pH-responsive albumin-mimetic synthetic nanoprobes for magnetic resonance/fluorescence imaging of thyroid cancer.

The combination of magnetic resonance and fluorescence imaging in dual-modality imaging not only resolves the limitations of conventional single molecular imaging techniques in terms of specificity, sensitivity, and resolution but also expands the possibilities of molecular imaging techniques in diagnostics and therapeutic monitoring. Herein, a novel pH-responsive magnetic resonance/near-infrared fluorescence (MR/NIRF) nanoprobe (MnO2@BSA-Cy5.5) was successfully prepared by biomineralizing manganese dioxide (MnO2) with bovine serum albumin (BSA) while coupling fluorescent dye Cy5.5 for precise tumor detection and visualization. The synthesized MnO2@BSA-Cy5.5 nanoprobes were spherical particles of approximately 22.62 ± 3.31 nm in size, and their relaxation rates and T1 imaging signals were activated-enhanced in an acidic environment. Cytotoxicity assay and hematoxylin and eosin staining demonstrated that MnO2@BSA-Cy5.5 had low cytotoxicity and good biocompatibility. More importantly, active targeting via solid tumor albumin-binding protein receptor and enhanced permeability and retention effect, the probe can be specifically aggregated to the tumor site of the 8305C tumor model and exhibit excellent MR/NIRF imaging properties. Our results show that MnO2@BSA-Cy5.5 has high resolution and sensitivity in tumor imaging and is expected to be applied as an MR/NIRF contrast agent for accurate diagnosis of thyroid cancer.

Redox/pH-responsive hollow manganese dioxide nanoparticles for thyroid cancer treatment.

The nano drug delivery system MnO2/CDDP@PDA-Cy5.5 was synthesized in this study to increase the efficacy of Cisplatin (CDDP) on thyroid cancer and alleviate the damage to normal tissue, with the aim of enhancing the anti-cancer efficacy, increasing the drug load, optimizing the control of drug release, and alleviating the systemic toxicity arising from drug off-target. On that basis, high efficacy and low toxicity win-win can be obtained. In this study, hollow manganese dioxide nanoparticles (MnO2 NPs) were prepared based on the template method. CDDP was loaded into the hollow cavity and then modified with polydopamine (PDA) and Cy5.5, with the aim of obtaining the nano-drug loading system MnO2/CDDP@PDA-Cy5.5 NPs. The NPs precisely delivered drugs by intelligently responding to the tumor microenvironment (TME). As indicated by the release curves, the NPs release CDDP rapidly by inducing the decomposition of PDA and MnO2 under acidic or redox conditions, and Magnetic resonance imaging (MRI) contrast agent Mn2+ was generated. The results of the in vivo MRI studies suggested that T1 contrast at the tumor site was notably enhanced under the Enhanced permeability and retention (EPR) effect. After the intravenous administration, the effective tumor accumulation exhibited by the NPs was confirmed by magnetic resonance imaging as a function of time. Compared with free CDDP, the in vivo therapeutic effect was remarkably increased. As indicated by the above-described results, MnO2/CDDP@PDA-Cy5.5 NPs is a drug delivery system exhibiting diagnostic and therapeutic functions.

Surgical management of proximal fibular tumors: risk factors for recurrence and complications.

Objectives The aim of this study was to identify patient- and treatment-specific independent risk factors for the recurrence of proximal fibular tumors and complications of their surgical management. Methods Patients who underwent surgical treatment of proximal fibular tumors at our institution from 2004 to 2015 were retrospectively reviewed. All patients had a pathologically confirmed diagnosis and were followed up for at least 12 months for recurrence and complications. All patients were evaluated with respect to seven patient-, disease-, and treatment-specific variables. Results In the univariate analysis, peroneal nerve palsy at presentation and malignancy were associated with an increased risk of recurrence, iatrogenic peroneal nerve injury, and wound healing problems. The multivariate analysis showed that peroneal nerve palsy at presentation was an independent risk factor for recurrence and iatrogenic peroneal nerve injury and that malignancy was an independent risk factor for wound healing problems. Conclusions Peroneal nerve palsy and malignant potential are independent risk factors for complications of surgical treatment of proximal fibular tumors. The recognition of these factors may contribute to proper management and help to prevent recurrence and postoperative complications.

Symptoms and signs associated with benign and malignant proximal fibular tumors: a clinicopathological analysis of 52 cases.

BACKGROUND: Malignant tumors in the proximal fibula are rare but life-threatening; however, biopsy is not routine due to the high risk of peroneal nerve injury. Our aim was to determine preoperative clinical indicators of malignancy. METHODS: Between 2004 and 2016, 52 consecutive patients with proximal fibular tumors were retrospectively reviewed. Details of the clinicopathological characteristics including age, gender, location of tumors, the presenting symptoms, the duration of symptoms, and pathological diagnosis were collected. Descriptive statistics were calculated, and univariate and multivariate regression were performed. RESULTS: Of these 52 patients, 84.6% had benign tumors and 15.4% malignant tumors. The most common benign tumors were osteochondromas (46.2%), followed by enchondromas (13.5%) and giant cell tumors (13.5%). The most common malignancy was osteosarcomas (11.5%). The most common presenting symptoms were a palpable mass (52.0%) and pain (46.2%). Pain was the most sensitive (100%) and fourth specific (64%); both high skin temperature and peroneal nerve compression had the highest specificity (98%) and third sensitivity (64%); change in symptoms had the second highest specificity (89%) while 50% sensitivity. Using multivariate regression, palpable pain, high skin temperature, and peroneal nerve compression symptoms were predictors of malignancy. CONCLUSIONS: Most tumors in the proximal fibula are benign, and the malignancy is rare. Palpable pain, peroneal nerve compression symptoms, and high skin temperature were specific in predicting malignancy.

[Analysis of risk factors for deep vein thrombosis of the lower extremity for patients with bone metastases].

OBJECTIVE: To analyze the risk factors for deep vein thrombosis (DVT) of the lower extremity in patients with bone metastases. METHODS: Ninety patients with bone metastases were admitted to our hospital From January 2010 to December 2011, and their clinical data were retrospectively analyzed. There were 57 males and 33 females with a mean age of 61 years (range, 27 to 78 years). On admission, all cases were detected by color Doppler ultrasonography for DVT of bilateral lower extremities. Univariate and multivariate analyses were performed to determine the probable risk factors including gender, age, body weight, tumor location, bed confinement and etc. RESULTS: Among the 90 patients, DVT was found in 24 patients on admission and the DVT incidence was 26.7% (24/90). The univariate analysis showed that bed confinement, multiple metastasis, pathological fracture, primary lesion detected, blood group, fibrinogen and hematocrit were significantly related to the incidence of DVT (P < 0.05). The logistic multivariate regression analysis showed that bed confinement, pathological fracture and fibrinogen were independent risk factors for the incidence of DVT. CONCLUSIONS: Bed confinement, pathological fracture and fibrinogen are independent risk factors for the incidence of DVT for patients with bone metastases. Patients with bed confinement >3 days, pathological fracture or fibrinogen >4 g/L should be routinely screened for lower extremity DVT on admission. Once identified, the DVT patients should be treated as early as possible.