Boosting 5-ALA-based photodynamic therapy by a liposomal nanomedicine through intracellular iron ion regulation

5-Aminolevulinic acid (5-ALA) has been approved for clinical photodynamic therapy (PDT) due to its negligible photosensitive toxicity. However, the curative effect of 5-ALA is restricted by intracellular biotransformation inactivation of 5-ALA and potential DNA repair of tumor cells. Inspired by the crucial function of iron ions in 5-ALA transformation and DNA repair, a liposomal nanomedicine (MFLs@5-ALA/DFO) with intracellular iron ion regulation property was developed for boosting the PDT of 5-ALA, which was prepared by co-encapsulating 5-ALA and DFO (deferoxamine, a special iron chelator) into the membrane fusion liposomes (MFLs). MFLs@5-ALA/DFO showed an improved pharmaceutical behavior and rapidly fused with tumor cell membrane for 5-ALA and DFO co-delivery. MFLs@5-ALA/DFO could efficiently reduce iron ion, thus blocking the biotransformation of photosensitive protoporphyrin IX (PpIX) to heme, realizing significant accumulation of photosensitivity. Meanwhile, the activity of DNA repair enzyme was also inhibited with the reduction of iron ion, resulting in the aggravated DNA damage in tumor cells. Our findings showed MFLs@5-ALA/DFO had potential to be applied for enhanced PDT of 5-ALA.

Efficacy of dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia for removal of foreign body in trachea in children / 中华麻醉学杂志

Objective To investigate the efficacy of dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia for removal of foreign body in the trachea in children.Methods Sixty ASA Ⅰ or Ⅱ children,aged 1-4 yr,weighing 8-23 kg,were randomly divided into 2 groups(n =30 each):combined intravenous-inhalational anesthesia group(group Ⅰ)and dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia group(group Ⅱ).In group Ⅱ,8％ sevoflurane was inhaled by mask to induce sleep after entering the operating room,and the concentration was reduced to 4％ after the children sere asleep.Anesthesia was maintained with iv infusion of dexmedetomidine 0.5 μg/kg,and then iv injection of propofo1 2 mg/kg,followed by iv infusion of propofol at 6 rag· kg-1· h-1 and remifentanil at 0-15 μg· kg-1 ·min-t.In group Ⅰ,dexmedetomidine was not used and the other procedures were the same as those in group Ⅱ.Sevoflurane inhalation was stopped 2 min later and the rigid bronchoscope was inserted.HR and SpO2 were monitored and recorded before insertion and at 1 and 5 min after insertion.Complications such as respiratory depression,laryngeal edema,and bradycardia were reconded.The amount of propofol and remifentanil consumed,satisfactory level of bronchoscopy,and emergence time were recorded after operation.Results Compared with group Ⅰ,HR was significantly decreased at 1 and 5 min after insertion,SpO2 was significantly increased at 1 min after insertion,the amount of propofol and remifentanil consumed was significantly reduced,the operation time was significantly shortened,the emergence time was significanlly prolonged,the satisfactory level of bronchoscopy was significandy increased,and the incidence of respiratory depression and laryngeal edema was significantly decreased in grmp Ⅱ(P ＜ 0.05).Conclnslon The efficacy of dexmedetomidine as an adjunct to combined intravenous-inhalational anesthesia is better than that of combined intravenous-inhalational anesthesia for removal of foreign body in the trachea in children,with fewer complications.

Application of propofol combined with midazolam in the bronchoscope of children / 中国基层医药

Objective To observe and compare the anesthesia effect of propofol combined with midazolam used in the bronchoscopes and the removal of children's intratraeheal foreign body.Methods 60 patients in hospital were choser to do the operation of bronchoscopes and the removal of children's intratracheal foreign body,the patients of selective operation were randomized into K group(n=30)related to midazolam-ketamine and P group(n=30)related to midazolam-propofol.The patients were respectively injected midazolam slowly given in a dose of 0.1～0.15mg/kg,and then offer oxygen 5～10 minutes with a face mask.After that the patients in group K were injected ketamine slowly in the dose of 2mg/kg,and 1～2mg/kg after laying the bronchoscope according as ease.The patients in group P were injected propofol slowly in the dose of 2mg/kg also,add 1～2mg/kg according as case.Observing the patients' BP,HR,SpO2,RR and if or not holding breath,bucking,postoperation laryngeal edema,glossocoma at the different periods:preoperation,laying the bronehoscope,during the operation and after the operation.Results To compare the two groups,the MAP,HR of group P are lower obviously than group K before and after laying the bmnchoscope(P＜0.05).The HR,MAP of groug P descended significantly after laying bronchoscope(P＜0.05),while the HR fluctuate little but MAP ascend significantly in the group K(P＜0.05).After laying bronchoscope the RR descend significantly than that when patients entered operation room(P＜0.05),and also lower than that ofgroup K(P＜0.05).The SpO2 in the two groups have no difference.The complications as holding breath,postoperative glossocema,laryngeal edema,holding breath during reviving time,in the group K happened at a high rate than the group P(P＜0.05),the awaking time is also longer in the former(P＜0.05).Conclusion The anesthesia effect of midazolam-propofol is superior to that of midazdam-ketamine in the removal of children's intratraeheal foreign body.

临床、保健、康复相结合的脑性瘫痪早期干预模式 / 中国康复理论与实践

@#目的探索脑瘫患儿早期发现、早期干预的工作模式。方法临床、保健、康复相结合 ,采用产前检查、孕妇学校、产时儿科医生进产房、新生儿行为神经评定测定、高危儿抚触训练室、婴儿期儿童保健监测、各街道防治站常规体检筛查转诊等多种形式结合早期发现并干预脑瘫高危儿。结果此工作模式较模式前显著提高了脑瘫的早期诊断率及康复疗效。结论临床、保健、康复相结合的方式整合了医疗资源,起到了促进脑瘫早发现、早诊断、早治疗的作用 ,值得推广。