The Fe2+/Fe3+ cycle could effectively drive the photocatalytic activation of PDS through indirect electron transfer and the formation of reactive radicals. This work illustrated that the degradation of BPA was rapidly in Vis/FexO4/PDS system mainly through 1O2, which further improve our understanding on the efficient removal of organic contaminants in the environment.

A study based on functional near-infrared spectroscopy: Cortical responses to music interventions in patients with myofascial pain syndrome.

Object: This study measured cerebral blood oxygen changes in patients with myofascial pain syndrome (MPS) using functional near-infrared spectroscopy (fNIRS). The aim was to investigate the effect of music intervention on pain relief in MPS patients. Materials and methods: A total of 15 patients with MPS participated in this study. A self-controlled block task design was used to collect the oxy-hemoglobin ([HbO2]) and deoxy-hemoglobin ([HbR]) concentrations in the prefrontal cortex (PFC) and motor cortex using fNIRS. The cerebral cortex response and channel connectivity were further analyzed. In the experiment, the therapist was asked to apply compression of 3-4 kg/cm2 vertically using the thumb to induce pain. Soothing synthetic music with frequencies of 8-150 Hz and 50-70 dB was used as the audio for the music intervention. Result: Compared to the group without music intervention, the activation of brain regions showed a decreasing trend in the group with music intervention under the onset of pain. The results of paired t-tests showed that nine of the data were significantly different (p < 0.05). It was also found that with music intervention, inter-channel connectivity was diminished. Besides, their dorsolateral prefrontal cortex (dlPFC) was significantly correlated with the anterior prefrontal cortex (aPFC) for pain response (r = 0.82), and weakly correlated with the premotor cortex (r = 0.40). Conclusion: This study combines objective assessment indicators and subjective scale assessments to demonstrate that appropriate music interventions can be effective in helping to relieve pain to some extent. The analgesic mechanisms between relevant brain regions under music intervention were explored in depth. New insights into effective analgesic methods and quantitative assessment of pain conditions are presented.

Cathode Electrolyte Interphase (CEI) Endows Mo6 S8 with Fast Interfacial Magnesium-Ion Transfer Kinetics.

Magnesium (Mg) metal secondary batteries have attracted much attention for their high safety and high energy density characteristics. However, the significant issues of the cathode/electrolyte interphase (CEI) in Mg batteries are still being ignored. In this work, a significant CEI layer on the typical Mo6 S8 cathode surface has been unprecedentedly constructed through the oxidation of the chloride-free magnesium tetrakis(hexafluoroisopropyloxy)borate (Mg[B(hfip)4 ]2 ) salt under a proper charge cut-off voltage condition. The CEI has been identified to contain Bx Oy effective species originating from the oxidation of [B(hfip)4 ]- anion. It is confirmed that the Bx Oy species is beneficial to the desolvation of solvated Mg2+ , speeding up the interfacial Mg2+ transfer kinetics, thereby improving the Mg2+ -storage capability of Mo6 S8 host. The firstly reported CEI in Mg batteries will give deeper insights into the interface issues in multivalent electrochemical systems.

Analgesic Electrical Stimulation Combined with Wrist-Ankle Acupuncture Reduces the Cortical Response to Pain in Patients with Myofasciitis: A Randomized Clinical Trial.

OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) based on wrist-ankle acupuncture has been shown to relieve pain levels in patients with myofascial pain syndrome (MPS). However, its efficacy is highly subjective. The purpose of this study was to evaluate the feasibility and effectiveness of TENS based on wrist-ankle acupuncture for pain management in patients with MPS from the perspective of cerebral cortex hemodynamics. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: We designed a double-blind, randomized, controlled clinical trial. Thirty-one male patients with MPS were randomly assigned to two parallel groups. The experimental group (n = 16) received TENS based on wrist-ankle acupuncture for analgesic treatment, while the control group (n = 15) did not. The pain was induced by mechanically pressurized at acupoint Jianjing. The multichannel functional near-infrared spectroscopy (fNIRS) equipment was utilized for measuring oxyhemoglobin (HbO) levels in the cerebral cortex during the tasks. RESULTS: After the intervention, visual analog scale (VAS), the activation degree and activation area of pain perception cortices were significantly reduced in the experimental group compared to the baseline values (P < .05). Particularly, Frontopolar Area (FPA), and Dorsolateral Prefrontal Cortex (DLPFC) are highly involved in the pain process and pain modulation. CONCLUSION: Compared to no intervention, TENS based on wrist-ankle acupuncture can be effective in relieving pain in patients with MPS in terms of cerebral cortical hemodynamics. However, further studies are necessary to quantify the analgesic effect in terms of cerebral hemodynamics and brain activation.

Effect of music intervention on subjective scores, heart rate variability, and prefrontal hemodynamics in patients with chronic pain.

Introduction: Music interventions have been proposed in recent years as a treatment for chronic pain. However, the mechanisms by which music relieves pain are unclear, and the effects of music intervention on physiological indicators in patients with chronic pain remain to be explored. This study aimed to explore whether a music intervention would have effects on subjective pain ratings, heart rate variability, and functional connectivity of the cerebral cortex in patients with chronic pain. Methods: A randomized controlled study was conducted on 37 pain patients aged 18-65 years, with the control group receiving usual care, and the intervention group receiving music intervention (8-150 Hz, 50-70 dB) for 30 min before bedtime for 7 days on top of usual care. Pain visual analog scale and heart rate variability were used as subjective and objective physiological indices before and after the music intervention, respectively. Changes in oxyhemoglobin and deoxyhemoglobin concentrations in the cerebral cortex were measured by functional near-infrared spectroscopy, and whole-brain correlation analysis was used to quantify the connectivity of prefrontal brain regions associated with the pain response. Results: Results showed that patients with chronic pain in the intervention group had significantly lower visual assessment scale scores, as well as significantly lower overall voluntary mobility during pain episodes, resulting in relatively higher vagal innervation compared to the control group. In addition, connections between the bilateral dorsolateral prefrontal cortex (BA9, BA46) and frontal areas (BA10) were significantly higher in the intervention group. Discussion: This study demonstrates the effectiveness of the combined application of music interventions with usual care in reducing pain levels in patients with chronic pain and provides insight into the pathological mechanisms of music interventions for analgesia, providing direction for new baseline indicators for quantitative clinical assessment of pain. The study was registered in the Chinese Clinical Trial Registry (No. ChiCTR2100052993). Clinical trial registration: [https://www.chictr.org.cn/showproj.aspx?proj=136268], identifier [ChiCTR2100052993].

Photoreversible Bond-Based Shape Memory Polyurethanes with Light-Induced Self-Healing, Recyclability, and 3D Fluorescence Encryption.

Developing a shape memory polyurethane with high mechanical properties, excellent self-healing has become a huge challenge for the development of smart materials. Herein, we report the design and fabrication of a shape memory polyurethane network terminated with coumarin units (HEOMC-PU) to address this conundrum. The synthesized HEOMC-PU exhibits exceptional mechanical performance with a breaking elongation of 746% and toughness of 55.5 MJ·m-3. By utilizing the dynamically reversible behavior of coumarin units to repair the damaged network, the efficient self-healing performance (99.2%) of HEOMC-PU is obtained. In addition, the prepared network and light-induced dynamic reversibility endow the HEOMC-PU with both liquid-state remoldability and solid-state plasticity, respectively, enabling polyurethane to be recycled and processed multiple times. Furthermore, based on the fluorescence responsive characteristic of coumarin, HEOMC-PU with a fluorescent pattern can be deformed into specific three-dimensional configurations by combining photolithography, self-healing, and the shape memory effect. Such a multilevel and multidimensional anti-counterfeiting platform with rewritable fluorescent patterns and reconfigurable shapes can open up a new encryption approach for future intelligent anti-counterfeiting.

Colon-targeted oral nanoparticles based on ROS-scavenging hydroxyethyl starch-curcumin conjugates for efficient inflammatory bowel disease therapy.

Co-delivery of anti-inflammatory drugs and reactive oxygen species (ROS) scavengers by stimuli-responsive oral nanoparticles is deemed to be a favorable strategy for inflammatory bowel disease (IBD) therapy. In this study, using micelles formed by CUR conjugated hydroxyethyl starch (HES) as vehicles, dexamethasone (DEX)-loaded HES-CUR nanoparticles (DHC NPs) with desirable size, negative surface charge, good stability in the harsh gastric environment, and excellent ROS scavenging activity are developed as a colon-targeted oral formulation for treating IBD. Due to the degradation of HES in response to α-amylase overexpressed in the inflamed colon, the DHC NPs release drugs in an α-amylase-responsive manner. Meanwhile, the DHC NPs can be effectively internalized by macrophages and show excellent cytocompatibility with macrophages since they are composed of food-derived compounds. Importantly, in vivo studies reveal that the DHC NPs are capable of targeting the inflamed colon induced by dextran sulfate sodium (DSS), and the targeted and combination therapy enhances the efficacy of free DEX and significantly relieves the impairment caused by DSS-induced ulcerative colitis. Incorporating the merits of targeted drug delivery and combined therapy with an anti-inflammatory drug and ROS scavenger, the DHC NPs are promising for developing novel oral formulations for IBD therapy.

Ketogenic diet for human diseases: the underlying mechanisms and potential for clinical implementations.

The ketogenic diet (KD) is a high-fat, adequate-protein, and very-low-carbohydrate diet regimen that mimics the metabolism of the fasting state to induce the production of ketone bodies. The KD has long been established as a remarkably successful dietary approach for the treatment of intractable epilepsy and has increasingly garnered research attention rapidly in the past decade, subject to emerging evidence of the promising therapeutic potential of the KD for various diseases, besides epilepsy, from obesity to malignancies. In this review, we summarize the experimental and/or clinical evidence of the efficacy and safety of the KD in different diseases, and discuss the possible mechanisms of action based on recent advances in understanding the influence of the KD at the cellular and molecular levels. We emphasize that the KD may function through multiple mechanisms, which remain to be further elucidated. The challenges and future directions for the clinical implementation of the KD in the treatment of a spectrum of diseases have been discussed. We suggest that, with encouraging evidence of therapeutic effects and increasing insights into the mechanisms of action, randomized controlled trials should be conducted to elucidate a foundation for the clinical use of the KD.

Pain modulation induced by electronic wrist-ankle acupuncture: A functional near-infrared spectroscopy study.

BACKGROUND: As a new technology, electronic wrist-ankle acupuncture (E-WAA) combines the advantages of wrist-ankle acupuncture and transcutaneous electrical nerve stimulation, but the analgesic effect and mechanism need to be clarified. The purpose of this study was to identify the pain modulation caused by E-WAA by evaluating the response of the prefrontal cortex (PFC) from the perspective of neurophysiology. METHODS: Fifty male volunteers (age 25.00 ± 1.05 years) with trapezius myofascial pain syndrome were randomly allocated into intervention group (E-WAA treatment) or sham control group at a 1:1 ratio. An outcome evaluation system was used to induce tenderness on the Jianjing point and record the pain value. A multichannel functional near-infrared spectroscope was used to detect the PFC activation during tenderness before and after treatment to demonstrate the neuromodulation mechanism. A general linear model and t-test (p < 0.05) were used to analyze the difference in the oxyhemoglobin (HbO) concentration and pain value. RESULTS: In the intervention group, the pain value of volunteers decreased significantly (p = 0.017) after E-WAA treatment, whereas there was no statistical difference (p = 0.082) in the sham group. Before treatment, the frontopolar (FP) and dorsolateral prefrontal cortex (DLPFC) were the activation areas of the PFC. The E-WAA treatment then suppressed the activation of the two areas. The HbO concentration of the FP and DLPFC changed from a sharp rise during tenderness to not changing with tenderness stimulation. CONCLUSION: The results demonstrated that the E-WAA have a great analgesic effect. The FP and DLPFC were relative to the analgesia neuromodulation induced by the E-WAA.

Intrinsic Catalytic Activities from Single Enzyme@Metal-Organic Frameworks by Using a Stochastic Collision Electrochemical Technique.

Enzymes encapsulated in metal-organic frameworks (enzyme@MOFs), as a promising immobilized enzyme, were investigated for intrinsic catalytic activities at the single entity level via a stochastic collision electrochemical technique. Zeolitic imidazolate frameworks with amorphous (aZIF-8) and crystalline (ZIF-8) structures were chosen as model MOFs to encapsulate glucose oxidase (GOx). We carried out single enzyme@MOF nanoparticle (NP) collision experiments using the carbon ultramicroelectrode (CUME), which demonstrated that the catalytic activity of GOx@ZIF-8 NPs was much less than GOx@aZIF-8 NPs. Meanwhile, the kcat and TON per GOx in aZIF-8 NPs were obtained, revealing the intrinsic catalytic activity of GOx in aZIF-8 NPs at the single entity level. This strategy is the first approach for investigating enzyme@MOFs at a single entity level, which can not only broaden the horizons of single entity electrochemistry (SEE) but also provide further insights into research on electrochemistry, catalysis, and nanocomposites.

Design and Implementation of an Intelligent Analgesic Bracelet Based on Wrist-ankle Acupuncture.

A flexible, multifunctional, and intelligent analgesic bracelet was proposed in this article to alleviate symptoms of pain. Based on the theory of wrist-ankle acupuncture in traditional Chinese medicine, transcutaneous electrical nerve stimulation is the technical basis of the method. A set of targeted circuit system capable of generating adjustable electrical stimulation signals to simulate filamentary acupuncture was designed. The system architecture includes a wireless communication module, a signal control module, a stimulus signal generation module, and a wearable, flexible bracelet. In addition, a pain assessment interface with a visual analog scale was designed to assess pain levels. Two comparative experiments were designed, involving a custom pain assessment scale and hand-held dolorimeter that were performed before and after wearing the bracelet to verify the analgesic effect of the bracelet. The results showed that the wrist-worn analgesic bracelet is significantly effective in alleviating pain in various parts of the human body.

Apatinib monotherapy for advanced VEGFR-2-negative nasopharyngeal carcinoma: A case report.

RATIONALE: Due to the anatomical and biological characteristics of nasopharyngeal carcinoma (NPC), radiotherapy is the standard treatment of choice. Recent advances in small molecule therapies targeting tumor angiogenesis also hold promise for the treatment of advanced NPC. PATIENT CONCERNS: The patient's symptoms, including nasal obstruction, nasal bleeding, and headache, reappeared periodically and eventually became so severe that the patient's vision became impaired. In January 2016, the patient presented with blurred vision, diplopia, language impairment, left temporal paralysis, and bilateral eyelid ptosis. DIAGNOSIS: Advanced NPC without metastasis in a 55-year-old man. INTERVENTIONS: The patient refused treatment with radiotherapy or chemotherapy and was treated with Chinese herbal medicines. Following a worsening of symptoms, the patient was subsequently treated with apatinib monotherapy (0.25 g, once daily). OUTCOMES: Symptom improvement, including decreased nasal bleeding and headache, was observed after 1 week of apatinib treatment. After 100 days of treatment, the patient was nearly asymptomatic with stable disease and improved quality of life. LESSONS: For patients with advanced NPC who refuse standard radiotherapy and chemotherapy, apatinib monotherapy may be a suitable treatment option to improve symptoms and quality of life even in those with vascular endothelial growth factor receptor-negative tumors.