Progress in research on B class CpG oligodeoxynucleotides in bacterial vaccines / 中国生物制品学杂志

@#CpG oligonucleotide(CpG ODN)is a synthetic oligodeoxynucleotide containing non-methylated CpG,which has broad application prospects in disease prevention and clinical treatment. Among them,B class CpG ODN is widely used in vaccine research because of its strong immune stimulation and some motifs have entered the clinical research stage. At the same time,the problem of bacterial resistance in clinical treatment has become increasingly serious,and the development of bacterial vaccine with B class CpG ODN as adjuvant has become a research hotspot. This paper reviewed the current research status and related progress of the existing B class CpG ODN 1826,2006,2007 and 1668 motifs in bacterial vaccines,with a view to providing a reference for the subsequent development and application of bacterial vaccines.

Compatibility Theory of Yiqi Zengmian Prescription as Vaccine Adjuvant / 中国实验方剂学杂志

ObjectiveThis study explored the application of Yiqi Zengmian prescription as a vaccine adjuvant， aiming to provide a new scheme for the prevention and control of corona virus disease 2019（COVID-19） with traditional Chinese medicine （TCM）. By analyzing the compatibility and efficacy， this paper examines the compatibility effect of Yiqi Zengmian prescription， which is modified from the classic tonifying agent Si Junzitang， as a vaccine adjuvant. MethodUsing the Database of Ancient Classical Prescriptions， this paper analyzed the composition of Yiqi Zengmian prescription and probed into the theoretical basis for the compatibility of this prescription from the properties， medicine combination， and efficacy. Furthermore， the compatibility effect of this prescription with vaccines was analyzed. ResultAs a TCM prescription， Yiqi Zengmian prescription focuses on the lung and spleen and enhances the Qi in the two organs. The lung governs Qi movement. The body breathes fresh air through the lungs and exchanges the turbid gas in the lungs， and the gas circulates alternately in the lungs to ensure the normal breathing of the human body. The spleen governing transportation and transformation is the hub for Qi movement， and Qi is the embodiment of metabolic function. By regulating qi movement and enhancing the functions of Qi and blood， Yiqi Zengmian prescription can enhance the immunogenicity of the vaccine， which provides a theoretical basis for enhancing the immune effects of vaccines. ConclusionYiqi Zengmian prescription has the effects of replenishing Qi and invigorating spleen， regulating Qi and drying dampness， and enhancing immunity. The in-depth analysis of the TCM theory of Yiqi Zengmian prescription as a vaccine adjuvant and the results of clinical and laboratory studies suggest that Yiqi Zengmian prescription may enhance the induction of immune response after vaccination and maintain the immune memory. However， the mechanism of Yiqi Zengmian prescription in regulating the complex immune network remains to be elucidated.

ASIA and BIA-ALCL as adverse reactions to silicone breast implants / ASIA e BIA-ALCL como reações adversas aos implantes mamários de silicone

Adjuvant-induced autoimmune/inflammatory syndrome leads to capsular contracture and fibrosis from the oxidation that takes place in silicone. Anaplastic large cell lymphoma occurs through the development of a seroma, with the formation of a periprosthetic effusion, or through the infiltration of the condition itself. To analyze these conditions, a review of the literature was carried out on the symptoms and pathophysiology of the autoimmune/inflammatory syndrome induced by adjuvants and anaplastic large cell lymphoma, searched using the terms "ASIA breast silicone," "Lymphoma," "Adjuvants" "Immunologic" " Breast Implants" on the PubMed platform. Analyzing the data obtained, it was noted that the symptoms of the autoimmune/inflammatory syndrome induced by adjuvants are nonspecific, such as fatigue, myalgia, arthralgia, morning stiffness, and night sweats, and therefore need attention. Anaplastic large cell lymphoma presents with breast pain, periprosthetic effusion, and palpable mass, among other characteristics. Because of these aspects, it is concluded that a good investigation should be carried out when nonspecific symptoms appear, regardless of the time the surgery was performed since these complications can occur years later.

A síndrome autoimune/inflamatória induzida por adjuvantes leva à contratura capsular e fibrose pela oxidação que acontece no silicone. O linfoma anaplásico de grandes células ocorre através do desenvolvimento de um seroma, com a formação de derrame periprotético ou por uma infiltração da própria afecção. Para análise destes acometimentos, foi realizada uma revisão da literatura acerca da sintomatologia e fisiopatologia da síndrome autoimune/inflamatória induzida por adjuvantes e linfoma anaplásico de grandes células, pesquisada através dos termos "ASIA breast silicone" "Lymphoma" "Adjuvants" "Immunologic" "Breast Implants" na plataforma PubMed. Analisando os dados obtidos, notou-se que os sintomas da síndrome autoimune/inflamatória induzida por adjuvantes são inespecíficos, como fadiga, mialgia, artralgia, rigidez matinal e suores noturnos, e, portanto, necessitam de atenção. Já o linfoma anaplásico de grandes células se apresenta com dor mamária, derrame periprotético, massa palpável, dentre outras características. Em vista destes aspectos, conclui-se que uma boa investigação deve ser realizada ao surgirem sintomas inespecíficos, independentemente do tempo que a cirurgia foi realizada, uma vez que estas complicações podem ocorrer anos após a cirurgia.

Hipertiroidismo por enfermedad de Graves posterior a vacuna contra SARS-CoV-2: reporte de 2 casos / Graves' disease hyperthyroidism following SARS-CoV-2 vaccination: a two cases report

Luego del inicio de las campañas de vacunación masiva contra la infección por COVID-19, se han publicado una serie de reportes que muestran la posible asociación entre la vacuna y alteraciones de la función tiroidea. Desde entonces, múltiples teorías han intentado explicar este hallazgo, en su mayoría de índole autoinmune. Dentro de estas destaca el síndrome autoinmune-autoinflamatorio secundario a adyuvantes (ASIA), que podría generar desórdenes tiroideos de novo o exacerbar los ya existentes. Presentamos dos casos de enfermedad de Graves Basedow posterior al uso de Coronavac. Ambas pacientes presentaron características similares a las descritas en la literatura y cumplen con los criterios de ASIA. No obstante, los beneficios de las vacunas superan los posibles riesgos asociados.

After the beginning of COVID-19 vaccination campaigns, a number of reports have shown the potential association between vaccines and thyroid disfunction. Since then several theories have tried to explain this finding, mostly autoinmmune. One of them is the autoimmune/inflammatory syndrome induced by adjuvants, that could trigger or exacerbate thyroid disease. We present two cases of Graves' disease post Coronavac vaccination. Both pacients share similar features than cases published previously and meet criteria for ASIA syndrome. Nevertheless, the benefts of vaccination largely outweigh any adverse events associated.

New-onset thyroid eye disease after COVID-19 vaccination in a radioactive iodine-treated graves’ disease patient: A case report and literature review / Journal of the ASEAN Federation of Endocrine Societies

@#Autoimmunity associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been well-described as the mechanism of development of thyroid dysfunction following Coronavirus Disease 19 (COVID-19) infection and SARS-CoV-2 vaccination. However, the occurrence of thyroid eye disease (TED) after SARS-CoV-2 vaccination is scarcely described. The postulated mechanisms include immune reactivation, molecular mimicry and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). We report a case of new-onset TED after receiving the SARSCoV- 2 vaccine.

Application and prospect of natural active ingredients of traditional Chinese medicine in immunological adjuvant for influenza vaccine / 中国中药杂志

Vaccination is an effective method for preventing influenza, and adjuvants can enhance the immune response intensity and persistence of influenza vaccines. However, there are currently shortcomings in clinical adjuvant approvals, ineffectiveness against weak antigens, and a tendency to cause headaches. Therefore, the development of safe and effective novel adjuvants for influenza vaccines is particularly important to enhance vaccine immunogenicity and safety. Given the wide range of sources, high safety, and biodegradability of traditional Chinese medicine(TCM), some studies have described it as a vaccine adjuvant. This article reviewed the current status and challenges of influenza vaccine adjuvants, summarized the types of TCM adjuvants, the safety and immunomodulatory effects of natural active ingredients from TCM combined with influenza vaccines, the role of TCM adjuvants in antigen storage, antigen presentation capability, immune cells and cytokines, and immune responses, and analyzed the advantages and disadvantages of TCM adjuvants compared with small molecule adjuvants, with the aim of promoting the clinical development and commercialization of TCM adjuvants for influenza vaccines.

Recent progress in application of nanovaccines for enhancing mucosal immune responses

Mucosal vaccines that stimulate both mucosal and systemic immune responses are desirable, as they could prevent the invading pathogens at their initial infection sites in a convenient and user-friendly way. Nanovaccines are receiving increasing attention for mucosal vaccination due to their merits in overcoming mucosal immune barriers and in enhancing immunogenicity of the encapsulated antigens. Herein, we summarized several nanovaccine strategies that have been reported for enhancing mucosal immune responses, including designing nanovaccines that have superior mucoadhesion and mucus penetration capacity, designing nanovaccines with better targeting efficiency to M cells or antigen-presenting cells, and co-delivering adjuvants by using nanovaccines. The reported applications of mucosal nanovaccines were also briefly discussed, including prevention of infectious diseases, and treatment of tumors and autoimmune diseases. Future research progresses in mucosal nanovaccines may promote the clinical translation and application of mucosal vaccines.

Evaluation of the humoral immunity in mice induced by foot-and-mouth disease virus-like particles-ZIF-8 complexes with different sizes / 生物工程学报

To further enhance the immune effect of the foot-and-mouth disease (FMD) virus-like particles (VLPs) vaccine, this study prepared FMDV VLPs-zeolitic imidazolate (framework-8, ZIF-8) complexes with different particle sizes. We used a biomimetic mineralization method with Zn2+ and 2-methylimidazole in different concentration ratios to investigate the effect of size on the immunization effect. The results showed that FMDV VLPs-ZIF-8 with three different sizes were successfully prepared, with an approximate size of 70 nm, 100 nm, and 1 000 nm, respectively. Cytotoxicity and animal toxicity tests showed that all three complexes exhibited excellent biological safety. Immunization tests in mice showed that all three complexes enhanced the titers of neutralizing and specific antibodies, and their immune effects improved as the size of the complexes decreased. This study showed that ZIF-8 encapsulation of FMDV VLPs significantly enhanced their immunogenic effect in a size-dependent manner.

Síndrome autoimune induzida por adjuvantes desencadeada por implantes mamários de silicone: revisão sistemática / Adjuvant-induced autoimmune syndrome triggered by silicone breast implants: systematic review

A síndrome autoimune induzida por adjuvantes (ASIA) e seus critérios diagnósticos foram descritos por Shoenfeld em 2011, relacionando sintomas de autoimunidade a adjuvantes, como o silicone, presente em próteses mamárias. Essa revisão sistemática objetivou reunir dados da literatura sobre a sintomatologia, a incidência e os tratamentos propostos para ASIA causada por implantes mamários de silicone (IMS). Foram realizadas pesquisas nas bases de dados PubMed, LILACS, Embase e Cochrane, utilizando os descritores "Autoimmune Syndrome Induced by Adjuvants", "Breast implant" e "Silicone Implant Incompatibility Syndrome". A estratégia de busca gerou 95 artigos, dos quais 20 foram incluídos na revisão. São as três as principais teorias sugeridas pelos autores para explicar o desenvolvimento da síndrome: predisposição genética, silicone bleeding e a formação de uma cápsula periprótese. As manifestações clínicas mais frequentemente descritas incluem fadiga crônica, artralgia, mialgia, distúrbios cognitivos e do sono. Não há consenso sobre os achados laboratoriais e os fatores de risco associados, além disso, estudos recentes propõem a ampliação dos critérios diagnósticos inicialmente descritos. O tratamento adequado permanece controverso, envolvendo desde o uso de medicações até o explante da prótese. Apesar dos artigos revisados sugerirem a existência da ASIA relacionada aos IMS, sua fisiopatologia precisa é desconhecida, os sintomas relatados são inespecíficos e o tempo entre a exposição e o surgimento das manifestações é incerto. Por meio dessa revisão sistemática, conclui-se que, até o presente momento, não existem evidências científicas suficientes para estabelecer a causalidade do desenvolvimento da síndrome autoimune induzida por adjuvantes decorrente de implantes mamários de silicone.

Adjuvant-induced autoimmune syndrome (ASIA) and its diagnostic criteria were described by Shoenfeld in 2011, relating symptoms of autoimmunity to adjuvants, such as silicone, present in breast implants. This systematic review aimed to gather data from the literature on symptomatology, incidence and proposed treatments for ASIA caused by silicone breast implants (SBI). Searches were carried out in PubMed, LILACS, Embase and Cochrane databases, using the descriptors "Autoimmune Syndrome Induced by Adjuvants," "Breast implant," and "Silicone Implant Incompatibility Syndrome." The search strategy generated 95 articles, of which 20 were included in the review. The authors suggest three main theories to explain the development of the syndrome: genetic predisposition, silicone bleeding and the formation of a periprosthetic capsule. The most frequently described clinical manifestations include chronic fatigue, arthralgia, myalgia, and cognitive and sleep disorders. There is no consensus on laboratory findings and associated risk factors; recent studies propose expanding the diagnostic criteria initially described. Adequate treatment remains controversial, ranging from medications to prosthesis explantation. Although the reviewed articles suggest the existence of ASIA related to SBI, its precise pathophysiology is unknown, the symptoms reported are nonspecific, and the time between exposure and the onset of manifestations is uncertain. This systematic review concludes that, to date, there is not enough scientific evidence to establish the causality of the development of adjuvant-induced autoimmune syndrome resulting from silicone breast implants.

Immunomodulatory potential of nanomaterials: Interaction with the immune system

Immunomodulation is an attractive approach to overcome the limitations of traditional therapeutic regimes against diseases. Immunomodulation-based therapies are emerging as promising alternative strategy that involves the defense mechanisms of the host to recognize and selectively eliminate diseases. Recent developments in nanotechnology have forged a revolution as development of nano-emulsions, nanotubes, and nanoparticles have provided promising strategies as novel immune-modulatorsto enhance efficacy at target sites. Moreover, interaction between nanoparticles and the immune system may cause unanticipated adverse reactions such as hypersensitivity, inflammation and necrosis. Therefore, to ensure a successful and safe clinical application of immune-modulatory nanoparticles, it is necessary to gain in-depth knowledge and a clear understanding of the multifaceted nature of the interactions between nanoparticles and immune system. Since elevated immunological responses are detrimental in elimination of exogenous or endogenous antigens, there are many bottlenecks that prevent the complete regulation of the immune system. Therefore, using nanostructures as transport vehicles to deliver immunological compounds to specific target sitesto overcome severe limitations. Different nanostructures are being exploited to develop novel adjuvants, innovative vaccines,and drugs to alter the immune system for various infectious and non-infectious diseases. The review focuses on various nanoparticle and their interplay with the immune system.

Control del dolor en el postoperatorio inmediato del servicio en servicio de cirugía / Pain control in the immediate postoperative period in the surgery service

Objetivo: Analizar el control del dolor en el postoperatorio inmediato del servicio en servicio de cirugía en el servicio de cirugía del Hospital Docente Ambato ­ Ecuador. Método: Descriptiva observacional en 99 pacientes quirúrgicos. Resultados: 52% de pacientes intervenidos quirúrgicamente se les diagnóstico una apendicitis aguda, seguido por la litiasis vesicular como patología quirúrgica con un 37, 4 % de representatividad. Conclusión: Para el bienestar del paciente es necesario el uso de medidas analgésicas frente a la consecuencia del acto quirúrgico, que es el dolor, se obtienen resultados positivos mediante la administración de medicación intravenosa (IV), manejo ambiental: confort y la vigilancia usando estas como las medidas base en el control de estos pacientes.

Objective: To analyze pain control in the immediate postoperative period in the surgery service at the surgery service of the Hospital Docente Ambato - Ecuador. Methods: Descriptive observational study in 99 surgical patients. Results: 52% of patients who underwent surgery were diagnosed with acute appendicitis, followed by vesicular lithiasis as a surgical pathology with 37.4% of representativeness. Conclusion: For the well-being of the patient it is necessary the use of analgesic measures against the consequence of the surgical act, which is pain, positive results are obtained through the administration of intravenous (IV) medication, environmental management: comfort and surveillance using these as the basic measures in the control of these patients.

mRNA cancer vaccines: Advances, trends and challenges

Patients exhibit good tolerance to messenger ribonucleic acid (mRNA) vaccines, and the choice of encoded molecules is flexible and diverse. These vaccines can be engineered to express full-length antigens containing multiple epitopes without major histocompatibility complex (MHC) restriction, are relatively easy to control and can be rapidly mass produced. In 2021, the U.S. Food and Drug Administration (FDA) approved the first mRNA-based coronavirus disease 2019 (COVID-19) vaccine produced by Pfizer and BioNTech, which has generated enthusiasm for mRNA vaccine research and development. Based on the above characteristics and the development of mRNA vaccines, mRNA cancer vaccines have become a research hotspot and have undergone rapid development, especially in the last five years. This review analyzes the advances in mRNA cancer vaccines from various perspectives, including the selection and expression of antigens/targets, the application of vectors and adjuvants, different administration routes, and preclinical evaluation, to reflect the trends and challenges associated with these vaccines.

Immune effects of Clostridium difficile toxoid B vaccine formulated with different mucosal adjuvants through microneedle immunization / 中华微生物学和免疫学杂志

Objective:To investigate the immune effects of Clostridium difficile toxoid B (CdtB) vaccine formulated with different mucosal adjuvants through microneedle immunization, and to provide ideas for the prevention and treatment of Clostridium difficile infection. Methods:CdtB vaccine was prepared with purified Clostridium difficile toxin B(TcdB) after formaldehyde detoxification. Female BALB/c mice were immunized with different doses of vaccine alone or in combination with mucosal adjuvants. The titers of specific serum IgG and fecal IgA were detected at 0 d, 7 d, 14 d, 28 d and 42 d after immunization. The protective effects of CdtB vaccine were evaluated by cell neutralization assay and Clostridium difficile challenge infection. Results:(1) With the increase of immune dose, the mice immunized with CdtB vaccine alone by microneedle not only produced better serum specific IgG, but also had higher level of IgA in feces. (2) When the mice were immunized with CdtB vaccine containing LT or CTB adjuvant by microneedle, the trend of serum specific IgG titer in each group increased with the increase of immune dose, especially in the group containing LT adjuvant. There were significant differences in the trend of specific IgA titer in feces between the adjuvant groups and the group without adjuvant, but the adjuvant effect was not obvious. (3) No significant difference in serum IgG titer was observed between the mice immunized with 10 μg CdtB by microneedle or intraperitoneal injection, but microneedle immunization significantly increased fecal IgA level. (4) The neutralization titers of specific antibodies in mouse serum after immunization and the test results of challenge protection in mice confirmed that the use of CdtB vaccine had certain protective effects.Conclusions:CdtB vaccine had better immune effects in mice through microneedle immunization, but the adjuvant effects of LT and CTB were not significant.

Hyperbaric oxygen therapy in wound healing in mice / [Oxigenoterapia hiperbárica na cicatrização de feridas em camundongos]

We investigated the local and systemic effects of hyperbaric oxygen therapy in BALB/C mice, exposed to two different exposure times, under 2.4 atmosphere (ATM). Fifteen animals were divided into three groups (GI, GII and Control) and underwent a surgical excision of a skin fragment of approximately one square centimeter of the dorsal region. The wounds were treated and monitored for 21 days. In the control group, the wound was cleaned once a day with sterile 0.9% NaCl solution. GI and GII mice were submitted to daily hyperbaric oxygen therapy of 30 or 60minutes sessions, respectively. The wounds were photographed every three days and their surfaces were analyzed by an image analyzer. At 21 days, all animals were euthanatized for histopathological analysis of the skin, lungs and liver in order to identify eventual alterations in wound healing or in the analyzed organs. Animals belonging to GI showed a faster skin wound healing in comparison to the other groups. Animals from GII, however, showed a delayed wound healing process and exhibited lung and microcirculatory alterations. These findings allow us to conclude that the exposure time to the oxygen in hyperbaric environment is crucial and can help or disturb skin wound healing or even be deleterious to other organs.(AU)

Investigaram-se os efeitos locais e sistêmicos da oxigenoterapia hiperbárica em camundongos BALB / C, submetidos a dois tempos de exposição diferentes, sob atmosfera 2,4 (ATM). Quinze animais foram divididos em três grupos (GI, GII e controle) e submetidos à excisão cirúrgica de fragmento de pele de aproximadamente um centímetro quadrado da região dorsal. As feridas foram tratadas e acompanhadas por 21 dias. No grupo controle, a ferida foi limpa uma vez ao dia, com solução estéril de NaCl 0,9%. Camundongos GI e GII foram submetidos à oxigenoterapia hiperbárica diária de 30 ou 60 minutos de sessões, respectivamente. As feridas foram fotografadas a cada três dias, e suas superfícies analisadas por um analisador de imagens. Aos 21 dias, todos os animais foram submetidos à eutanásia para análise histopatológica da pele, do pulmão e do fígado, em busca de eventuais alterações na cicatrização da ferida ou nos órgãos analisados. Animais pertencentes ao GI apresentaram cicatrização mais rápida de feridas cutâneas em comparação aos outros grupos. Já os animais do GII apresentaram retardo na cicatrização da ferida e alterações pulmonares e microcirculatórias. Esses achados permitem concluir que o tempo de exposição ao oxigênio em ambiente hiperbárico é fundamental e pode auxiliar ou atrapalhar a cicatrização de feridas cutâneas ou mesmo ser deletério para outros órgãos.(AU)

Hallazgos quirúrgicos en pacientes con alogenosis iatrogénica / Surgical findings in patients with iatrogenic allogenosis

INTRODUCCION: los biopolímeros son macromoléculas cuyo uso como sustancias de relleno con fines estéticos ha ido en aumento en los últimos años. Esto ha generado un incremento de complicaciones por alogenosis iatrogénica de difícil tratamiento. OBJETIVO: describir los hallazgos intraoperatorios en las pacientes con alogenosis iatrogénica intervenidas quirúrgicamente en el Departamento de Cirugía Plástica del Hospital Hermanos Ameijeiras. METODO: se realizó un estudio descriptivo, prospectivo, longitudinal y monocéntrico con 15 pacientes femeninas que recibieron tratamiento quirúrgico para extracción de sustancias modelantes desde enero 2017 a diciembre 2019. RESULTADOS: el rango de edad predominante fue entre los 19 y 29 años con un 66.6% y entre los 30 y 40 años de edad con un 33.3%. El procedimiento quirúrgico fue realizado bajo anestesia general en el 33.3% de las pacientes; de ellos el 20% fue en la región mamaria, 40% glúteos y 40% genitales y pubis. Se empleó anestesia local en el 66.6%, distribuidas en 20% en la región frontal y glabelar, 30% en los párpados y 50% en los labios. El 100% mostró hallazgos intraoperatorios similares. CONCLUSIONES: independientemente del producto inyectado, la región anatómica y la expresión clínica de la enfermedad, los hallazgos transoperatorios son los mismos. Tanto en las zonas más inyectadas que fueron la región glútea, genital y púbica como en la de menor frecuencia que correspondió a las zonas frontales y glabelar, la extracción del producto resultó en múltiples nódulos en forma de perlas de pequeño tamaño y cavernas.

INTRODUCTION: biopolymers are macromolecules whose use as fillers for aesthetic purposes has been increasing in recent years. This has generated an increase in complications due to iatrogenic alogenosis that is difficult to treat. OBJECTIVE: to describe the intraoperative findings in patients with iatrogenic alogenosis who underwent surgery at the Department of Plastic Surgery of the Hermanos Ameijeiras Hospital. METHODS: a descriptive, prospective, longitudinal, single-center study was conducted with 15 female patients who received surgical treatment for removal of modeling substances from January 2017 to December 2019. RESULTS: the predominant age range was between 19 and 29 years old with 66.6% and between 30 and 40 years old with 33.3%. The surgical procedure was performed under general anesthesia in 33.3% of the patients; of them 20% were in the breast region, 40% buttocks and 40% genitalia and pubis. Local anesthesia was used in 66.6%, distributed in 20% in the frontal and glabellar region, 30% in the eyelids and 50% in the lips. 100% showed similar intraoperative findings. CONCLUSIONS: regardless of the product injected, the anatomic region and the clinical expression of the disease, the transoperative findings are the same. Both in the most injected areas which were the gluteal, genital and pubic region and in the less frequently injected areas which corresponded to the frontal and glabellar areas, the extraction of the product resulted in multiple nodules in the form of small pearls and caverns.

Nano-bio interfaces effect of two-dimensional nanomaterials and their applications in cancer immunotherapy

The field of two-dimensional (2D) nanomaterial-based cancer immunotherapy combines research from multiple subdisciplines of material science, nano-chemistry, in particular nano-biological interactions, immunology, and medicinal chemistry. Most importantly, the "biological identity" of nanomaterials governed by bio-molecular corona in terms of bimolecular types, relative abundance, and conformation at the nanomaterial surface is now believed to influence blood circulation time, bio-distribution, immune response, cellular uptake, and intracellular trafficking. A better understanding of nano-bio interactions can improve utilization of 2D nano-architectures for cancer immunotherapy and immunotheranostics, allowing them to be adapted or modified to treat other immune dysregulation syndromes including autoimmune diseases or inflammation, infection, tissue regeneration, and transplantation. The manuscript reviews the biological interactions and immunotherapeutic applications of 2D nanomaterials, including understanding their interactions with biological molecules of the immune system, summarizes and prospects the applications of 2D nanomaterials in cancer immunotherapy.

Historical evolution and research advance in processing adjuvant--vinegar / 中国中药杂志

Processing of Chinese medicinals with vinegar is one of the characteristic processing techniques. Vinegar is vital for the quality of vinegar-processed decoction pieces. However, there have been no specified standards for adjuvants. Through consulting relevant literature and monographs, we comprehensively reviewed the historical evolution of processing with vinegar in records, selection and application of vinegar, and summarized the relevant standards and current status of vinegar as an adjuvant in China. According to the records in literature, vinegar is effective in activating blood, moving qi, dispersing blood stasis, removing toxin, promoting appetite, and nourishing the liver. Traditionally, rice vinegar is chosen in processing. Nowadays, the vinegar made from rice under solid-state fermentation should be chosen. At present, only food standards can be taken for reference for vinegar in the processing. Integrative and specific inspection indicators are lacking, so the standards for adjuvants need to be improved urgently. In addition, the inadequacy in quality control and management is also a major problem to be solved. Through literature research, we reviewed the historical evolution and research advance in vinegar to provide a reference for the standardization and further research of vinegar used in the Chinese medicinal processing.

An Observational Comparative Study to Assess the Block Characteristics of Intrathecal Buprenorphine and Clonidine When Added to Bupivacaine for Orthopaedic Lower Limb Surgeries

Postoperative analgesia enables faster rehabilitation, improves the patient's level of satisfaction, and reduces hospital stay. Regional anaesthesia is the most common anaesthetic technique used for orthopaedic surgeries across the world. Adjuvants are often administered along with a local anaesthetic during spinal anaesthesia to prolong intraoperative and postoperative analgesia. The main objective of this study was to compare the effect of 60 mcg buprenorphine with that of 30 mcg clonidine when added to 3.2 ml bupivacaine with respect to onset and duration of sensory and motor block, maximum level of sensory block, duration of analgesia, and side effects if any.METHODSAfter obtaining institutional ethical committee clearance, a prospective observational study was conducted among 88 participants undergoing orthopaedic surgery of lower limb. Spinal anaesthesia was given, under aseptic precautions with 0.5% bupivacaine heavy 3.2 ml along with either 60 mcg buprenorphine (0.2 ml) or clonidine 30 mcg (0.2 ml). The buprenorphine receiving patients (n=44) were under group A and the clonidine receiving patients (n=44) were under group B. The heart rate, blood pressure, sensory block level, and duration of analgesia, were recorded.RESULTSAnalysis of the data shows that the use of clonidine significantly prolonged the duration of analgesia compared to buprenorphine. The incidence of hypotension, bradycardia, nausea and vomiting, etc. were similar in both groups.CONCLUSIONSUse of 30 mcg clonidine as an adjuvant in spinal anaesthesia provides significant prolongation of analgesia (mean duration of analgesia 190.5 minutes) compared to 60 mcg buprenorphine (mean duration of analgesia 157.5 minutes) without causing any increased incidence of adverse effects.

Efficacy of Potassium Chloride 0.2 mmol as Adjuvant to 0.5% Ropivacaine versus Plain Ropivacaine 0.5% in Supraclavicular Brachial Plexus Block

Background: Brachial plexus block is one of the most common regional anesthetic techniques used for upper limb surgeries.Various adjuvants have been tried for prolonging the duration of post-operative analgesia and also to enhance the quality ofblock. We aimed to study the effects of the addition of potassium chloride to ropivacaine in supraclavicular brachial plexusblock compared to plain ropivacaine.Materials and Methods: This prospective, randomized, double-blind, and controlled study includes 80 adult patients agedbetween 20 and 60 years with ASA Grade I and II scheduled for upper limb surgeries. These patients were randomly allocatedinto two groups of 40 each. The patients in the group I/non-KCL group received 30 ml of 0.5 % ropivacaine along with 1 mlnormal saline (control group). Group II/KCL group received 30 ml of 0.5% ropivacaine along with 0.2 mmol (0.1 ml) of potassiumchloride (prepared by adding 0.1 ml of potassium chloride diluted with normal saline to make a volume of 1 ml) (study group).The onset, duration of sensory and motor blockade, quality of sensory and motor blockade, and the duration of post-operativeanalgesia were compared between both the groups.Results: The onset of sensory and motor blockade was earlier in Group II/ study group when compared to plain ropivacainegroup/Group I and was statistically significant with a P < 0.05. The mean duration of sensory and motor blockade was prolongedin Group II with enhanced quality of analgesia compared to Group I.Conclusion: In our study, it concludes that the addition of potassium chloride as an adjuvant to ropivacaine had a significantclinical advantage over plain ropivacaine on the onset, duration, quality of sensory and motor blockade, and post-operativeanalgesia in supraclavicular brachial plexus block.

A Clinical Comparative Study of Dexmedetomidine with Fentanyl as an Adjuvant to Intrathecal Hyperbaric Bupivacaine for Vaginal Hysterectomy.

Currently only few local anaesthetics are used for intrathecal administration, like bupivacaine, lignocaine, ropivacaine and tetracaine. Opioid analogues have been used as additive in spinal anaesthesia to improve the onset of action, to prolong the duration of block and to improve the quality of intraoperative and postoperative analgesia. Fentanyl is a partial agonist on μ-opioid receptors and Dexmedetomidine is a α2-agonist. Intrathecal dexmedetomidine when combined with spinal bupivacaine prolongs the sensory block by depressing the release of C-fibers transmitters and by hyperpolarization of post-synaptic dorsal horn neurons.1 We compared the effects of adding Dexmedetomidine and Fentanyl as an adjuvant to intrathecal hyperbaric bupivacaine for vaginal hysterectomy.METHODSA total of 100 patients of age 35 to 65 yrs. of body mass index (BMI) within normal range (18.5 to 24.9 Kg/m2) posted for vaginal hysterectomy were divided into two equal groups (Group 1 and 2) in a prospective, randomized, double-blind fashion. In Group 1 (n=50), (2.5 ml) Hyperbaric Bupivacaine + (0.5 ml) Dexmedetomidine (5 mcg) and in Group 2 (n=50) (2.5 ml) Hyperbaric Bupivacaine + (0.5 ml) Fentanyl (25 mcg) were used. Total volume injected intrathecally was 3.0 ml. We observed the effect on onset of sensory and motor blockade, maximum level of sensory and motor blockade, haemodynamic effects during intraoperative period (for 120 min), effect on overall duration and quality of analgesia during postoperative period using VAS score and any side effects.RESULTSWe observed that mean time to achieve sensory block and motor block/ Bromage-3 was shorter in dexmedetomidine group. There was no statistically significant difference for the onset of sensory and motor block in dexmedetomidine and fentanyl group (p value > 0.05). The sensory and motor block were more prolonged in dexmedetomidine group than fentanyl group showing significant difference among the two groups (p value<0.001). Overall duration of analgesia was significantly longer in dexmedetomidine group than fentanyl group showing significant difference among the two groups (p value <0.001).CONCLUSIONSIn our opinion adding Dexmedetomidine 5 mcg to Bupivacaine 12.5 mg not only provides rapid onset, profound analgesia with good relaxation for surgery but also prolongs the duration of sensory and motor blockade. The overall effect and duration are superior to addition of 25 mcg of Fentanyl.