Chlorin e6-loaded sonosensitive magnetic nanoliposomes conjugated with the magnetic field for enhancing anti-tumor effect of sonodynamic therapy.

In sonodynamic therapy (SDT), when Chlorin e6 (Ce6) accumulates in tumor tissues, its anti-tumor effect can be achieved by ultrasound activation. To increase the local drug concentration of Ce6 in tumor cells, we had established a novel drug delivery system, Ce6-loaded sonosensitive magnetic nanoliposome (Ce6/SML), which realized the targeting delivery by the external magnetic field. It was worth mentioning that the targeting release of Ce6/SML and the activation on Ce6 could be achieved simultaneously by ultrasound of SDT. In our study, after Ce6 was loaded into the sonosensitive magnetic nanoliposome (SML), the values of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in vitro and in vivo were determined, indicating the activation on Ce6 of ultrasound. The delivery system also displayed the tumor-targeting ability and anti-tumor activity, which associated with the determined tumor growth and expression levels of angiogenin (ANG), vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF-α). In conclusion, the Ce6/SML-SDT-Targeted delivery system could effectively enhance the anti-tumor activity of SDT and had a great potential application for the treatment of malignant tumors located in deep tissues.

[Value of preventive tracheotomy in patients with acute cervical spinal cord injury].

OBJECTIVE: To evaluate the value of preventive tracheotomy in patients with acute cervical spinal cord injury. METHODS: A retrospective analysis was performed on 54 cases of severe C4-C8 cervical spinal cord injury patients undergoing anterior fixation. They were classified as A and B according to the criteria of American Spinal Injury Association. And no tracheotomy was performed preoperatively. The patients with a high risk of dyspnea and with an indication for preventive tracheotomy received a preventive tracheotomy right after anterior fixation. 11 cases were classified into tracheotomy group and 43 cases were in non-tracheotomy group. The preoperative and hospital stays, incidence of hypoxemia and pulmonary infection, incidence of surgical incision site infection and mortality were analyzed between two groups. RESULTS: The preoperative and hospital stays of tracheotomy group were shorter than those of non-tracheotomy group (2.9 ± 1.2 vs 5.7 ± 4.4 days, 10.3 ± 4.0 vs 16.5 ± 9.2 days). The incidence of hypoxemia was lower in tracheotomy group (9.1% vs 44.2%). There was difference existed between two groups. 44.2% patients in the non-tracheotomy group underwent tracheotomy or endotracheal intubation for dyspnea and hypoxemia. There was no significant difference between two groups in the incidence of pulmonary infection (9.1% vs 7.0%) or surgical incision site infection (0 vs 2.3%). The mortality of non-tracheotomy group was 3.07 folds of that of tracheotomy group (9.1% vs 27.9%). But there was no significant statistical difference. CONCLUSION: The preventive tracheotomy is an effective solution for the patients with respiratory compromises, a high risk of dyspnea and with an indication for preventive tracheotomy. The preventive tracheotomy for severe cervical spinal cord can improve respiratory function effectively and fixation may be performed earlier. And there are lower rates of mortality and infection.

Application of triangular vector to functionally reconstruct the medial collateral ligament with double-bundle allograft technique.

PURPOSE: The purpose of this study was to present a novel medial collateral ligament (MCL) reconstruction technique and investigate the clinical outcomes of this surgical procedure. METHODS: From July 2006 to June 2009, 56 patients with medial instability of the knee were treated with MCL reconstruction and followed up for 33 months on average. These patients were divided into 2 groups based on whether anterior cruciate ligament (ACL) injury was present: 27 patients had isolated MCL injury, whereas 29 patients had combined MCL-ACL injury. All patients underwent reconstruction of the MCL with triangular double-bundle allograft, and we evaluated International Knee Documentation Committee (IKDC) scores, anteromedial rotatory instability (AMRI), and excessive knee medial opening (EKMO) both preoperatively and at follow-up. RESULTS: EKMO was significantly reduced to 2.9 mm at follow-up compared with 10.1 mm preoperatively. The incidence of AMRI was reduced to 9.4% (5 patients) compared with 67.9% (36 patients) preoperatively. Of the patients, 58.9% (33 patients) had a grade A IKDC subjective score and 35.7% (20 patients) had a grade B IKDC subjective score. Most patients had normal or nearly normal range of motion of the knee joint, whereas 4 patients (7.1%) lost more than 6° of range of motion in extension and 2 (3.6%) lost more than 25° in flexion. In 47 patients (83.9%) the symptoms were graded as normal or nearly normal according to IKDC symptom scores. No significant differences in IKDC subjective score, IKDC symptom score, flexion deficit score, AMRI, and EKMO were found between the isolated MCL injury group and the MCL-ACL injury group; however, a significant difference was found in knee extension deficit between groups. CONCLUSIONS: We have presented a new technique for reconstruction of the MCL with a triangular shape. This technique improved both valgus and rotational stability at short-term outcome. The clinical outcomes using IKDC evaluation indicate that no major difference exists in isolated MCL injury and combined MCL-ACL injury treated with this new technique. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Poly[diaqua-µ-oxalato-µ-pyrazine-2-carbox-yl-ato-lanthanum(III)].

In the title complex, [La(C(5)H(3)N(2)O(2))(C(2)O(4))(H(2)O)(2)](n), the La(III) ion is coordinated by one N and three O atoms from two pyrazine-2-carboxylate ligands, by four O atoms from two oxalate ligands and by two O atoms of two water molecules, displaying a distorted bicapped square-anti-prismatic geometry. The carboxyl-ate groups of pyrazine-2-carboxyl-ate and oxalate ligands link the lanthanum metal centres, forming layers parallel to (10). The layers are further connected by inter-molecular O-H⋯O and N-H⋯O hydrogen-bonding inter-actions, forming a three-dimensional supra-molecular network.

Medial Compartment Decompression by Fibular Osteotomy to Treat Medial Compartment Knee Osteoarthritis: A Pilot Study.

Compared with high tibial osteotomy and total knee arthroplasty, the authors found a simpler surgical procedure, partial fibular osteotomy, could effectively relieve knee pain and also correct the varus deformity for patients with medial compartment knee osteoarthritis (OA). From January 1996 to April 2012, a total of 156 patients with medial compartment OA were treated by proximal fibular osteotomy in the authors' hospital. A 2-cm-long section of fibula was resected 6 to 10 cm below the fibular head. A total of 110 patients with follow-up of more than 2 years were included in the study, including 34 males and 76 females with an average age of 59.2 years. Anteroposterior and lateral weight-bearing radiographs, the femorotibial angle (FTA) and lateral joint space, and the American Knee Society Score (KSS) and the visual analog scale (VAS) score of the knee joint were evaluated preoperatively and at final follow-up, respectively. At final follow-up, mean FTA and lateral joint space were 179.4°±1.8° and 6.9±0.7 mm, respectively, which were significantly smaller than those measured preoperatively (182.7°±2.0° and 12.2±1.1 mm, respectively; both P<.001). Mean KSS at final follow-up was 92.3±31.7, significantly higher than the mean preoperative score of 45.0±21.3 (P<.001). Mean VAS score and interquartile range were 2.0 and 2.0, significantly lower than the preoperative data (7 and 1.0, respectively; P<.001). The authors found that proximal fibular osteotomy can significantly improve both the radiographic appearance and function of the affected knee joint and also achieve long-term pain relief. This procedure may be an alternative treatment option for medial compartment OA.