Current Status of Angiogenic Cell Therapy and Related Strategies Applied in Critical Limb Ischemia

Critical limb ischemia (CLI) constitutes the most severe form of peripheral arterial disease (PAD), it is characterized by progressive blockade of arterial vessels, commonly correlated to atherosclerosis. Currently, revascularization strategies (bypass grafting, angioplasty) remain the first option for CLI patients, although less than 45% of them are eligible for surgical intervention mainly due to associated comorbidities. Moreover, patients usually require amputation in the short-term. Angiogenic cell therapy has arisen as a promising alternative for these “no-option” patients, with many studies demonstrating the potential of stem cells to enhance revascularization by promoting vessel formation and blood flow recovery in ischemic tissues. Herein, we provide an overview of studies focused on the use of angiogenic cell therapies in CLI in the last years, from approaches testing different cell types in animal/pre-clinical models of CLI, to the clinical trials currently under evaluation. Furthermore, recent alternatives related to stem cell therapies such as the use of secretomes, exosomes, or even microRNA, will be also described.     

一种家用手持式红外偏振光治疗仪的设计与实现

红外偏振光治疗仪是一种将红外技术与电子技术应用到医学领域的康复理疗设备,主要用于软组织损伤和慢性疼痛的康复治疗,已在医院得到了推广使用。然而,现有医院使用的台式治疗仪由于体积大、售价高等特点,不方便居家使用。为了开发体积小、售价低、家庭可用的红外偏振光治疗仪,满足家用市场的潜在需求,本文提出了一种新的便携手持式红外偏振光治疗仪,并开发了该智能控制系统。本文首先介绍了一种新的家用手持式治疗仪应具备的特点和关键技术指标,在此基础上设计了手持式治疗仪的硬件总体方案和软件架构,简要介绍了该治疗仪的一些关键技术,最终实现了治疗仪样机的研制。为了验证该样机的性能,本文通过大量的测试,结果表明,研制的手持式红外偏振光治疗仪在关键参数指标上达到了医院同类产品的水平,能够很好地满足家用的需求,具有良好的市场前景。     

Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study

There is currently an outbreak of respiratory disease caused by a novel coronavirus. The virus has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes has been named coronavirus disease 2019 (COVID-19). More than 16% of patients developed acute respiratory distress syndrome, and the fatality ratio was 1%–2%. No specific treatment has been reported. Herein, we examined the effects of favipiravir (FPV) versus lopinavir (LPV)/ritonavir (RTV) for the treatment of COVID-19. Patients with laboratory-confirmed COVID-19 who received oral FPV (Day 1: 1600 mg twice daily; Days 2–14: 600 mg twice daily) plus interferon (IFN)-α by aerosol inhalation (5 million international unit (IU) twice daily) were included in the FPV arm of this study, whereas patients who were treated with LPV/RTV (Days 1–14: 400 mg/100 mg twice daily) plus IFN-α by aerosol inhalation (5 million IU twice daily) were included in the control arm. Changes in chest computed tomography (CT), viral clearance, and drug safety were compared between the two groups. For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms. A shorter viral clearance median time was found for the FPV arm versus the control arm (4 d (interquartile range (IQR): 2.5–9) versus 11 d (IQR: 8–13), P < 0.001). The FPV arm also showed significant improvement in chest CT compared with the control arm, with an improvement rate of 91.43% versus 62.22% (P = 0.004). After adjustment for potential confounders, the FPV arm also showed a significantly higher improvement rate in chest CT. Multivariable Cox regression showed that FPV was independently associated with faster viral clearance. In addition, fewer adverse events were found in the FPV arm than in the control arm. In this open-label before-after controlled study, FPV showed better therapeutic responses on COVID-19 in terms of disease progression and viral clearance. These preliminary clinical results provide useful information of treatments for SARS-CoV-2 infection.     

Combating Biofilm Associated Infection In Vivo: Integration of Quorum Sensing Inhibition and Photodynamic Treatment based on Multidrug Delivered Hollow Carbon Nitride Sphere

Recently, quorum sensing (QS) inhibitors (QSIs) have been combined with antibiotics to enhance antibiofilm efficacy in vitro and in vivo. However, targeting QS signals alone is not enough to prevent bacterial infections. Drug resistance and recurrence of biofilms makes it difficult to eradicate. Herein, photodynamic therapy (PDT) is selected to unite QSIs and antibiotics. A synergistically antibiofilm system, which combines QSIs, antibiotics, and PDT based on hollow carbon nitride spheres (HCNSs) is envisaged. First, HCNS provides the multidrug delivering ability, enabling QSIs and antibiotics to be released in sequence. Subsequently, multistage releases sensitize bacteria effectively, potentiating the chemotherapeutic effects of the antibiotics. Finally, the integration of QSIs and PDT not only minimizes the possibility of drug resistance, but also overcomes the problem of limited mass and extension of PDT. Even after 48 h of incubation, the bacterial biofilm is obviously inhibited. And its biofilm disperse efficiency exceeds 48% (compared with QSI‐potentiated chemotherapy group) and 40% (compared with PDT group). Besides, the inhibition of the QS system influences phenotypes related to virulence factor production and surface hydrophobicity, which weaken biofilm invasion and formation. Eventually, this system is applied to disperse bacterial biofilm in vivo. Overall, PDT and QS modulation are devoted to eradicate drug resistance and recurrence of the biofilm.     

心源性猝死一级预防植入心律转复除颤器前非持续室性心动过速与植入后恰当治疗的关系

目的探讨植入型心律转复除颤器(implantable cardioverter defibrillator,ICD)用于心源性猝死一级预防时,植入前发生非持续性室性心动过速(non-sustained ventricular tachycardia,NSVT)与植入后ICD恰当治疗的关系。方法本研究为单中心回顾性队列研究,连续纳入2006年1月至2017年12月在北京协和医院住院植入ICD用于一级预防的心脏病患者,患者在住院期间ICD植入前均完善Holter检查。根据Holter检查是否出现NSVT,将患者分为NSVT组及无NSVT组。门诊或电话随访至2018年8月,随访事件包括全因死亡、植入后ICD放电治疗及抗心动过速起搏(antitachycardia pacing,ATP)治疗情况。结果纳入60例符合入选和排除标准的患者,随访时间37 (14～61)个月,KaplanMeier生存曲线及Log-Rank检验提示,NSVT组与无NSVT组相比,全因死亡率无统计学差异(P=0. 108),NSVT组恰当治疗的风险高于无NSVT组(P=0. 033),NSVT和左心室射血分数与ICD恰当治疗独立相关(NSVT:HR=5. 099,95%CI:1. 399～18. 588,P=0. 014;左心室射血分数:HR=1. 077,95%CI:1. 013～1. 145,P=0. 018)。结论 ICD一级预防患者植入前出现NSVT提示接受ICD恰当治疗的风险增加。     

An automated treatment planning strategy for highly noncoplanar radiotherapy arc trajectories

Radiation therapy is a technology-driven cancer treatment modality that has experienced significant advances over the last decades, due to multidisciplinary contributions that include engineering and computing. Recent technological developments allow the use of noncoplanar volumetric modulated arc therapy (VMAT), one of the most recent photon treatment techniques, in clinical practice. In this work, an automated noncoplanar arc trajectory optimization framework designed in two modular phases is presented. First, a noncoplanar beam angle optimization algorithm is used to obtain a set of noncoplanar irradiation directions. Then, anchored in these directions, an optimization strategy is proposed to compute an optimal arc trajectory. The computational experiments considered a pool of twelve difficult head-and-neck tumor cases. It was possible to observe that, for some of these cases, the optimized noncoplanar arc trajectories led to significant treatment planning quality improvements, when compared with coplanar VMAT treatment plans. Although these experiments were done in a research environment treatment planning software (matRad), the conclusions can be of interest for a clinical setting: automated procedures can simplify the current treatment workflow, produce high-quality treatment plans, making better use of human resources and allowing for unbiased comparisons between different treatment techniques.     

Mitochondrial Bioenergetic,Photobiomodulation and Trigeminal Branches Nerve Damage,What’s the Connection? A Review

Background: Injury of the trigeminal nerve in oral and maxillofacial surgery can occur. Schwann cell mitochondria are regulators in the development, maintenance and regeneration of peripheral nerve axons. Evidence shows that after the nerve injury, mitochondrial bioenergetic dysfunction occurs and is associated with pain, neuropathy and nerve regeneration deficit. A challenge for research is to individuate new therapies able to normalise mitochondrial and energetic metabolism to aid nerve recovery after damage. Photobiomodulation therapy can be an interesting candidate, because it is a technique involving cell manipulation through the photonic energy of a non-ionising light source (visible and NIR light), which produces a nonthermal therapeutic effect on the stressed tissue. Methods: The review was based on the following questions: (1) Can photo-biomodulation by red and NIR light affect mitochondrial bioenergetics? (2) Can photobiomodulation support damage to the trigeminal nerve branches? (preclinical and clinical studies), and, if yes, (3) What is the best photobiomodulatory therapy for the recovery of the trigeminal nerve branches? The papers were searched using the PubMed, Scopus and Cochrane databases. This review followed the ARRIVE-2.0, PRISMA and Cochrane RoB-2 guidelines. Results and conclusions: The reliability of photobiomodulatory event strongly bases on biological and physical-chemical evidence. Its principal player is the mitochondrion, whether its cytochromes are directly involved as a photoacceptor or indirectly through a vibrational and energetic variation of bound water: water as the photoacceptor. The 808-nm and 100 J/cm² (0.07 W; 2.5 W/cm²; pulsed 50 Hz; 27 J per point; 80 s) on rats and 800-nm and 0.2 W/cm² (0.2 W; 12 J/cm²; 12 J per point; 60 s, CW) on humans resulted as trustworthy therapies, which could be supported by extensive studies.     

Recent Development of Photothermal Agents (PTAs) Based on Small Organic Molecular Dyes

Photothermal therapy (PTT) has attracted great attention due to its noninvasive and effective use against cancer. Various photothermal agents (PTAs) including organic and inorganic PTAs have been developed in the last decades. Organic PTAs based on small-molecule dyes exhibit great potential for future clinical applications considering their good biocompatibility and easy chemical modification or functionalization. In this review, we discuss the recent progress of organic PTAs based on small-molecule dyes for enhanced PTT. We summarize the strategies to improve the light penetration of PTAs, methods to enhance their photothermal conversion efficiency, how to optimize PTAs’ delivery into deep tumors, and how to resist photobleaching under repeated laser irradiation. We hope that this review can rouse the interest of researchers in the field of PTAs based on small-molecule dyes and help them to fabricate next-generation PTAs for noninvasive cancer therapy.     

microRNA在亨廷顿病中的研究进展

亨廷顿病(Huntington's disease, HD)是神经退行性疾病(neurodegenerative disorders)中一种单基因遗传病,由亨廷顿基因(the huntingtin gene, HTT)第一个外显子中的CAG三核苷酸序列重复扩增引起,尚无法治愈。HTT编码的蛋白产物被称为亨廷顿蛋白(Huntingtin protein, Htt)。突变亨廷顿蛋白(mutated huntingtin protein, mHtt)容易形成聚集体,具有毒性,导致一系列细胞学异常和神经元功能障碍。microRNA(miRNA)在基因转录后水平调控中起重要作用,其表达的改变与HD病理过程有关,成为治疗HD的潜在生物标志物。近年来,对一些特定miRNA在HD中调控机制及靶基因预测方面的研究可为HD提供潜在的治疗方法。本文就miRNA在HD中的相关研究进展进行综述。     

Reducing treatment zone diameter in orthokeratology and its effect on peripheral ocular refraction

PurposeTo determine whether orthokeratology (OK) induced treatment zone (TZ) diameter can be reduced by altering OK lens design, and if so the impact of modifying TZ diameter on relative peripheral refraction (RPR).Methods16 subjects (mean age 23.4 ± 1.5 years; 8 female) completed the study. Standard (Control) OK lens design (PJ, Capricornia, Australia) or a modified version (Test) where the back optic zone diameter was reduced, and back optic zone asphericity and intermediate lens curves were altered, were worn overnight only for 7-nights in a randomised double masked order, with a minimum 1-week wash out (no lens wear) between lens designs. Full correction of refractive error was targeted. Refraction; best corrected visual acuity (BCVA); RPR (Shin-Nippon NVision-k 5001) along the horizontal and vertical meridians; and corneal topography (Medmont E300) were measured before starting lens wear and in the morning after lens removal after the seventh night of lens wear for both lens designs. TZ diameter and decentration was calculated from corneal topography.ResultsAfter 7-nights of wear both lens designs created -2.00D refraction effect with no significant difference in refractive effect or change to BCVA between the designs. The Test design created a significantly smaller horizontal (4.78 ± 0.37 vs 5.70 ± 0.37 mm, p < 0.001) and vertical (5.09 ± 0.51 vs 5.92 ± 0.51 mm p < 0.001) TZ diameter. The TZ was decentered inferior temporal with no significant difference between designs. There was no significant difference between the lens designs in RPR along the horizontal and vertical meridians at any measurement period.ConclusionsOK induced TZ diameter can be reliably reduced by altering OK lens design without detrimentally effecting lens centration or refractive effect. Reducing TZ diameter did not alter RPR, though measurement artifacts could be responsible for masking an effect. Longitudinal studies are needed to assess whether smaller TZ OK lens designs increase efficacy for slowing progression of myopia.