Tailoring bismuth-based nanoparticles for enhanced radiosensitivity in cancer therapy.

Achieving a complete response to cancer treatment is a severe challenge, and has puzzled humans for a long time. Fortunately, radiotherapy (RT) gives rise to a common clinical treatment method, during which the usage of radiosensitizers is essential. Among preclinical radiosensitizers, bismuth-based nanoparticles (Bi-based NPs) are widely explored in cancer diagnosis and treatment, because they share favourable properties, such as low toxicity, strong X-ray absorption and facile preparation. However, pure Bi alone cannot achieve both efficient and safe RT outcomes, mainly due to poor targeting of tumor sites, long retention-induced systemic toxicity and immune resistance. This work provides an overview of recent advances and developments in Bi-based NPs that are tailored to enhance radiosensitivity. For the fabrication process, surface modification of Bi-based NPs is essential to achieve tumor-targeted delivery and penetration. Moreover, the incorporation of other elements, such as Fe ions, can increase diagnostic accuracy with optimal theranostic efficacy. Meanwhile, the structure-activity relationship can also be manipulated to maximize the chemotherapeutic drug loading capability of Bi-based NPs, to enhance X-ray attenuation by means of a large surface area or to achieve safer metabolic routes with rapid clearance from the human body. In addition, Bi-based NPs exhibit synergistic antitumor potential when combined with diverse therapies, such as photothermal therapy (PTT) and high-intensity focused ultrasound (HIFU). To summarize, the latest research on Bi-based NPs as radiosensitizers is described in the review, including both their advantages and disadvantages for improving treatment, thus providing a useful guide for future clinical application.

Molecular mapping of major QTL conferring resistance to orange wheat blossom midge (Sitodiplosis mosellana) in Chinese wheat varieties with selective populations.

KEY MESSAGE: Two novel midge resistance QTL were mapped to a 4.9-Mb interval on chromosome arm 4AL based on the genetic maps constructed with SNP markers. Orange wheat blossom midge (OWBM) is a devastating insect pest affecting wheat production. In order to detect OWBM resistance genes and quantitative trait loci (QTL) for wheat breeding, two recombinant inbred line (RIL) populations were established and used for molecular mapping. A total of seven QTL were detected on chromosomes 2D, 4A, 4D and 7D, respectively, of which positive alleles were all from the resistant parents except for the QTL on 7D. Two stable QTL (QSm.hbau-4A.2-1 and QSm.hbau-4A.2-2) were detected in both populations with the LOD scores ranging from 5.58 to 29.22 under all three environments, and they explained a combined phenotypic variation of 24.4-44.8%. These two novel QTL were mapped to a 4.9-Mb physical interval. The single-nucleotide polymorphism (SNP) markers AX-109543456, AX-108942696 and AX-110928325 were closely linked to the QTL and could be used for marker-assisted selection (MAS) for OWBM resistance in wheat breeding programs.

Screening for differential expression of genes for resistance to Sitodiplosis mosellana in bread wheat via BSR-seq analysis.

KEY MESSAGE: Five putative candidate genes for OWBM resistance in Chinese winter wheat 'Jimai 24' were identified via BSR-seq and differential expression analyses. Orange wheat blossom midge (OWBM), Sitodiplosis mosellana, is one of the most serious threats to wheat production worldwide. Conventional gene mapping methods to identify genes require significant amounts of financial support and time. Here, bulked segregant RNA-seq (BSR-seq) was applied to profile candidate genes and develop associated markers for OWBM resistance. Previously, we identified a major QTL (QSm.hebau-4A) for OWBM resistance on the long arm of chromosome 4A. In this study, we aimed at screening differentially expressed resistance genes associated with this QTL. Twelve differentially expressed genes (DEGs) were obtained based on BSR-seq and differential expression analyses. Among them, four were confirmed to be associated with OWBM resistance via quantitative reverse transcription PCR, using an additional set of wheat samples subjected to OWBM invasion. One SPI-like gene and one Malectin-like gene were revealed by gene annotation, respectively. Sequencing results confirmed that the four DEGs and the SPI gene had SNP polymorphisms between wheat parents. All these five resistance-related genes for OWBM were located in the same genomic region with QSm.hebau-4A. Furthermore, six new markers developed based on sequences of the five genes were also mapped in the same genomic region using genetic population. These five genes may be the candidate genes for OWBM resistance in Chinese wheat 'Jimai 24' and should be the targets for further positional isolation.

A Randomized Comparison of Double Small, Standard, and Endoscopic Approaches for Carpal Tunnel Release.

BACKGROUND: The purpose of this study was to introduce a new surgical technique of carpal tunnel release through double small incisions, and to compare the technique with the standard open release and endoscopic release. METHODS: Two hundred and seven patients were allocated randomly into group A (n = 73), B (n = 65), or C (n = 69). Patients in group A were treated with carpal tunnel release by means of double small incisions. Patients in group B were treated by means of the standard incision. Patients in group C had endoscopic release. RESULTS: Preoperatively, the mean severity of symptoms of groups A, B, and C was 3.7 ± 0.58, 3.8 ± 0.62, and 3.7 ± 0.52, respectively; and the mean functional status was 3.2 ± 0.71, 3.2 ± 0.71, and 3.5 ± 0.64, respectively. At the final follow-up of 3 years, the mean severity of symptoms of the groups was 1.2 ± 0.45, 1.2 ± 0.31, and 1.5 ± 0.36, respectively; and the mean functional status was 1.2 ± 0.38, 1.2 ± 0.41, and 1.5 ± 0.42, respectively. Patient satisfaction was 95 ± 4.2, 90 ± 5.8, and 93 ± 4.4, respectively. There were no significant differences between groups regarding symptom severity or function status (p > 0.05). For scar appearance, there were significant differences between groups A and B and between B and C, but not between A and C; for patient satisfaction, there were significant differences in all comparisons. CONCLUSIONS: Carpal tunnel release by means of double small incisions is a minimally invasive and less technically challenging procedure with good nerve visualization, resulting in good appearance of scars. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

High Glucose Concentration Promotes Vancomycin-Enhanced Biofilm Formation of Vancomycin-Non-Susceptible Staphylococcus aureus in Diabetic Mice.

We previously demonstrated that vancomycin treatment increased acquisition of eDNA and enhanced biofilm formation of drug-resistant Staphylococcus aureus through a cidA-mediated autolysis mechanism. Recently we found that such enhancement became more significant under a higher glucose concentration in vitro. We propose that besides improper antibiotic treatment, increased glucose concentration environment in diabetic animals may further enhance biofilm formation of drug-resistant S. aureus. To address this question, the diabetic mouse model infected by vancomycin-resistant S. aureus (VRSA) was used under vancomycin treatment. The capacity to form biofilms was evaluated through a catheter-associated biofilm assay. A 10- and 1000-fold increase in biofilm-bound bacterial colony forming units was observed in samples from diabetic mice without and with vancomycin treatment, respectively, compared to healthy mice. By contrast, in the absence of glucose vancomycin reduced propensity to form biofilms in vitro through the increased production of proteases and DNases from VRSA. Our study highlights the potentially important role of increased glucose concentration in enhancing biofilm formation in vancomycin-treated diabetic mice infected by drug-resistant S. aureus.

Photocrosslinkable gellan gum film as an anti-adhesion barrier.

The purpose of this study was to develop a gellan gum-based film which could be photocrosslinked for medical applications. Gellan gum was grafted with cinnamate to yield the photo crosslinkable polymer (gellan gum-cin). This material had 14.7% of its D-galacturonic residues reacted with cinnamate groups and displayed maximum absorption at 254 nm. Investigation of the photochemical properties showed that the crosslinking efficiency was 82% after 16 min of UV irradiation. The anti-adhesion films prepared from gellan gum-cin polymers exhibited high gel contents (88 ± 2%) and suitable mechanical properties. When implanted into rats, the gellan gum-cin film exhibited the most promising anti-adhesion potential in 2 out of 10 rats without forming any tissue adhesion. Furthermore, the gellan gum-cin film could effectively inhibit inflammation in rats based on the results of fluid leukocyte analyses. The gellan gum-cin film thus has potential in clinical applications.

Treatment of bony boutonniere deformity with a loop wire.

Boutonniere deformity associated with a dorsal avulsion fracture of the central slip overlying the proximal interphalangeal joint results in loss of extension of the joint and hyperextension of the distal interphalangeal joint. This article reports a surgical technique for treatment of the injury in 21 digits, which involves application of loop stainless steel wire. We also present the long-term results using the technique on the digits. Loop wire fixation is a successful surgical technique for the treatment of displaced central slip avulsion fracture.

Temporary ex vivo posterior tibial artery bypass for iliofemoral artery injury.

BACKGROUND: The objective of this study is to report a temporary, ex vivo, distal extremity revascularization technique providing distal perfusion and allowing for a staged repair of complex iliofemoral injury. In addition, the objective of this report is to provide outcome data after this novel procedure including mortality, limb salvage, and quality of limb assessment. METHODS: From February 1993 to December 2005, temporary ex vivo posterior tibial artery revascularization from the uninjured (donor) to the injured extremity was performed in 14 patients. All patients had blunt iliofemoral artery injury with class III or IV hemorrhagic shock. An end-to-end anastomosis between the two posterior tibial arteries was performed. Muscle strength of both legs was measured using the Medical Research Council scale and grade 5 means normal strength. RESULTS: The mean age at surgery was 35 years+/-7.4 years (mean+/-SD). All patients with ipsilateral legs survived. Patency of the bypass was achieved in all cases. At a mean time of 30 days+/-10 days after injury, the injured iliofemoral artery was reconstructed, and the bypass was transected 7 days later. At the final follow-up, the muscle strength of both legs was of grade 5 based on Medical Research Council scale. Static two-point discrimination test scores were similar on both feet. CONCLUSIONS: Temporary ex vivo revascularization of the posterior tibial artery is a feasible option in selecting patients with blunt iliofemoral artery injury with ischemia and severe physiologic derangements. This unconventional method provides extremity perfusion distal to the injury and maintains neuromuscular viability during an interval period, allowing for a staged, proximal revascularization after improvement in the patient's physiologic condition.

Pull-out wire fixation for acute mallet finger fractures with k-wire stabilization of the distal interphalangeal joint.

PURPOSE: The aim of this study was to describe and assess a surgical technique for the treatment of mallet finger fractures using a pull-out wire with K-wire stabilization of the distal interphalangeal (DIP) joint in extension. METHODS: From May 2003 to January 2008, we performed pull-out wire fixation of the fracture fragment with stabilization of the DIP joint using a K-wire in 65 closed mallet finger fractures in 65 patients with a mean age of 32 years (range, 18-48). The mean time between the injury and surgery was 8 days (range, 0-19 d). In this cohort, the mean joint surface involvement was 39% (range, 30% to 49%) and all injuries were associated with DIP joint subluxation. Fifteen days after surgery, the digits were assessed for skin necrosis, skin breakdown, and wound and wire track infection. Patient follow-up lasted 24 to 27 months, with a mean period of 25.5 months. The fingers were assessed for loss of extension and flexion of the DIP joints. We graded the results using Crawford's criteria. RESULTS: Fracture reduction was maintained and all fractures united. We found no skin necrosis, skin breakdown, infection, or nail deformities. At the final follow-up, the mean extensor loss of the DIP joints was 7° (range, 0° to 37°). The mean flexion loss of the DIP joints was 1° (range, 0° to 15°). We noted extensor loss of the joint less than 10° in 57 digits and 10° to 15° (mean, 13°) in 8 digits. Based on Crawford's criteria, 52 digits were excellent, 8 were good, 4 were fair, and one was poor. CONCLUSIONS: Pull-out wire fixation of the reduced fracture fragment and K-wire stabilization of the DIP joint is a useful technique for the treatment of mallet finger fractures. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Second dorsal metacarpal artery flap from the dorsum of the middle finger for coverage of volar thumb defect.

PURPOSE: The second dorsal metacarpal artery flap from the middle finger is a reconstructive technique that can be used to repair extensive volar defects in a normal-length thumb. However, few reports advocate using it for coverage of volar thumb defects. In this article, an anatomic study of 9 flaps used for resurfacing thumb defects is presented along with the clinical experience of the authors. METHODS: From 2004 to 2006, 9 patients (6 men and 3 women; mean age, 33 years; range, 18-51 years) with extensive volar defects of their normal-length thumbs had reconstruction using the described technique. In all cases, the first dorsal metacarpal artery flap technique was unable to be used because of injury. Donor sites were covered using full-thickness skin grafts. After surgery, the thumb was immobilized with a splint, followed by rehabilitation. During the follow-up period, which lasted 24 to 30 months, flap-site skin quality, scar contractures, and finger mobility were assessed. The range of motion of the hand was measured by a goniometer. Sensibility was evaluated by the 2-point discrimination test and the Semmes-Weinstein monofilament test. Cold intolerance was also assessed. RESULTS: Patient postoperative courses were uneventful, and all flaps survived completely without complication. Good coverage was obtained in all cases. Full active range of motion was observed in all patients in both the donor finger and the thumb. The mean Semmes-Weinstein sensitivity and 2-point discrimination scores of the flap were 4.02 g and 8.4 mm, respectively. Mild cold intolerance was observed in all of the thumbs. CONCLUSIONS: The second dorsal metacarpal artery flap from the middle finger is a single-stage flap that produces good results. Although its pedicle length is limited, it is reliable and can be used as an alternative for reconstruction of extensive thumb-pulp defects, especially when the first dorsal metacarpal artery flap cannot be used. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

[Identification of sulphur residue in chrysanthemum by Fourier transform infrared spectroscopy].

Qi and Huai chrysanthemum samples processed in different ways were discriminated by means of Fourier transform infrared (FTIR) spectroscopy. It was shown that different processing methods may result in the variation of relative content of effective components in chrysanthemum. The variation of chemical structure may also occur. And the variations can be reflected differently on the transform infrared spectra. The dry chrysanthemum smoked with sulphur had different characters in the vibration frequency and shape of IR from other samples at 1 600 and 1 060 cm(-1), and showed static characteristic absorptions at 922, 818 and 777 cm(-1), which were stronger than others. The chrysanthemum processed in different ways showed differences in the Fourier transform infrared spectra. The sulphur residue in chrysanthemum can be identified by FTIR without separation and abstraction. This method is not only quick and precise but also convenient and direct. Different sorts of chrysanthemum can be identified in this way.

[Study of flos lonicerae in local herbs and other areas by FTIR spectrum].

The FTIR spectra of flos lonicerae(FL) in four different areas are analysed by FTIR and the comparison of local(Henan) FL and FL in other areas is also studied. The result shows that the FL in different areas have the different content of main effective substance, so their absorption frequency and form in FTIR spectra are different as well. There is an obvious difference between Sichuan and local FL in wave number and form. Although FL in Shandong is famous as local herbs, their spectra are different slightly. The FL in Hebei and Shandong have almost the same spectrum. The local FL has a weak peak at 1 734 cm(-1), however, the FL in Shandong and Hebei don't have. The local FL has a group of weak peaks at 1 522 cm(-1) and others have stronger and independent absorption or split peaks at the same point. The peak forms of local herbs are sharp from 1 155 to 1 045 cm(-1) while those of Shandong and Hebei are flat and split ones. Therefore, FTIR can be not only a fast and reliable method to identify local herbs, but also a method to monitor the cultivating process and to purify and restore the Chinese medicine.

[Identification of wheat varieties by FTIR spectrum].

The spectra of eight kinds of wheat roots were determined by FTIR spectrometry and the absorption peaks were analyzed. Results from the comparison of the spectra showed that there were some differences in the shape, wave number and the number of absorption peaks of their spectra within the same range of wave number. The spectra of different wheat varieties exhibited remarkable differences. The first difference was in the region of 2800-2980 cm(-1) which mainly reflected the stretching vibration of methyl and methylene, the length of molecular chain of compound, and the molecular weight. The second difference existed in the region of 1510-1730 cm(-1), which mainly reflected the substituent nature of amide N and alpha-C. The major differences of spectra in this region might result from the differences in genes. So FTIR spectra could be used for the identification of wheat varieties.