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Hu R, Lan J, Zhang D, Shen W. Nanotherapeutics for prostate cancer treatment: A comprehensive review. Biomaterials 2024; 305:122469. [PMID: 38244344 DOI: 10.1016/j.biomaterials.2024.122469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
Prostate cancer (PCa) is the most prevalent solid organ malignancy and seriously affects male health. The adverse effects of prostate cancer therapeutics can cause secondary damage to patients. Nanotherapeutics, which have special targeting abilities and controlled therapeutic release profiles, may serve as alternative agents for PCa treatment. At present, many nanotherapeutics have been developed to treat PCa and have shown better treatment effects in animals than traditional therapeutics. Although PCa nanotherapeutics are highly attractive, few successful cases have been reported in clinical practice. To help researchers design valuable nanotherapeutics for PCa treatment and avoid useless efforts, herein, we first reviewed the strategies and challenges involved in prostate cancer treatment. Subsequently, we presented a comprehensive review of nanotherapeutics for PCa treatment, including their targeting methods, controlled release strategies, therapeutic approaches and mechanisms. Finally, we proposed the future prospects of nanotherapeutics for PCa treatment.
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Affiliation(s)
- Ruimin Hu
- Department of Urology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Department of Chemistry, College of Basic Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Department of Pharmaceutics, College of Pharmacy, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Jin Lan
- Department of Ultrasound, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Dinglin Zhang
- Department of Urology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Department of Chemistry, College of Basic Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
| | - Wenhao Shen
- Department of Urology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Qian Z, Zhang Y, Yuan J, Gong S, Chen B. Current applications of nanomaterials in urinary system tumors. Front Bioeng Biotechnol 2023; 11:1111977. [PMID: 36890910 PMCID: PMC9986335 DOI: 10.3389/fbioe.2023.1111977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
The development of nanotechnology and nanomaterials has provided insights into the treatment of urinary system tumors. Nanoparticles can be used as sensitizers or carriers to transport drugs. Some nanoparticles have intrinsic therapeutic effects on tumor cells. Poor patient prognosis and highly drug-resistant malignant urinary tumors are worrisome to clinicians. The application of nanomaterials and the associated technology against urinary system tumors offers the possibility of improving treatment. At present, many achievements have been made in the application of nanomaterials against urinary system tumors. This review summarizes the latest research on nanomaterials in the diagnosis and treatment of urinary system tumors and provides novel ideas for future research on nanotechnologies in this field.
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Affiliation(s)
- Zhounan Qian
- Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yang Zhang
- Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jie Yuan
- Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Sun Gong
- Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Binghai Chen
- Department of Urology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Johnson RP, Ratnacaram CK, Kumar L, Jose J. Combinatorial approaches of nanotherapeutics for inflammatory pathway targeted therapy of prostate cancer. Drug Resist Updat 2022; 64:100865. [PMID: 36099796 DOI: 10.1016/j.drup.2022.100865] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 12/24/2022]
Abstract
Prostate cancer (PC) is the most prevalent male urogenital cancer worldwide. PC patients presenting an advanced or metastatic cancer succumb to the disease, even after therapeutic interventions including radiotherapy, surgery, androgen deprivation therapy (ADT), and chemotherapy. One of the hallmarks of PC is evading immune surveillance and chronic inflammation, which is a major challenge towards designing effective therapeutic formulations against PC. Chronic inflammation in PC is often characterized by tumor microenvironment alterations, epithelial-mesenchymal transition and extracellular matrix modifications. The inflammatory events are modulated by reactive nitrogen and oxygen species, inflammatory cytokines and chemokines. Major signaling pathways in PC includes androgen receptor, PI3K and NF-κB pathways and targeting these inter-linked pathways poses a major therapeutic challenge. Notably, many conventional treatments are clinically unsuccessful, due to lack of targetability and poor bioavailability of the therapeutics, untoward toxicity and multidrug resistance. The past decade witnessed an advancement of nanotechnology as an excellent therapeutic paradigm for PC therapy. Modern nanovectorization strategies such as stimuli-responsive and active PC targeting carriers offer controlled release patterns and superior anti-cancer effects. The current review initially describes the classification, inflammatory triggers and major inflammatory pathways of PC, various PC treatment strategies and their limitations. Subsequently, recent advancement in combinatorial nanotherapeutic approaches, which target PC inflammatory pathways, and the mechanism of action are discussed. Besides, the current clinical status and prospects of PC homing nanovectorization, and major challenges to be addressed towards the advancement PC therapy are also addressed.
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Affiliation(s)
- Renjith P Johnson
- Polymer Nanobiomaterial Research Laboratory, Nanoscience and Microfluidics Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka 575018, India
| | - Chandrahas Koumar Ratnacaram
- Cell Signaling and Cancer Biology Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, Karnataka 575018, India
| | - Lalit Kumar
- Department of Pharmaceutics, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka 576 104, India
| | - Jobin Jose
- NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Department of Pharmaceutics, Mangalore 575018, India.
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Morarasu S, Morarasu BC, Ghiarasim R, Coroaba A, Tiron C, Iliescu R, Dimofte GM. Targeted Cancer Therapy via pH-Functionalized Nanoparticles: A Scoping Review of Methods and Outcomes. Gels 2022; 8:232. [PMID: 35448133 PMCID: PMC9030880 DOI: 10.3390/gels8040232] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: In recent years, several studies have described various and heterogenous methods to sensitize nanoparticles (NPs) to pH changes; therefore, in this current scoping review, we aimed to map current protocols for pH functionalization of NPs and analyze the outcomes of drug-loaded pH-functionalized NPs (pH-NPs) when delivered in vivo in tumoral tissue. (2) Methods: A systematic search of the PubMed database was performed for all published studies relating to in vivo models of anti-tumor drug delivery via pH-responsive NPs. Data on the type of NPs, the pH sensitization method, the in vivo model, the tumor cell line, the type and name of drug for targeted therapy, the type of in vivo imaging, and the method of delivery and outcomes were extracted in a separate database. (3) Results: One hundred and twenty eligible manuscripts were included. Interestingly, 45.8% of studies (n = 55) used polymers to construct nanoparticles, while others used other types, i.e., mesoporous silica (n = 15), metal (n = 8), lipids (n = 12), etc. The mean acidic pH value used in the current literature is 5.7. When exposed to in vitro acidic environment, without exception, pH-NPs released drugs inversely proportional to the pH value. pH-NPs showed an increase in tumor regression compared to controls, suggesting better targeted drug release. (4) Conclusions: pH-NPs were shown to improve drug delivery and enhance antitumoral effects in various experimental malignant cell lines.
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Affiliation(s)
- Stefan Morarasu
- Regional Institute of Oncology (IRO), 700483 Iasi, Romania; (C.T.); (R.I.); (G.-M.D.)
| | - Bianca Codrina Morarasu
- Internal Medicine Department, Saint Spiridon University Hospital, Grigore T Popa University of Medicine and Pharmacy, 700483 Iasi, Romania;
| | - Razvan Ghiarasim
- Centre of Advanced Research in Bionanoconjugates and Biopolymers Department, “Petru Poni” Institute of Macromolecular Chemistry, 700483 Iasi, Romania; (R.G.); (A.C.)
| | - Adina Coroaba
- Centre of Advanced Research in Bionanoconjugates and Biopolymers Department, “Petru Poni” Institute of Macromolecular Chemistry, 700483 Iasi, Romania; (R.G.); (A.C.)
| | - Crina Tiron
- Regional Institute of Oncology (IRO), 700483 Iasi, Romania; (C.T.); (R.I.); (G.-M.D.)
| | - Radu Iliescu
- Regional Institute of Oncology (IRO), 700483 Iasi, Romania; (C.T.); (R.I.); (G.-M.D.)
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Guo S, Shi Y, Liang Y, Liu L, Sun K, Li Y. Relationship and improvement strategies between drug nanocarrier characteristics and hemocompatibility: What can we learn from the literature. Asian J Pharm Sci 2021; 16:551-576. [PMID: 34849162 PMCID: PMC8609445 DOI: 10.1016/j.ajps.2020.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/01/2020] [Accepted: 12/21/2020] [Indexed: 01/30/2023] Open
Abstract
This article discusses the various blood interactions that may occur with various types of nano drug-loading systems. Nanoparticles enter the blood circulation as foreign objects. On the one hand, they may cause a series of inflammatory reactions and immune reactions, resulting in the rapid elimination of immune cells and the reticuloendothelial system, affecting their durability in the blood circulation. On the other hand, the premise of the drug-carrying system to play a therapeutic role depends on whether they cause coagulation and platelet activation, the absence of hemolysis and the elimination of immune cells. For different forms of nano drug-carrying systems, we can find the characteristics, elements and coping strategies of adverse blood reactions that we can find in previous researches. These adverse reactions may include destruction of blood cells, abnormal coagulation system, abnormal effects of plasma proteins, abnormal blood cell behavior, adverse immune and inflammatory reactions, and excessive vascular stimulation. In order to provide help for future research and formulation work on the blood compatibility of nano drug carriers.
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Affiliation(s)
- Shiqi Guo
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
| | - Yanan Shi
- College of Life Science, Yantai University, Yantai 264005, China
| | - Yanzi Liang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
| | - Lanze Liu
- College of Life Science, Yantai University, Yantai 264005, China
| | - Kaoxiang Sun
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
- State Key Laboratory of Long-acting and Targeting Drug Delivery System, Luye Pharmaceutical Co., Ltd., Yantai 264003, China
| | - Youxin Li
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
- State Key Laboratory of Long-acting and Targeting Drug Delivery System, Luye Pharmaceutical Co., Ltd., Yantai 264003, China
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Salve R, Kumar P, Ngamcherdtrakul W, Gajbhiye V, Yantasee W. Stimuli-responsive mesoporous silica nanoparticles: A custom-tailored next generation approach in cargo delivery. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 124:112084. [PMID: 33947574 DOI: 10.1016/j.msec.2021.112084] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/28/2022]
Abstract
The pre-mature release of therapeutic cargos in the bloodstream or off-target sites is a major hurdle in drug delivery. However, stimuli-specific drug release responses are capable of providing greater control over the cargo release. Herein, various types of nanocarriers have been employed for such applications. Among various types of nanoparticles, mesoporous silica nanoparticles (MSNPs) have several attractive characteristics, such as high loading capacity, biocompatibility, small size, porous structure, high surface area, tunable pore size and ease of functionalization of the external and internal surfaces, which facilitates the entrapment and development of stimuli-dependent release of drugs. MSNPs could be modified with such stimuli-responsive entities like nucleic acid, peptides, polymers, organic molecules, etc., to prevent pre-mature cargo release, improving the therapeutic outcome. This controlled drug release system could be modulated to function upon extracellular or intracellular specific stimuli, including pH, enzyme, glucose, glutathione, light, temperature, etc., and thus provide minimal side effects at non-target sites. This system has great potential applications for the targeted delivery of therapeutics to treat clinically challenging diseases like cancer. This review summarizes the synthesis and design of stimuli-responsive release strategies of MSNP-based drug delivery systems along with investigations in biomedical applications.
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Affiliation(s)
- Rajesh Salve
- Nanobioscience Group, Agharkar Research Institute, Pune 411004, India; Savitribai Phule Pune University, Pune 411004, India
| | - Pramod Kumar
- Nanobioscience Group, Agharkar Research Institute, Pune 411004, India; Savitribai Phule Pune University, Pune 411004, India
| | | | - Virendra Gajbhiye
- Nanobioscience Group, Agharkar Research Institute, Pune 411004, India; Savitribai Phule Pune University, Pune 411004, India.
| | - Wassana Yantasee
- PDX Pharmaceuticals, Inc., Portland, OR 97239, USA; Biomedical Engineering, OHSU School of Medicine, Portland, OR 97239, USA.
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Dong J, Cheng Z, Tan S, Zhu Q. Clay nanoparticles as pharmaceutical carriers in drug delivery systems. Expert Opin Drug Deliv 2020; 18:695-714. [PMID: 33301349 DOI: 10.1080/17425247.2021.1862792] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Clay minerals are a class of silicates with chemical inertness, colloid, and thixotropy, which have excellent physicochemical properties, good biocompatibility, low toxicity, and have high application potential in biomedical fields. These inorganic materials have been widely used in pharmaceutical excipients and active substances. In recent years, nanoclay mineral materials have been used as drug vehicles for the delivery of a variety of drugs based on their broad specific surface area, rich porosity, diverse morphology, good adsorption performance, and high ion exchange capacity. AREAS COVERED This review introduces the structures, properties, and applications of various common natural and synthetic nanoclay materials as drug carriers. Natural nanoclays have different morphologies including nanoplates, nanotubes, and nanofibers. Synthetic materials have controllable sizes and flexible structures, where mesoporous silica nanoparticles, laponite, and imogolite are typical ones. These inorganic nanoparticles are often linked to polymers to form multifunctional drug delivery systems for better pharmaceutical performance. EXPERT OPINION The clay nanomaterials have typical properties, including enhanced solubility of insoluble drugs, targeting therapeutic sites, controlled release, and stimulation of responsive drug delivery systems.
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Affiliation(s)
- Jiani Dong
- Department of Pharmacy, Xiangya School of Pharmaceutical Sciences in Central South University, Changsha, Hunan, China
| | - Zeneng Cheng
- Department of Pharmacy, Xiangya School of Pharmaceutical Sciences in Central South University, Changsha, Hunan, China
| | - Songwen Tan
- Department of Pharmacy, Xiangya School of Pharmaceutical Sciences in Central South University, Changsha, Hunan, China
| | - Qubo Zhu
- Department of Pharmacy, Xiangya School of Pharmaceutical Sciences in Central South University, Changsha, Hunan, China
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Goněc R, Franc A, Doležel P, Farkaš P, Sova P. Multivariate analysis in the development of bioequivalent tablets containing bicalutamide. Pharm Dev Technol 2020; 26:48-59. [PMID: 33121318 DOI: 10.1080/10837450.2020.1833036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The pharmaceutical industry has to tackle the explosion of high amounts of poorly soluble APIs. This phenomenon leads to numerous sophisticated solutions. These include the use of multifactorial data analysis identifying correlations between the components and dosage form properties, laboratory and production process parameters with respect to the API liberation Example of such API is bicalutamide. Improved liberation is achieved by particle size reduction. Laboratory batches, with different PSD of API, were filled into gelatinous capsules and consequently granulated for tablet compression. Comparative dissolution profiles with Casodex 150 mg (Astra Zeneca) were performed. The component analysis was used for the statistical evaluation of f1 and f2 factors and D(v,0.9) and D[4,3] parameters of PSD to identify optimal PSD values. Suitable PSD limits for API were statistically confirmed in laboratory and in commercial scale with respect to optimized tablet properties. The tablets were bioequivalent with originator (n = 20; 90% CI for ln AUC0-120: 99.8-111.9%; 90% CI for ln cmax: 101.1-112.9%). In conclusion, the micronisation of the API is still an efficient and inexpensive method improving the bioavailability, although there are more complicated and expensive methods available. Statistical multifactorial methods improved the safety and reproducibility of production.
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Affiliation(s)
- Roman Goněc
- Masaryk Memorial Cancer Institute, Brno, Czechia
| | - Aleš Franc
- Department of Pharmaceutics, Pharmaceutical Faculty, Veterinary and Pharmaceutical University, Brno, Czechia
| | - Petr Doležel
- Department of Pharmaceutics, Pharmaceutical Faculty, Veterinary and Pharmaceutical University, Brno, Czechia
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Ghaferi M, Koohi Moftakhari Esfahani M, Raza A, Al Harthi S, Ebrahimi Shahmabadi H, Alavi SE. Mesoporous silica nanoparticles: synthesis methods and their therapeutic use-recent advances. J Drug Target 2020; 29:131-154. [PMID: 32815741 DOI: 10.1080/1061186x.2020.1812614] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Mesoporous silica nanoparticles (MSNPs) are a particular example of innovative nanomaterials for the development of drug delivery systems. MSNPs have recently received more attention for biological and pharmaceutical applications due to their capability to deliver therapeutic agents. Due to their unique structure, they can function as an effective carrier for the delivery of therapeutic agents to mitigate diseases progress, reduce inflammatory responses and consequently improve cancer treatment. The potency of MSNPs for the diagnosis and management of various diseases has been studied. This literature review will take an in-depth look into the properties of various types of MSNPs (e.g. shape, particle and pore size, surface area, pore volume and surface functionalisation), and discuss their characteristics, in terms of cellular uptake, drug delivery and release. MSNPs will then be discussed in terms of their therapeutic applications (passive and active tumour targeting, theranostics, biosensing and immunostimulative), biocompatibility and safety issues. Also, emerging trends and expected future advancements of this carrier will be provided.
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Affiliation(s)
- Mohsen Ghaferi
- Department of Chemical Engineering, Islamic Azad University, Shahrood Branch, Shahrood, Iran
| | - Maedeh Koohi Moftakhari Esfahani
- School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Molecular Design and Synthesis Discipline, Queensland University of Technology, Brisbane, Australia
| | - Aun Raza
- School of Pharmacy, The University of Queensland, Woolloongabba, Australia
| | - Sitah Al Harthi
- School of Pharmacy, The University of Queensland, Woolloongabba, Australia.,Department of Pharmaceutical Science, College of Pharmacy, Shaqra University, Dawadmi, Saudi Arabia
| | - Hasan Ebrahimi Shahmabadi
- Department of Microbiology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Yang Y, Zhao W, Tan W, Lai Z, Fang D, Jiang L, Zuo C, Yang N, Lai Y. An Efficient Cell-Targeting Drug Delivery System Based on Aptamer-Modified Mesoporous Silica Nanoparticles. NANOSCALE RESEARCH LETTERS 2019; 14:390. [PMID: 31872318 PMCID: PMC6928176 DOI: 10.1186/s11671-019-3208-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 11/12/2019] [Indexed: 05/05/2023]
Abstract
How to deliver chemotherapeutic drugs efficiently and selectively to tumor cells to improve therapeutic efficacy remains a difficult problem. We herein construct an efficient cell-targeting drug delivery system (Sgc8-MSN/Dox) based on aptamer-modified mesoporous silica nanoparticles that relies on the tumor-targeting ability of the aptamer Sgc8 to deliver doxorubicin (Dox) to leukemia cells in a targeted way, thereby improving therapeutic efficacy and reducing toxicity. In this work, Sgc8-MSN/Dox showed sustained Dox release, and they targeted and efficiently killed CCRF-CEM human acute T lymphocyte leukemia cells, suggesting potential as a cancer therapy.
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Affiliation(s)
- Yang Yang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Weihua Zhao
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Wenwen Tan
- Department of Pharmacy, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Zongqiang Lai
- Department of Pharmacy, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China
| | - Dong Fang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lei Jiang
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Chuantian Zuo
- Department of Surgery Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Nuo Yang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Yongrong Lai
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
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