Tissue adhesive indocyanine green-locking granular gel-mediated photothermal therapy combined with checkpoint inhibitor for preventing postsurgical recurrence and metastasis of colorectal cancer.

Developing effective therapy to inhibit postoperative recurrence and metastasis of colorectal cancer (CRC) is challenging and significant to reduce mortality and morbidity. Here, a granular hydrogel, assembled from gelatin microgels by dialdehyde starch and interpenetrated with in situ polymerized poly(sulfobetaine methacrylate-co-N-isopropylacrylamide) (P(SBMA-co-NIPAM)), is prepared to load and lock Food and Drug Administration (FDA)-approved indocyanine green (ICG) with definite photothermal function and biosafety for photothermal therapy (PTT) combining with checkpoint inhibitor. The presence of P(SBMA-co-NIPAM) endows granular hydrogel with high retention to water-soluble ICG, preventing easy diffusion and rapid scavenging of ICG. The ICG-locking granular hydrogel can be spread and adhered onto the surgery site at wet state in vivo, exerting a persistent and stable PTT effect. Combined with αPD-L1 treatment, ICG-locking granular hydrogel-mediated PTT can eradicate postsurgery residual and metastatic tumors, and prevent long-term tumor recurrence. Further mechanistic studies indicate that combination treatment effectively promotes dendritic cells maturation in lymph nodes, enhances the number and infiltration of CD8+ T and CD4+ T cells in tumor tissue, and improves memory T cell number in spleen, thus activating the antitumor immune response. Overall, ICG-locking gel-mediated PTT is expected to exhibit broad clinical applications in postoperative treatment of cancers, like CRC.

Analysis of risk factors of hyperthermia in the early period of an acute cerebral infarction / 中国基层医药

Objective To investigate the risk factors of hyperthermia in early period of an acute cerebral infarction.Methods 299 patients admitted to hospital from January 2003 to December 2004 with a diagnosis of cerebral infartion by CT or MRI,were retrospectively studied.The risks of hyperthermia in the early period for stroke,such as admission conscious level,bulbar palsy,emphysema,atrial fibrillation,multi-cerebral infarction,diabetes mellitus and chronic heart failure were analyzed,Logistic regression analysis was used to determine the factors that were associated with hyperthermia in the early period of stroke.Results 71 patients had fever in early period of an acute cerebral infarction(23.7%).The most common infection was pneumonia(18.4%).The analysis showed that the admission conscious level and atrial fibrillation were the risks of early hyperthermia of an acute cerebral infarction.Conclusion Admission conscious level(subconscious or unconscious/coma) and atrial fibrillation and chronic heart failure are independent risk factors for development of early hyperthermia for acute stroke.