Improvements of myocardial strain and work in diabetes patients with normal ejection fraction after empagliflozin treatment.

AIMS/INTRODUCTION: To assess the effect of empagliflozin treatment on left ventricular (LV), right ventricular (RV) and left atrial (LA) functions in diabetes patients with normal ejection fraction. MATERIALS AND METHODS: The study included a total of 128 diabetes patients with multiple cardiovascular risk factors who were subjected to a 6-month follow up from the initiation of empagliflozin treatment. Before and after treatment with empagliflozin, LV, RV and LA strain, and noninvasive myocardial work parameters were evaluated by speckle tracking echocardiography. RESULTS: In 128 diabetes patients (mean age 56 ± 8 years, 85 men) with multiple cardiovascular risk factors, myocardial strain and work parameters were impaired, despite the absence of significant clinical symptoms of heart failure. After 6-month treatment with empagliflozin, the absolute value of LV strain in all directions increased, represented by LV global longitudinal strain (-18.0 ± 1.7% to -19.2 ± 1.7% [mean ± SD]). The same trend in LV global work efficiency (93 [91-94] % to 94 [93-95] % [median (IQR)]), RV free-wall longitudinal strain (-24.0 ± 2.7% to -25.0 ± 2.8%), LA reservoir (31 ± 5% to 34 ± 5%) and conduit strain (-14 ± 4% to -16 ± 4%) was also observed. LV mass index (106.9 ± 16.8-103.6 ± 16.4 g/m2) and LV global wasted work (143 [111-185] mmHg% to 108 [88-141] mmHg%) decreased after treatment (P < 0.05 for all). LV volume and LA volume index remained unchanged after treatment. In the multivariable analysis, the change in LA reservoir strain (ß = 0.050, P = 0.035) and baseline global longitudinal strain (ß = -0.488, P < 0.001) were independent predictors of improvement in LV global longitudinal strain. CONCLUSIONS: This study suggests that 6-month treatment with empagliflozin improved LV, RV and LA functions in diabetes patients with normal ejection fraction.

Relative apical sparing obtained with speckle tracking echocardiography is not a sensitive parameter for diagnosing light-chain cardiac amyloidosis.

Background: Distinguishing light-chain cardiac amyloidosis (AL CA) from left ventricular wall thickening (LVWT) resulted from other etiologies has proven to be challenging. This study aimed to determine the sensitivity and specificity of relative apical sparing in diagnosing AL CA and investigate the differences in clinical and echocardiographic characteristics between AL CA patients with apical sparing and those with non-apical sparing. Methods: A total of 63 consecutive patients with AL CA, 102 consecutive patients with LVWT (including 51 hypertrophic cardiomyopathy (HCM) and 51 hypertension) and 33 healthy individuals were recruited retrospectively at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Conventional and speckle tracking echocardiography were performed on all subjects. Results: Although wall thickening was observed in all patients, almost all functional parameters were worse in AL CA, except for relative apical longitudinal strain (LS) (P=0.906). Of 63 patients with AL CA, only 17.5% (n=11) showed an apical sparing pattern. Patients with apical sparing had poorer cardiac performance than those with non-apical sparing. Relative apical sparing showed the lowest diagnostic accuracy with an area under the curve (AUC) of 0.58 [95% confidence interval (CI): 0.49-0.67, sensitivity: 17.5%, specificity: 98.0%, P=0.095] to detect AL CA, but right ventricular strain (RVS) (AUC: 0.86, P<0.001) showed the highest among all echocardiographic parameters. When diagnosing AL CA patients with non-apical sparing, RVS continued to maintain excellent diagnostic accuracy (AUC: 0.84, P<0.001), followed by left atrial reservoir strain (LASr) (AUC: 0.77, P<0.001). Conclusions: The diagnostic value of relative apical sparing for AL CA was limited with low sensitivity. In clinical practice, the diagnosis of early AL CA patients should not solely rely on relative apical sparing.

Pressure-driven dome-shaped superconductivity in topological insulator GeBi2Te4.

The discovery of new superconductors based on topological insulators always captures special attention due to their unique structural and electronic properties. High pressure is an effective way to regulate the lattice as well as electronic states in the topological insulators, thus altering their electronic properties. Herein, we report the structural and electrical transport properties of the topological insulator GeBi2Te4by using high-pressure techniques. The synchrotron x-ray diffraction revealed that GeBi2Te4underwent two structural phase transitions fromR-3m(phase I) toC2/m(phase II) and then intoIm-3m(phase III). Superconductivity was observed at 6.6 GPa to be associated with the first structural phase transition. The superconducting transition temperatureTcreached a maximum value of 8.4 K, accompanied by theRHsign changing from negative to positive at 14.6 GPa, then gradually decreased with increasing pressure in phase III, showing a dome-shaped phase diagram. The present results provide a platform for understanding the interplay between the crystal structure and superconductivity by the regulation of pressure in the topological insulator materials.

Giant Reduction of Stabilized Pressure for the Superconducting Re0.8V0.2Se2 Phase.

Access to new superconducting phases in transition-metal dichalcogenides (TMDs) via pressure treatment has been the primary target in this field. As equally essential as the fabrication of new superconducting materials at high pressure, maneuvering new superconducting phases at moderate pressures is also one of the core goals in the synthesis community. Here, we successfully reduced the synthesized pressure of the superconducting phase in ReSe2 by combining V-doping and high-pressure techniques, with a reduction in pressure of 50% in contrast to ReSe2. Our electrical transport measurements displayed that metallization appeared at 10 GPa and subsequently superconductivity appeared at about 52.4 GPa with Tc ∼ 1.9 K. There was a giant reduction in the stable pressure of the superconducting phase derived from the d-electrons and interlayer interaction changes, as evidenced by the Hall effect and X-ray diffraction measurements. These findings serve as ideal starting points and guidance for designing superconducting TMDs at moderate pressures.

Research Status and Application Prospects of the Medicinal Mushroom Armillaria mellea.

Armillaria is one of the most common diseases underlying chronic root rot in woody plants. Although there is no particularly effective way to prevent it, soil disinfection is a common effective protective measure. However, Armillaria itself has important medicinal value and is a symbiotic fungus in the cultivation of Gastrodia elata and Polyporus umbellatus. Therefore, researching Armillaria is of great practical significance. In this review, the biological characteristics, cultivation methods, chemical components, food and medicinal value and efficacy of Armillaria were all reviewed, and its development and utilization direction were analyzed and discussed.

Evaluation of Fetal Cardiac Function in Maternal Gestational Diabetes Mellitus by Speckle-Tracking Echocardiography.

OBJECTIVES: Gestational diabetes mellitus (GDM) is the most common metabolic disease that occurs during pregnancy and may result in fetal cardiac dysfunction. Our study aimed to assess the cardiac function in fetuses of mothers with GDM by a quantitative analysis software based on speckle-tracking echocardiography. METHODS: Forty-nine fetuses exposed to GDM and 50 normal fetuses were enrolled, and fetal echocardiography were performed and analyzed in this prospective cross-sectional study. We compared cardiac systolic function between the two groups using fetal cardiac quantitative analysis software. RESULTS: In the GDM group, left ventricular (24 ± 4 versus 28 ± 4, P < .001) and right ventricular global longitudinal strain (23 ± 4 versus 26 ± 4, P = .002) and right ventricular free wall strain (26 ± 6 versus 29 ± 5, P = .006) were significantly lower compared with the control group, whereas there was no significant difference in global spherical index (1.2 ± 0.1 versus 1.2 ± 0.1, P = .425). Additionally, 24-segment transverse fraction shortening of the right ventricle was more impaired than the left, and the segments with reduced fraction shortening were mainly located in the mid and apical sections of the right ventricle, and midsection of the left ventricle. CONCLUSION: Fetuses exposed to GDM may have cardiac dysfunction before the onset of cardiac morphologic abnormalities, and the right ventricle is more vulnerable than the left during fetal development.

Effects of Human Capital on Energy Consumption: The Role of Income Inequality.

High-quality human capital (HC) development has a strong influence on achieving a win-win target of economic growth and energy consumption mitigation based on the background of the contemporary "carbon neutrality" constraints in China. We here aim to empirically assess the effect of HC on energy consumption (EC) in 30 provinces of China from 2000 to 2019. Moreover, we broaden the literature by discussing the effect of HC in terms of impact mechanism and nonlinear relationship. Based on methods of the augmented mean group (AMG), the estimation of long-term impacts indicates that the improvement of HC significantly discourages the increase in EC. The intrinsic mechanism shows that the accumulation of HC significantly promotes the decline of EC through economic structure adjustment and technological innovation. Moreover, the threshold model indicates that income equality lifts the inhibitory impact of HC on EC. Accordingly, the development of HC should be involved in the policy preference of China's provincial and national development strategies considering its effectiveness in stimulating the reduction of energy consumption.

Integrated Gradient-Based Continuous Wavelet Transform for Bearing Fault Diagnosis.

Bearing fault diagnosis is important to ensure safe operation and reduce loss for most rotating machinery. In recent years, deep learning (DL) has been widely used for bearing fault diagnosis and has achieved excellent results. Continuous wavelet transform (CWT), which can convert original sensor data to time-frequency images, is often used to preprocess vibration data for the DL model. However, in time-frequency images, some frequency components may be important, and some may be unimportant for DL models for fault diagnosis. So, how to choose a frequency range of important frequency components is needed for CWT. In this paper, an Integrated Gradient-based continuous wavelet transform (IG-CWT) method is proposed to address this issue. Through IG-CWT, the important frequency components and the component frequency range can be detected and used for data preprocessing. To verify our method, experiments are conducted on four famous bearing datasets using 3 DL models, separately, and compared with CWT, and the results are compared with the original CWT. The comparisons show that the proposed IG-CWT can achieve higher fault diagnosis accuracy.

Semi-Supervised Defect Detection Method with Data-Expanding Strategy for PCB Quality Inspection.

Printed circuit board (PCB) defect detection plays a crucial role in PCB production, and the popular methods are based on deep learning and require large-scale datasets with high-level ground-truth labels, in which it is time-consuming and costly to label these datasets. Semi-supervised learning (SSL) methods, which reduce the need for labeled samples by leveraging unlabeled samples, can address this problem well. However, for PCB defects, the detection accuracy on small numbers of labeled samples still needs to be improved because the number of labeled samples is small, and the training process will be disturbed by the unlabeled samples. To overcome this problem, this paper proposed a semi-supervised defect detection method with a data-expanding strategy (DE-SSD). The proposed DE-SSD uses both the labeled and unlabeled samples, which can reduce the cost of data labeling, and a batch-adding strategy (BA-SSL) is introduced to leverage the unlabeled data with less disturbance. Moreover, a data-expanding (DE) strategy is proposed to use the labeled samples from other datasets to expand the target dataset, which can also prevent the disturbance by the unlabeled samples. Based on the improvements, the proposed DE-SSD can achieve competitive results for PCB defects with fewer labeled samples. The experimental results on DeepPCB indicate that the proposed DE-SSD achieves state-of-the-art performance, which is improved by 4.7 mAP at least compared with the previous methods.

Pathogenicity of Beauveria bassiana PfBb and Immune Responses of a Non-Target Host, Spodoptera frugiperda (Lepidoptera: Noctuidae).

Exploring the pathogenicity of a new fungus strain to non-target host pests can provide essential information on a large scale for potential application in pest control. In this study, we tested the pathogenicity of Beauveria bassiana PfBb on the important agricultural pest Spodoptera frugiperda (Lepidoptera: Noctuidae) by determining the relative activities of protective enzymes and detoxifying enzymes in different larval instars. Our results show that the B. bassiana PfBb strain could infect all six larval instars of S. frugiperda, and its virulence to S. frugiperda larvae gradually increased with an increase in spore concentration. Seven days after inoculation, the LC50 of B. bassiana PfBb was 7.7 × 105, 5.5 × 106, 2.2 × 107, 3.1 × 108, 9.6 × 108, and 2.5 × 1011 spores/mL for first to sixth instars of S. frugiperda, respectively, and the LC50 and LC90 of B. bassiana PfBb for each S. frugiperda instar decreased with infection time, indicating a significant dose effect. Furthermore, the virulence of B. bassiana PfBb to S. frugiperda larvae gradually decreased with an increase in larval instar. The activities of protective enzymes (i.e., catalase, peroxidase, and superoxide dismutase) and detoxifying enzymes (i.e., glutathione S-transferases, carboxylesterase, and cytochrome P450) in S. frugiperda larvae of the first three instars infected with B. bassiana PfBb changed significantly with infection time, but such variations were not obvious in the fifth and sixth instars. Additionally, after being infected with B. bassiana PfBb, the activities of protective enzymes and detoxification enzymes in S. frugiperda larvae usually lasted from 12 to 48 h, which was significantly longer than the control. These results indicate that the pathogenicity of B. bassiana PfBb on the non-target host S. frugiperda was significant but depended on the instar stage. Therefore, the findings of this study suggest that B. bassiana PfBb can be used as a bio-insecticide to control young larvae of S. frugiperda in an integrated pest management program.

Predicting prognosis and immune responses in hepatocellular carcinoma based on N7-methylguanosine-related long noncoding RNAs.

Background: Hepatocellular carcinoma (HCC), which has high rates of recurrence and metastasis and is the main reason and the most common tumor for cancer mortality worldwide, has an unfavorable prognosis. N7-methylguanosine (m7G) modification can affect the formation and development of tumors by affecting gene expression and other biological processes. In addition, many previous studies have confirmed the unique function of long noncoding RNAs (lncRNAs) in tumor progression; however, studies exploring the functions of m7G-related lncRNAs in HCC patients has been limited. Methods: Relevant RNA expression information was acquired from The Cancer Genome Atlas (TCGA, https://portal.gdc.cancer.gov), and m7G-related lncRNAs were identified via gene coexpression analysis. Afterward, univariate Cox regression, least absolute shrinkage and selection operator (LASSO) regression, and multivariate regression analyses were implemented to construct an ideal risk model whose validity was verified using Kaplan-Meier survival, principal component, receiver operating characteristic (ROC) curve, and nomogram analyses. In addition, the potential functions of lncRNAs in the novel signature were explored through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses and gene set enrichment analysis (GSEA). At last, in both risk groups and subtypes classified based on the expression of the risk-related lncRNAs, we analyzed the immune characteristics and drug sensitivity of patients. Results: After rigorous screening processes, we built a model based on 11 m7G-related lncRNAs for predicting patient overall survival (OS). The results suggested that the survival status of patients with high-risk scores was lower than that of patients with low-risk scores, and a high-risk score was related to malignant clinical features. Cox regression analysis showed that the m7G risk score was an independent prognostic parameter. Moreover, immune cell infiltration and immunotherapy sensitivity differed between the risk groups. Conclusion: The m7G risk score model constructed based on 11 m7G-related lncRNAs can effectively assess the OS of HCC patients and may offer support for making individualized treatment and immunotherapy decisions for HCC patients.

lncRNA XIST is associated with preeclampsia and mediates trophoblast cell invasion via miR-340-5p/KCNJ16 signaling pathway.

BACKGROUND: Preeclampsia (PE) is a syndrome commonly occurring among the pregnant. Shallow trophoblast invasion is considered to be closely related to PE. Therefore, in trophoblast cells, we explored the potential mechanisms of lncRNA XIST in the modulation of trophoblast invasion and proliferation. METHODS: GEO online analyzer was used to screen the abnormally expressed RNAs in placenta tissues from patients with severe PE and healthy controls. The prediction of target bindings was performed on TargetScan and starBase. Transfection was conducted to regulate the RNA expression levels in trophoblast cells, HTR-8/SVneo. RT-qPCR measured expression of lncRNA XIST, miR-340-5p and KCNJ16. The CCK-8 assay examined cell viability. Flow cytometer analyzed apoptosis and luciferase assay determined the luciferase activity. Transwell assays detected the invasion and western blot verified the changes in protein expression of MMP2, MMP9 and KCNJ16 in trophoblast cells. RESULTS: lncRNA XIST expression was enhanced in PE patients. Upregulation of lncRNA XIST in HTR-8/SVneo cells inhibited the cell proliferation and invasion, and induced apoptosis. XIST upregulation inhibited MMP2 and MMP9 protein expression. lncRNA XIST/ KCNJ16 interplayed as ceRNAs of miR-340-5p. Specifically,miR-340-5p overexpression reversed the effect of XIST upregulation on the cell apoptosis, proliferation and invasive ability and the knockdown of KCNJ16 could add to the effect of miR-340-5p overexpression in HTR-8/SVneo. CONCLUSION: lncRNA XIST was upregulated in PE. Upregulation of lncRNA XIST exerted the inhibitory effects on the proliferation and invasion of trophoblast cells through the interactions with miR-340-5p/KCNJ16, which suggests that the lncRNA XIST/miR-340-5p/KCNJ16 axis might play a role in PE.

The Global, Regional, and National Burden and Trends of Infective Endocarditis From 1990 to 2019: Results From the Global Burden of Disease Study 2019.

Introduction: Infective endocarditis (IE) presents with increasing incidence and mortality in some regions and countries, as well as serious socioeconomic burden. The current study aims to compare and interpret the IE burden and temporal trends globally and in different regions from 1990 to 2019. Methods: Data on the incidence, deaths and disability-adjusted life years (DALYs) caused by IE were extracted and analyzed from the Global Burden of Disease Study 2019. Estimated annual percentage changes (EAPC) were adopted to quantify the change trends of age-standardized rates (ASRs). Besides, potential contributors of serious IE burden were also evaluated including age, gender, social-demographic index (SDI), and age-standardized incident rate (ASIR) in 1990. Results: Globally, the number of IE cases and deaths has increased sharply during the past 30 years from 478,000 in 1990 to 1,090,530 in 2019 and from 28,750 in 1990 to 66,320 in 2019, and both presented an upward temporal trend annually (EAPC:1.2 for incidence and 0.71 for death). However, the EAPC of age-standardized DALYs demonstrated a negative temporal trend despite increasing DALYs from 1,118,120 in 1990 to 1,723,590 in 2019. Moreover, older patients and men were more severely affected. Meanwhile, different SDI regions had different disease burdens, and correlation analyses indicated that SDI presented a positive association with ASIR (R = 0.58, P < 0.0001), no association with age-standardized death rate (R = -0.06, P = 0.10), and a negative association with age-standardized DALYs (R = -0.40, P < 0.0001). In addition, the incidence of IE increased in most countries during the past 30 years (190 out of 204 countries). However, the change trends of deaths and DALYs were heterogeneous across regions and countries. Finally, we discovered positive associations of the EAPC of ASRs with the SDI in 2019 among 204 countries and territories but few associations with the ASIR in 1990. Conclusion: Generally, the global burden of IE is increasing, and there is substantial heterogeneity in different genders, ages and regions, which may help policy-makers and medical staff respond to IE and formulate cost-effective interventional measures.

Persistent Endothelial Dysfunction in Coronavirus Disease-2019 Survivors Late After Recovery.

BACKGROUND: Coronavirus disease 2019 (COVID-19) can result in an endothelial dysfunction in acute phase. However, information on the late vascular consequences of COVID-19 is limited. METHODS: Brachial artery flow-mediated dilation (FMD) examination were performed, and inflammatory biomarkers were assessed in 86 survivors of COVID-19 for 327 days (IQR 318-337 days) after recovery. Comparisons were made with 28 age-matched and sex-matched healthy controls and 30 risk factor-matched patients. RESULTS: Brachial artery FMD was significantly lower in the survivors of COVID-19 than in the healthy controls and risk factor-matched controls [median (IQR) 7.7 (5.1-10.7)% for healthy controls, 6.9 (5.5-9.4)% for risk factor-matched controls, and 3.5(2.2-4.6)% for COVID-19, respectively, p < 0.001]. The FMD was lower in 25 patients with elevated tumor necrosis factor (TNF)-α [2.7(1.2-3.9)] than in 61 patients without elevated TNF-α [3.8(2.6-5.3), p = 0.012]. Furthermore, FMD was inversely correlated with serum concentration of TNF-α (r = -0.237, p = 0.007). CONCLUSION: Survivors of COVID-19 have a reduced brachial artery FMD, which is inversely correlated with increased serum concentration of TNF-α. Prospective studies on the association of endothelial dysfunction with long-term cardiovascular outcomes, especially the early onset of atherosclerosis, are warranted in survivors of COVID-19.

Normalized Cardiac Structure and Function in COVID-19 Survivors Late After Recovery.

Background: Coronavirus disease 2019 can result in myocardial injury in the acute phase. However, information on the late cardiac consequences of coronavirus disease 2019 (COVID-19) is limited. Methods: We conducted a prospective observational cohort study to investigate the late cardiac consequences of COVID-19. Standard echocardiography and myocardial strain assessment were performed, and cardiac blood biomarkers were tested in 86 COVID-19 survivors 327 days (IQR 318-337 days) after recovery. Comparisons were made with 28 age-matched and sex-matched healthy controls and 30 risk factor-matched patients. Results: There were no significant differences in all echocardiographic structural and functional parameters, including left ventricular (LV) global longitudinal strain, right ventricular (RV) longitudinal strain, LV end-diastolic volume, RV dimension, and the ratio of peak early velocity in mitral inflow to peak early diastolic velocity in the septal mitral annulus (E/e') among COVID-19 survivors, healthy controls and risk factor-matched controls. Even 26 patients with myocardial injury at admission did not have any echocardiographic structural and functional abnormalities. There were no significant differences among the three groups with respect to serum concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (cTnI). Conclusion: This study showed that COVID-19 survivors, including those with myocardial injury at admission and those with severe and critical types of illness, do not have any echocardiographic evidence of cardiac structural and functional abnormalities 327 days after diagnosis.

Hypervalent Iodine(III)-Mediated Tosyloxylation of 4-Hydroxycoumarins.

An efficient approach was developed for synthesis of 3-tosyloxy-4-hydroxycoumarins under mild conditions by using Koser's reagents. The reaction tolerated various functional groups, and the products served as useful aromatic building blocks. Additionally, a plausible mechanism via iodonium ylide was proposed, and the oral anticoagulant Warfarin was synthesized in good yield.

Utilization of waste cake for fermentative ethanol production.

In this study, utilization of waste cake for bioethanol production via a two-step of enzymatic hydrolysis and ethanol fermentation was developed. At the first step, namely waste cake hydrolysis, effects of α-amylase volumes (C1: 0.1 mL/L, C2: 0.4 mL/L, C3, 0.8 mL/L) on the performance of hydrolysis were investigated. Both chemical oxygen demand (COD) and reducing sugar (RS) could reach the highest values after 80 min for all the conditions. The maximum COD of 86.3 g/L, RS of 44 g/L and waste reduction of 85.2% were achieved at C3. At the second step, namely ethanol fermentation, the produced waste cake hydrolysate was used as the sole feedstock for fermentative ethanol production, and the highest ethanol production of 46.6 g/L and ethanol yield of 1.13 g/g RS were obtained (C3), respectively. This corresponds to an overall ethanol yield of 1.12 g ethanol/g initial dry cake which is the highest ethanol yield compared to using other food wastes reported to date. These values are higher than using the glucose as feedstock since the waste cake hydrolysate could provide the carbon and nitrogen sources for ethanol fermentation.

Corrigendum to "Expression of HE4 in Endometrial Cancer and Its Clinical Significance".

[This corrects the article DOI: 10.1155/2015/437468.].

Layer-by-layer nanoparticles co-loading gemcitabine and platinum (IV) prodrugs for synergistic combination therapy of lung cancer.

PURPOSE: Cisplatin plus gemcitabine (GEM) is a standard regimen for the first-line treatment of advanced non-small cell lung cancer. The aim of this study was to prepare biocompatible and biodegradable polymeric prodrugs and construct nanoparticles (NPs) with layer-by-layer (LbL) technique. METHODS: Platinum (Pt) (IV) complex with a carboxyl group was conjugated to the amino group of chitosan (CH), resulting in a CH-Pt conjugation with positive charge. GEM with amino group was conjugated to the carboxyl group of hyaluronic acid (HA), resulting in a HA-GEM conjugation with negative charge. Novel LbL NPs consisting of the CH-Pt core and the HA-GEM layer, named as HA-GEM/CH-Pt NPs, were constructed. The physicochemical properties of the HA-GEM/CH-Pt NPs were investigated. In vitro cytotoxicity against human non-small lung cancer cells (NCl-H460 cells) was investigated, and in vivo antitumor efficiency was evaluated on mice bearing NCl-H460 cells xenografts. RESULTS: HA-GEM/CH-Pt NPs have a size of about 187 nm, a zeta potential value of -21 mV and high drug encapsulation efficiency of 90%. The drug release of HA-GEM/CH-Pt NPs exhibited a sustained behavior. HA-GEM/CH-Pt NPs could significantly enhance in vitro cytotoxicity and in vivo antitumor effect against lung cancer animal model compared to the single-drug-loaded NPs and free drug solutions. CONCLUSION: The results demonstrated that the HA-GEM/CH-Pt NPs might be a promising system for the synergetic treatment of lung carcinoma.