Fabrication and in vitro/vivo evaluation of quercetin nanocrystals stabilized by glycyrrhizic acid for liver targeted drug delivery

The purpose of this study was to design novel drug nanocrystals (NCs) stabilized by glycyrrhizic acid (GL) for achieving liver targeted drug delivery due to the presence of GL receptor in the hepatocytes. Quercetin (QT) exhibits good pharmacological activities for the treatment of liver diseases, including liver steatosis, fatty hepatitis, liver fibrosis, and liver cancer. It was selected as a model drug owing to its poor water solubility. QT NCs stabilized by GL (QT-NCs/GL) were fabricated by wet media milling technique and systemically evaluated. QT-NCs stabilized by poloxamer 188 (QT-NCs/P188) were prepared as a reference for comparison of in vitro and in vivo performance with QT-NCs/GL. QT-NCs/GL and QT-NCs/P188 with similar particle size around 130 nm were successfully fabricated by wet media milling technique. Both of QT-NCs/GL and QT-NCs/P188 showed irregular particles and short rods under SEM. XRPD revealed that QT-NCs/GL and QT-NCs/P188 remained in crystalline state with reduced crystallinity. QT-NCs/GL and QT-NCs/P188 exhibited significant solubility increase and drug release improvement of QT as compared to raw QT. No significant difference for the plasma concentration-time curves and pharmacokinetic parameters of QT were found following intravenous administration of QT-NCs/GL and QT-NCs/P188. However, a significantly higher liver distribution of QT following intravenous administration of QT-NCs/GL was observed in comparison to QT-NCs/P188, indicating QT-NCs stabilized by GL could achieve liver targeted delivery of QT. It could be concluded that GL used as stabilizer of QT NCs have a great potential for liver targeted drug delivery.

Rubusoside As a Multifunctional Stabilizer for Novel Nanocrystal-Based Solid Dispersions with a High Drug Loading: A Case Study

The oral bioavailability of poorly soluble drugs has always been the focus of pharmaceutical researchers. We innovatively combined nanocrystal technology and solid dispersion technology to prepare novel nanocrystalline solid dispersions (NCSDs), which enable both the solidification and redispersion of nanocrystals, offering a promising new pathway for oral delivery of insoluble Chinese medicine ingredients. The rubusoside (Rub) was first used as the multifunctional stabilizer of novel apigenin nanocrystal-based solid dispersions (AP-NSD), improving the in vitro solubilization rate of the insoluble drug apigenin(AP). AP-NSD has been produced using a combination of homogenisation and spray-drying technology. The effects of stabilizer type and concentration on AP nanosuspensions (AP-NS) particles, span, and zeta potential were studied. And the effects of different types of protective agents on the yield and redispersibility of AP-NSD were also studied. Furthermore, AP-NSD was characterized by infrared spectroscopy (IR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), differential scanning calorimetry (DSC), and powder X-ray diffraction (PXRD). Solubility was used to assess the in vitro dissolution of AP-NSD relative to APIs and amorphous solid dispersions (AP-ASD), and AP-ASD was prepared by the solvent method. The results showed that 20% Rub stabilized AP-NSD exhibited high drug-loading and good redispersibility and stability, and higher in vitro dissolution rate, which may be related to the presence of Rub on surface of drug. Therefore provides a natural and safe option for the development of formulations for insoluble drugs.

Pore engineering of micro/mesoporous nanomaterials for encapsulation, controlled release and variegated applications of essential oils

Essential oils have become increasingly popular in fields of medical, food and agriculture, owing to their strongly antimicrobial, anti-inflammation and antioxidant effects, greatly meeting demand from consumers for healthy and safe natural products. However, the easy volatility and/or chemical instability of active ingredients of essential oils (EAIs) can result in the loss of activity before realizing their functions, which have greatly hindered the widely applications of EAIs. As an emerging trend, micro/mesoporous nanomaterials (MNs) have drawn great attention for encapsulation and controlled release of EAIs, owing to their tunable pore structural characteristics. In this review, we briefly discuss the recent advances of MNs that widely used in the controlled release of EAIs, including zeolites, metal-organic frameworks (MOFs), mesoporous silica nanomaterials (MSNs), and provide a comprehensive summary focusing on the pore engineering strategies of MNs that affect their controlled-release or triggered-release for EAIs, including tailorable pore structure properties (e.g., pore size, pore surface area, pore volume, pore geometry, and framework compositions) and surface properties (surface modification and surface functionalization). Finally, the variegated applications and potential challenges are also given for MNs based delivery strategies for EAIs in the fields of healthcare, food and agriculture. These will provide considerable instructions for the rational design of MNs for controlled release of EAIs.

[The comparison between endoscopic and surgical treatment of delayed iatrogenic bile duct injury by propensity score matching]

Objective: To compare the safety and clinical efficacy of endoscopic and surgical treatment of patients with delayed iatrogenic bile duct injury (DBDI) with severity (SG) grade 1 to 2. Methods: The clinical data of 129 patients with SG grade 1 to 2 DBDI who received endoscopic or surgical treatment in the First Hospital of Lanzhou University from November 2007 to November 2021 were retrospectively collected. There were 46 males and 83 females,aged (M(IQR)) 54(22)years(range: 21 to 82 years). The baseline data of the two groups were matched 1∶1 by propensity score matching(caliper value was 0.2). Independent sample t test,rank sum test,χ2 test or Fisher exact probability test were used to analyze the data of the two matched groups. Results: There were 48 patients in each of the endoscopic treatment and surgical groups after matching,and there was no difference in general information between the two groups(both P>0.05). The bile duct injury-repair interval and intraoperative anesthesia complications were not statistically significant between the two groups after matching(all P>0.05). Compared with the surgical group, patients in the endoscopic treatment group had significantly shorter operative time(50 (30) minutes vs. 185 (100) minutes, Z=7.675,P<0.01) and postoperative hospital stay(5 (5) days vs. 12 (7) days, Z=5.848, P<0.01).For safety,there was no statistical difference in the incidence of immediate postoperative complications between the two groups with Clavien-Dindo classification of surgical complications<Ⅲ;the incidence of serious postoperative complications (Clavien-Dindo classification of surgical complications≥Ⅲ) was significantly higher in the surgical group than in the endoscopic treatment group(P=0.012). The incidence of long-term postoperative complications was not statistically different between the two groups(28.1% vs. 20.7%,P=0.562). In terms of efficacy,the postoperative liver function indexes of patients in both groups improved significantly compared with the preoperative period and returned to normal or near normal levels; the postoperative infection indexes of both groups showed an increasing trend,but were within the normal range. Of the 96 patients in both groups,61 obtained follow-up,and the follow-up time was (89.4±48.0)months(range: 3 to 165 months),and there was no statistical difference between the two groups(P=0.079). The probability of excellent long-term follow-up (78.1% vs. 86.2%) was not statistically different between the two groups(P=0.412).In patients with Strasberg-Bismuth type E1,the probability of excellent long-term follow-up was higher in the endoscopic treatment group compared with the surgical group(13/14 vs. 2/5,P=0.037). Conclusions: For DBDI patients with SG grade 1 to 2 and bile duct continuity,endoscopy can be used as the first deterministic treatment. The advantages of endoscopic therapy compared to surgery are the lower incidence of postoperative serious complications,and the shorter duration of surgery and postoperative hospital stay.

Powering mesoporous silica nanoparticles into bioactive nanoplatforms for antibacterial therapies: strategies and challenges

Bacterial infection has been a major threat to worldwide human health, in particular with the ever-increasing level of antimicrobial resistance. Given the complex microenvironment of bacterial infections, conventional use of antibiotics typically renders a low efficacy in infection control, thus calling for novel strategies for effective antibacterial therapies. As an excellent candidate for antibiotics delivery, mesoporous silica nanoparticles (MSNs) demonstrate unique physicochemical advantages in antibacterial therapies. Beyond the delivery capability, extensive efforts have been devoted in engineering MSNs to be bioactive to further synergize the therapeutic effect in infection control. In this review, we critically reviewed the essential properties of MSNs that benefit their antibacterial application, followed by a themed summary of strategies in manipulating MSNs into bioactive nanoplatforms for enhanced antibacterial therapies. The chemically functionalized platform, photo-synergized platform, physical antibacterial platform and targeting-directed platform are introduced in details, where the clinical translation challenges of these MSNs-based antibacterial nanoplatforms are briefly discussed afterwards. This review provides critical information of the emerging trend in turning bioinert MSNs into bioactive antibacterial agents, paving the way to inspire and translate novel MSNs-based nanotherapies in combating bacterial infection diseases.

Alexithymia and Internet Addiction in Children: Meaning in Life as Mediator and Reciprocal Filial Piety as Moderator

Purpose

To explore the psychological mechanism between alexithymia and Internet addiction, the present study constructed a moderated mediation model based on the problem behavior theory.

Methods

A total of 899 middle school students (Mage=13.95, SD=1.10) were surveyed using the 20-item Toronto-alexithymia-scale, meaning in life questionnaire, dual filial piety scale, and Internet addiction disorder diagnostic scale.

Results

First, alexithymia was significantly negatively correlated with meaning in life and reciprocal filial piety, and positively correlated with Internet addiction; meaning in life was significantly positively correlated with reciprocal filial piety, and negatively correlated with Internet addiction; reciprocal filial piety was significantly positively correlated with authoritarian filial piety, and negatively correlated with Internet addiction. Second, alexithymia could not only directly predict Internet addiction, but also indirectly predict Internet addiction through meaning in life. Third, reciprocal filial piety played a moderating role between meaning in life and Internet addiction, while authoritarian filial piety did not. For middle school students with low reciprocal filial piety, meaning in life can negatively predict Internet addiction; for those with high reciprocal filial piety, there is no correlation between meaning in life and Internet addiction.

Conclusion

This study reveals the internal mechanism of the relationship between alexithymia and Internet addiction in middle school students, emphasizes the role of positive psychology and family environment, and provides specific evidence and theoretical guidance for preventing Internet addiction in middle school students.

Multiparametric mapping by cardiovascular magnetic resonance imaging in cardiac tumors

BACKGROUND

There is a paucity of quantitative measurements of cardiac tumors and myocardium using parametric mapping techniques. This study aims to explore quantitative characteristics and diagnostic performance of native T1, T2, and extracellular volume (ECV) values of cardiac tumors and left ventricular (LV) myocardium.

METHODS

Patients with suspected cardiac tumors who underwent cardiovascular magnetic resonance (CMR) between November 2013 and March 2021 were prospectively enrolled. The diagnoses of primary benign or malignant tumors were based on pathologic findings if available, comprehensive medical history evaluations, imaging, and long-term follow-up data. Patients with pseudo-tumors, cardiac metastasis, primary cardiac diseases, and prior radiotherapy or chemotherapy were excluded. Multiparametric mapping values were measured on both cardiac tumors and the LV myocardium. Statistical analyses were performed using independent-samples t-test, receiver operating characteristic, and Bland-Altman analyses.

RESULTS

A total of 80 patients diagnosed with benign (n = 54), or primary malignant cardiac tumors (n = 26), and 50 age and sex-matched healthy volunteers were included. Intergroup differences in the T1 and T2 values of cardiac tumors were not significant, however, patients with primary malignant cardiac tumors showed significantly higher mean myocardial T1 values (1360 ± 61.4 ms) compared with patients with benign tumors (1259.7 ± 46.2 ms), and normal controls (1206 ± 44.0 ms, all P < 0.05) at 3 T. Patients with primary malignant cardiac tumors also showed significantly higher mean ECV (34.6 ± 5.2%) compared with patients with benign (30.0 ± 2.5%) tumors, and normal controls (27.3 ± 3.0%, all P < 0.05). For the differentiation between primary malignant and benign cardiac tumors, the mean myocardial native T1 value showed the highest efficacy (AUC: 0.919, cutoff value: 1300 ms) compared with mean ECV (AUC: 0.817) and T2 (AUC: 0.619) values.

CONCLUSION

Native T1 and T2 of cardiac tumors showed high heterogeneity, while myocardial native T1 values in primary malignant cardiac tumors were elevated compared to patients with benign cardiac tumors, which may serve as a new imaging marker for primary malignant cardiac tumors.

Effect of molecular distillation on the anti-inflammatory activity and neurotoxicity of Asarum essential oil

Asarum essential oil (AEO) has been shown to have good pharmacological activities for the anti-inflammatory and analgesic effects, but increasing the dose may cause toxicity. Therefore, we studied the toxic and pharmacodynamic components of AEO by molecular distillation (MD). Anti-inflammatory activity was assessed using RAW264.7 cells. Neurotoxicity was assessed in PC12 cells and the overall toxicity of AEO was evaluated in the mouse acute toxicity assay. The results showed that AEO is primarily composed of safrole, methyl eugenol, and 3,5-dimethoxytoluene. After MD, three fractions were obtained and contained different proportions of volatile compounds relative to the original oil. The heavy fraction had high concentrations of safrole and methyl eugenol, while the light fraction contained high concentrations of α-pinene and β- pinene. The original oil and all three fractions exhibited anti-inflammatory effects, but the light fraction demonstrated more excellent anti-inflammatory activity than the other fractions. Asarum virgin oil and MD products are all neurotoxic. The exposure of PC12 cells to high concentrations of AEO resulted in abnormal nuclei, an increased number of apoptotic cells, increased ROS formation, and decreased SOD levels. Moreover, the results of acute toxicity tests in mice revealed that the light fractions were less toxic than virgin oils and other fractions. In summary, the data suggest that the MD technology enables the enrichment and separation of essential oil components and contributes to the selection of safe concentrations of AEO.

Rambutan-liked Pickering emulsion stabilized by cellulose nanocrystals for enhancing anti-bacterial activity and anti-inflammatory effect of Chimonanthus nitens Oliv. essential oil

Owing to volatility and poor water solubility, the medical application of Chimonanthus nitens Oliv. essential oil (CEO) in the fields of medicine was strictly limited. To tackle this problem, a novel CEO loaded rambutan-liked Pickering emulsion (CEO-RPE) with a spiky surface was effectively designed by coating with carboxymethyl cellulose sodium modified cellulose nanocrystals (CCN) as stabilizer. The effect of CCN concentration on the formation and stabilization of CEO-RPE was investigated. The results showed that CEO-RPE stabilized by 1 % CCN had a smaller droplet size and exhibited a rambutan-liked surface, and was stabilized against concentrated salt and high pH condition due to the steric barrier of CCN that covered in the droplet surface. Subsequently, the antibacterial performance of CEO-RPE was investigated against E. coli, S. aureus, P. aeruginosa, and S. pneumoniae by determining the minimum inhibitory concentration (MIC). The results showed that the CEO-RPE exhibited higher antibacterial activity compared to CEO, which could be attributed to its effective adhesion to the cell membrane of bacteria. In addition, the results of anti-inflammatory experiments showed that CEO-RPE also exhibited strong anti-inflammatory effect on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in rats. Therefore, the CCN stabilized rambutan-liked Pickering emulsion seemed to be a promising strategy to increase the antibacterial and anti-inflammatory activity of CEO.

Mucus-penetrating dendritic mesoporous silica nanoparticle loading drug nanocrystal clusters to enhance permeation and intestinal absorption

Multiple gastrointestinal barriers (mucus clearance and epithelium barrier) are the main challenges in the oral administration of nanocarriers. To achieve efficient mucus penetration and epithelial absorption, a novel strategy based on mesoporous silica nanoparticles with dendritic superstructure, hydrophilicity, and nearly neutral-charged modification was designed. The mPEG covalently grafted dendritic mesoporous silica nanoparticles (mPEG-DMSNs) had a particle size of about 200 nm and a loading capacity of up to 50% andrographolide (AG) as a nanocrystal cluster in the mesoporous structure. This dual strategy of combining with the surface topography structure and hydrophilic modification maintained a high mucus permeability and showed an increase in cell absorption. The mPEG-DMSN formulation also exhibited effective transepithelial transport and intestinal tract distribution. The pharmacokinetics study demonstrated that compared with other AG formulations, the andrographolide nanocrystals-loaded mPEG-DMSN (AG@mPEG-DMSN) exhibited much higher bioavailability. Also, AG@mPEG-DMSN could significantly improve the in vitro and in vivo anti-inflammatory efficacy of AG. In summary, mPEG-DMSN offers an interesting strategy to overcome the mucus clearance and epithelium barriers of the gastrointestinal tract.

Sponge-liked Silica Nanoporous Particles for Sustaining Release and Long-Term Antibacterial Activity of Natural Essential Oil

To improve the sustained release and long-term antibacterial activity of Chimonanthus nitens Oliv. essential oil (CEO), novel sponge-liked nanoporous silica particles (SNP) were synthesized via the soft template method, which was employed as a biocompatible carrier to prepare spong-liked nanoporous silica particles loading with CEO (CEO-SNP) through physical adsorption. The structure and properties of the samples were characterized via N2 adsorption/desorption measurements, thermogravimetry (TGA), Fourier transform infrared, SEM and TEM. The result showed that the SNP exhibited an excellent loading capability of CEO up to 76.3%. The thermal stability and release behavior of the CEO were significantly improved via the physical adsorption of the SNP materials. The release profile of CEO was in accordance with the first-order kinetic model, which meant that the release mechanism was drug Fick's diffusion. The antibacterial evaluation results demonstrated that the CEO-SNP exhibited strong antibacterial activity against S. aureus, E. coli and P. aeruginosa. The antibacterial results have shown that the CEO-SNP could destroy the cell structure of bacteria, and result in the generation of oxidative stress and the release of nucleic acid. After storage of 30 d at 25 °C, the CEO-SNP still had the stronger antibacterial activity towards S. aureus, E. coli and P. aeruginosa in comparison with CEO. Therefore, the sponge-like silica nanoporous particles seemed to be a promising carrier for long-term stability and antibacterial delivery of CEO.

A two-ward acute care hospital outbreak of SARS-CoV-2 delta variant including a point-source outbreak associated with the use of a mobile vital signs cart and sub-optimal doffing of personal protective equipment

BACKGROUND

The arrival of the Delta variant of SARS-CoV-2 was associated with increased transmissibility and illness of greater severity. Reports of nosocomial outbreaks of Delta variant COVID-19 in acute care hospitals have been described but control measures varied widely.

AIM

Epidemiological investigation of a linked two-ward COVID-19 Delta variant outbreak was conducted to elucidate its source, risk factors, and control measures.

METHODS

Investigations included epidemiologic analysis, detailed case review serial SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) testing of patients and healthcare workers (HCWs), viral culture, environmental swabbing, HCW-unaware personal protective equipment (PPE) audits, ventilation assessments, and the use of whole genome sequencing (WGS).

FINDINGS

This linked two-ward outbreak resulted in 17 patient and 12 HCW cases, despite an 83% vaccination rate. In this setting, suboptimal adherence and compliance to PPE protocols, suboptimal hand hygiene, multi-bedded rooms, and a contaminated vital signs cart with potential fomite or spread via the hands of HCWs were identified as significant risk factors for nosocomial COVID-19 infection. Sudden onset of symptoms, within 72 h, was observed in 79% of all Ward 2 patients, and 93% of all cases (patients and HCWs) on Ward 2 occurred within one incubation period, consistent with a point-source outbreak. RT-PCR assays showed low cycle threshold (C_T) values, indicating high viral load from environmental swabs including the vital signs cart. WGS results with ≤3 SNP differences between specimens were observed.

CONCLUSION

Outbreaks on both wards settled rapidly, within 3 weeks, using a `back-to-basics' approach without extraordinary measures or changes to standard PPE requirements. Strict adherence to recommended PPE, hand hygiene, education, co-operation from HCWs, including testing and interviews, and additional measures such as limiting movement of patients and staff temporarily were all deemed to have contributed to prompt resolution of the outbreak.

Development of a graphene oxide nanosheet and double-stranded DNA structure based fluorescent “signal off” aptasensor for ochratoxin A detection in malt

•

A fluorescence “signal off” aptasensor was developed for OTA detection in malt.

•

It was based on the fluorescence quenching of GO nanosheets on FAM fluorophores labeled on cDNA.

•

An OTA concentration-dependent quenched fluorescence was measured for OTA quantitation.

•

The aptasensor exhibited outstanding sensitivity with a LOD of 11 pg/mL and a wide dynamic range.

•

The feasibility and reliability was verified by determining OTA in malt samples.

A “signal off” fluorescent aptasensor based on graphene oxide (GO) nanosheet and double-stranded DNA structure was fabricated for OTA detection. In the absence of OTA, the aptamer and its complementary DNA (cDNA) formed double-stranded conjugates that could coexist with GO, presenting fluorescence responses. Then, the presented OTA was captured by the aptamers, causing the release of cDNA-FAM probes. The free probes were adsorbed by GO, leading to an OTA concentration-dependent fluorescence quenching through fluorescence resonance energy transfer. Under optimum conditions, the fluorescent aptasensor exhibited outstanding sensitivity with a LOD of 11 pg/mL and a wide dynamic range of 0.04–30 ng/mL. The selectivity of the aptasensor was confirmed against other four mycotoxins, and the feasibility and reliability were verified by determining OTA in the spiked malt samples with satisfactory recovery of 95.50%-112.05%. This aptasensing platform could be adapted to measure other mycotoxins by replacing the aptamer sequences for food safety.

Nanocrystals based mucosal delivery system: Research Advances

Nanocrystal technology is a new way to increase the solubility and bioavailability of poorly soluble drugs. As an intermediate preparation technology, nanocrystals are widely used in drug delivery for oral, venous, percutneous and inhalation administration, which exhibits a broad application prospect. By referring to the domestic anforeign literatures, this paper mainly reviews the preparation methods of nanocrystals for poorly soluble natural products and its application in the mucosal delivery for skin, eye, oral cavity and nasal cavity. This can provide the reference for the research and development of nanocrystal technology in natural product preparations.

To Enhance Mucus Penetration and Lung Absorption of Drug by Inhalable Nanocrystals-In-Microparticles

To effectively achieve the pulmonary delivery for curcumin (CN), novel inhalable mucus-penetrating nanocrystal-based microparticles (INMP) were designed. The D-Tocopherol acid polyethylene glycol 1000 succinate (TPGS) modified CN nanocrystals (CN-NS@TPGS) were prepared by high pressure homogenization and further converted into nanocrystal-based microparticles (CN-INMP@TPGS) using spray-drying. It was demonstrated that CN-NS@TPGS exhibited little interaction with the negatively charged mucin due to a strong electrostatic repulsion effect and PEG hydrophilic chain, and exhibited a much higher penetration ability across the mucus layer compared with poloxamer 407 modified CN-NS (CN-NS@P407) and tween 80 modified CN-NS (CN-NS@TW80). The aerodynamic results demonstrated that the CN-INMP with 10% TPGS acting as the stabilizer presented a high FPF value, indicating excellent deposition in the lung after inhalation administration. Additionally, in vivo bioavailability studies indicated that the AUC(0-t) of CN-INMP@TPGS (2413.18 ± 432.41 µg/L h) were 1.497- and 3.32-fold larger compared with those of CN-INMP@TW80 (1612.35 ± 261.35 µg/L h) and CN-INMP@P407 (3.103 ± 196.81 µg/L h), respectively. These results indicated that the CN-INMP@TPGS were absorbed rapidly after pulmonary administration and resulted in increased systemic absorption. Therefore, the inhalable CN-INMP could significantly improve the bioavailability of CN after inhalation administration. The developed mucus-penetrating nanocrystals-in-microparticles might be regarded as a promising formulation strategy for the pulmonary administration of poorly soluble drugs.

Nanocrystals based pulmonary inhalation delivery system: advance and challenge

Pulmonary inhalation administration is an ideal approach to locally treat lung disease and to achieve systemic administration for other diseases. However, the complex nature of the structural characteristics of the lungs often results in the difficulty in the development of lung inhalation preparations. Nanocrystals technology provides a potential formulation strategy for the pulmonary delivery of poorly soluble drugs, owing to the decreased particle size of drug, which is a potential approach to overcome the physiological barrier existing in the lungs and significantly increased bioavailability of drugs. The pulmonary inhalation administration has attracted considerable attentions in recent years. This review discusses the barriers for pulmonary drug delivery and the recent advance of the nanocrystals in pulmonary inhalation delivery. The presence of nanocrystals opens up new prospects for the development of novel pulmonary delivery system. The particle size control, physical instability, potential cytotoxicity, and clearance mechanism of inhaled nanocrystals based formulations are the major considerations in formulation development.

Traditional herbal medicine and nanomedicine: Converging disciplines to improve therapeutic efficacy and human health

Traditional herbal medicine (THM), an ancient science, is a gift from nature. For thousands of years, it has helped humans fight diseases and protect life, health, and reproduction. Nanomedicine, a newer discipline has evolved from exploitation of the unique nanoscale morphology and is widely used in diagnosis, imaging, drug delivery, and other biomedical fields. Although THM and nanomedicine differ greatly in time span and discipline dimensions, they are closely related and are even evolving toward integration and convergence. This review begins with the history and latest research progress of THM and nanomedicine, expounding their respective developmental trajectory. It then discusses the overlapping connectivity and relevance of the two fields, including nanoaggregates generated in herbal medicine decoctions, the application of nanotechnology in the delivery and treatment of natural active ingredients, and the influence of physiological regulatory capability of THM on the in vivo fate of nanoparticles. Finally, future development trends, challenges, and research directions are discussed.

Nanocrystal-Loaded Micelles for the Enhanced In Vivo Circulation of Docetaxel

Prolonging in vivo circulation has proved to be an efficient route for enhancing the therapeutic effect of rapidly metabolized drugs. In this study, we aimed to construct a nanocrystal-loaded micelles delivery system to enhance the blood circulation of docetaxel (DOC). We employed high-pressure homogenization to prepare docetaxel nanocrystals (DOC(Nc)), and then produced docetaxel nanocrystal-loaded micelles (DOC(Nc)@mPEG-PLA) by a thin-film hydration method. The particle sizes of optimized DOC(Nc), docetaxel micelles (DOC@mPEG-PLA), and DOC(Nc)@mPEG-PLA were 168.4, 36.3, and 72.5 nm, respectively. The crystallinity of docetaxel was decreased after transforming it into nanocrystals, and the crystalline state of docetaxel in micelles was amorphous. The constructed DOC(Nc)@mPEG-PLA showed good stability as its particle size showed no significant change in 7 days. Despite their rapid dissolution, docetaxel nanocrystals exhibited higher bioavailability. The micelles prolonged the retention time of docetaxel in the circulation system of rats, and DOC(Nc)@mPEG-PLA exhibited the highest retention time and bioavailability. These results reveal that constructing nanocrystal-loaded micelles may be a promising way to enhance the in vivo circulation and bioavailability of rapidly metabolized drugs such as docetaxel.

Role of lysosomes in physiological activities, diseases, and therapy

Long known as digestive organelles, lysosomes have now emerged as multifaceted centers responsible for degradation, nutrient sensing, and immunity. Growing evidence also implicates role of lysosome-related mechanisms in pathologic process. In this review, we discuss physiological function of lysosomes and, more importantly, how the homeostasis of lysosomes is disrupted in several diseases, including atherosclerosis, neurodegenerative diseases, autoimmune disorders, pancreatitis, lysosomal storage disorders, and malignant tumors. In atherosclerosis and Gaucher disease, dysfunction of lysosomes changes cytokine secretion from macrophages, partially through inflammasome activation. In neurodegenerative diseases, defect autophagy facilitates accumulation of toxic protein and dysfunctional organelles leading to neuron death. Lysosomal dysfunction has been demonstrated in pathology of pancreatitis. Abnormal autophagy activation or inhibition has been revealed in autoimmune disorders. In tumor microenvironment, malignant phenotypes, including tumorigenesis, growth regulation, invasion, drug resistance, and radiotherapy resistance, of tumor cells and behaviors of tumor-associated macrophages, fibroblasts, dendritic cells, and T cells are also mediated by lysosomes. Based on these findings, a series of therapeutic methods targeting lysosomal proteins and processes have been developed from bench to bedside. In a word, present researches corroborate lysosomes to be pivotal organelles for understanding pathology of atherosclerosis, neurodegenerative diseases, autoimmune disorders, pancreatitis, and lysosomal storage disorders, and malignant tumors and developing novel therapeutic strategies.

Advances in the Application of Natural Products and the Novel Drug Delivery Systems for Psoriasis

Psoriasis, an incurable autoimmune skin disease, is one of the most common immune-mediated disorders. Presently, numerous clinical research studies are underway, and treatment options are available. However, these treatments focus on improving symptoms of the disease and fail to achieve a radical cure; they also have certain toxic side effects. In recent years, natural products have increasingly gained attention because of their high efficiency and low toxicity. Despite their obvious therapeutic effects, natural products’ biological activity was limited by their instability, poor solubility, and low bioavailability. Novel drug delivery systems, including liposomes, lipospheres, nanostructured lipid carriers, niosomes, nanoemulsions, nanospheres, microneedles, ethosomes, nanocrystals, and foams could potentially overcome the limitations of poor water solubility and permeability in traditional drug delivery systems. Thus, to achieve a therapeutic effect, the drug can reach the epidermis and dermis in psoriatic lesions to interact with the immune cells and cytokines.

Differential and prognostic value of cardiovascular magnetic resonance derived scoring algorithm in cardiac tumors

OBJECTIVES

To establish a scoring algorithm based on cardiovascular magnetic resonance (CMR) parameters for differentiating between benign and malignant cardiac tumors and for predicting outcome.

METHODS

Patients referred for CMR for suspected cardiac tumors were prospectively enrolled. Tumors were categorized as benign or malignant based on pathology, imaging, and clinical information. The CMR protocol included cine, T1-weighted, T2-weighted, first-pass perfusion, and late gadolinium enhancement (LGE) sequences. Variables independently associated with malignancy in the multivariable logistic analysis were used to construct the scoring algorithm, and receiver operating characteristic analyses were used to assess the ability to discriminate malignant from benign tumors. The ability of the score to predict outcome (all-cause mortality) was also assessed by Kaplan-Meier survival analysis.

RESULTS

Among the 105 enrolled patients, 74 had benign and 31 had malignant tumors. In multivariable analysis, the independent predictors of malignant tumors were invasiveness (odds ratio, OR = 11.4, 2 points), irregular border (OR = 5.8, 1 point), and heterogenous LGE (OR 10.6, 2 points). The area under curves (AUC) of the scoring algorithm was 0.912 (cut-off score of 5) and showed significantly higher AUCs than individual variables (all P < 0.05) in differentiating benign and malignant tumors. After median follow-up of 18.2 months, mortality was significantly higher in patients with a score of 5 than in patients with score ≤ 4.

CONCLUSIONS

The scoring algorithm based on CMR-detected invasiveness, irregularity of border, and heterogenous LGE is an effective method for differentiating malignant from benign cardiac tumors and for predicting outcome.

Cellulose nanocrystals based clove oil Pickering emulsion for enhanced antibacterial activity

An effective antibacterial system was developed by using clove essential oil Pickering emulsion (CO-PE). The carboxymethyl cellulose sodium modified cellulose nanocrystals (CNC) was used as the stabilizer of CO-PE, which were prepared by environmentally friendly approach of homogenization technology. The factors affecting the formation and stability of CO-PE were studied, such as CNC concentration, homogenization pressure, CO concentration and ionic concentration and pH. And the antibacterial performance of CO-PE against E. coli and S. aureus was investigated by determining the minimal inhibitory concentration (MIC). The results showed that 1% CNC stabilized CO-PE exhibited small droplet size and rough surface, and had good stability at high pH values or salt concentration, owing to the presence of CNC on interface of droplet. And the CNC-stabilized CO-PE exhibited higher antimicrobial activity at equivalent CO concentration, which might be attributed to efficiently adhere to bacterial membrane. Therefore, our research would provide new insights for antibacterial application of Pickering emulsions loading essential oils in the food and other industries.

Nose-to-Brain Delivery by Nanosuspensions-Based in situ Gel for Breviscapine

Purpose

Nose-to-brain drug delivery is an effective approach for poorly soluble drugs to bypass the blood–brain barrier. A new drug intranasal delivery system, a nanosuspension-based in situ gel, was developed and evaluated to improve the solubility and bioavailability of the drug and to prolong its retention time in the nasal cavity.

Materials and Methods

Breviscapine (BRE) was chosen as the model drug. BRE nanosuspensions (BRE-NS) were converted into BRE nanosuspension powders (BRE-NP). A BRE nanosuspension in situ gelling system (BRE-NG) was prepared by mixing BRE-NP and 0.5% gellan gum (m/v). First, the BRE-NP were evaluated in terms of particle size and by differential scanning calorimetry (DSC), powder X-ray diffraction (PXRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Subsequently, the critical ionic concentration of the gellan gum phase transition, influence of the deacetylated gellan gum (DGG) concentration on the expansion coefficient (S%), water-holding capacity, rheological properties and in vitro release behaviour of the BRE-NG were investigated. The pharmacokinetics and brain distribution of the BRE-NG after intranasal administration were compared with those of the intravenously injected BRE-NP nanosuspensions in rats.

Results

The rheology results demonstrated that BRE-NG was a non-Newtonian fluid with good spreadability and bioadhesion performance. Moreover, the absolute bioavailability estimated for BRE-NG after intranasal administration was 57.12%. The drug targeting efficiency (DTE%) of BRE in the cerebrum, cerebellum and olfactory bulb was 4006, 999 and 3290, respectively. The nose-to-brain direct transport percentage (DTP%) of the cerebrum, cerebellum and olfactory bulb was 0.975, 0.950 and 0.970, respectively.

Conclusion

It was concluded that the in situ gel significantly increased the drug retention time at the administration site. Therefore, the nanosuspension-based in situ gel could be a convenient and effective intranasal formulation for the administration of BRE.

Development and usability test of an intelligent cardiovascular risk elimination application for patients with coronary heart disease

Background

The mortality of coronary heart disease (CHD) can be largely reduced by improving CHD risk factors through facilitating adherence to unhealthy lifestyle modification (UhLM) and secondary preventive medications (SPMs). Current interventions, however, have been unsatisfactory worldwide.

Purpose

To develop an Individualized, Intelligent and Integrated Cardiovascular Application for Risk Elimination system (iCARE) for facilitating adherence to UhLM and SPMs, and test its usability and feasibility for implementation.

Methods

Based on a set of individualized interventions formulated in our preliminary work, we developed iCARE using mHealth techniques and a user-centred approach, which included 3 phases: (1) identifying patient preferences regarding formats for providing interventions; (2) designing the functions, architecture, and user interface (UI); (3) developing the iCARE using prototyping techniques. Usability test was conducted in patients with acute coronary syndromes and/or underwent percutaneous coronary intervention from January to March 2019 in two University affiliated hospitals in our city. The iCARE was implemented in 4 cardiac units of the same hospitals thereafter.

Results

The iCARE architecture and UI are displayed in Fig 1. Different from most current available mHealth CHD management system, the iCARE has a set of interventions and IF-THEN algorithms triggering interventions to ensure that patients receive individualized recommendations for UhLM and SPMs adherence. To improve effectiveness of iCARE interventions, visualization was used to augment patients' perceptions of risks of non-adherence to UhLM and SPMs, and effectiveness of adopting healthy lifestyles etc. Interventions are triggered by results of initial assessment and health data from daily monitoring. The initial assessment is conducted before patients are discharged, and a health report as well as individualized goals for risk reduction are formulated automatically. Daily diet, physical activities, smoking, medication adherence, blood pressure, blood sugar, and symptoms are monitored either through wearable devices or manual entry. Instant and individualized feedbacks as well as recommended actions are sent to patients automatically. A build-in artificial intelligent Q-A function was also included in iCARE. For the usability test, 88 patients with 71.3% male and mean age of 60 (SD 9.9) were recruited, 87.5% were satisfied with iCARE; 89.5% and 81.4% reported that iCARE was useful and easy to use, respectively. Currently, a total of 201 patients with 83.1% male and mean age of 54 (SD 10.2) were recruited from June 2019 to January 2020, and 46 of them have been followed up for 3 months.

Conclusions

The iCARE has achieved its functions of serving as an individualized and intelligent CHD management tool to improve adherence to UhLM and SPMs. The usability is satisfactory and it is feasible to implement in clinical settings.

Figure 1. The iCARE system. iCARE, Individualized, Intelligent and Integrated Cardiovascular Applicaton for Risk Elimination (iCARE) system, CHD, coronary heart disease.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): National Natural Science Funding of China

Roles of maltodextrin and inulin as matrix formers on particle performance of inhalable drug nanocrystal-embedded microparticles

The objective of this study was to investigate the influence of inulin (IL) and maltodextrin (MD) as matrix formers on the physical properties of drug nanocrystal-embedded microparticles (NEM) during spray-drying and storage. The redispersibility, aerodynamic performance and phase behaviour of NEM/MD and NEM/IL stored at different water activity (a_w) values were evaluated. NEM with 2 g/g (relative to the weight of drug) of IL and MD exhibited the excellent performance after spray-drying. The water activity significantly influenced the redispersibility and aerodynamic performance of NEM/MD and NEM/IL. The NEM/MD presented a higher T_g at all a_w values than did NEM/IL. The moisture-induced collapse of the amorphous glassy matrix of IL and MD could be responsible for the poor redispersibility and aerodynamic performance of NEM/IL and NEM/MD, respectively. The NEM/MD exhibited better aerodynamic performance at high a_w (0.528) than did NEM/IL. Therefore, MD could be an excellent matrix former for inhalable NEM.

[Renal angiomyolipoma with epithelial cysts: a clinicopathological analysis of four cases]

Objective: To investigate the clinicopathological features,diagnosis and differential diagnosis of renal angiomyolipoma with epithelial cysts(AMLEC). Methods: Four cases of renal AMLEC diagnosed between January 2014 and June 2019 at the Department of Pathology,Zhejiang Provincial People's Hospital were subjected to clinicopathological, histological and immunohistochemistry analyses along with a literature review. Results: All the four patients were females and aged from 19 to 52 years (mean 34.5 years). Three cases were accidentally discovered by physical examination, and the medical history was 1 to 6 years. The preoperative imaging Bosniak classification was grade Ⅲ in 3 and grade Ⅳ in 1 case. The maximum diameter of the tumor ranged from 2.5 to 9.0 cm (average 5.0 cm). Histologically, all of the 4 tumors showed three histological components: (1) simple epithelial cysts lined by a layer of cuboidal/low-columnar to occasionally, hobnailcells; (2) a thin, compact subepithelial "cambium-like" layer of cellular, mullerian-like short spindle cell stromas with prominent admixedchronic inflammation; (3) a outermost layer of thick, long-fascicles of smooth muscle-like stromas, often surrounded by dysplastic, tortuous thick-walled blood vessels. There was often a prominent lymphatic channel network in the smooth muscle component forming slit like branched and curvilinear spaces. None of the 4 tumors had fat content.Immunohistochemically, the epithelial cells lining the cysts strongly expressed PAX8 and CK7. The subepithelial "cambium-like" stromas strongly expressed melanocytic markers (HMB45, Melan A, Cathspin K, MiTF) and mullerian markers (ER,PR,CD10), and were negative for smooth-muscle markers(SMA,desmin,calponin). The outermost layer of smooth muscle-like stromas strongly expressed smooth-muscle markers, and were only focally positive for melanocytic and mullerian markers. Follow-up information was obtained in 3 cases, among which no evidence of tumor recurrence or metastasis was found at 3, 5, and 66 months of follow-up, respectively. Conclusions: Renal AMLEC is a rare histological subtype of angiomyolipoma with benign biological behavior, and has characteristic histological and immunophenotypic characteristics.Pathologists should be familiar with the clinicopathological appearances of AMLEC and include it in the differential diagnostic spectrums of renal tumors with biphasic epithelial and mesenchymal features.

A novel CPC composite cement reinforced by dopamine coated SCPP fibers with improved physicochemical and biological properties

Traditional CPC cements have attracted wide attentions in repairing bone defects for injectability, easy plasticity and good osseointegration. However, its further application was limited by poor mechanical properties, long setting time and unsatisfactory biocompatibility. To solve these problems, polydopamine (DOPA) coated strontium-doped calcium polyphosphate (SCPP) fibers were added into CPC cements for the first time. A doping amount at fiber weight fraction of 0%, 1%, 2% and 5% was designed to develop a multifunctional composite fitting for bone tissues' regeneration and reconstruction and the optimum amount was selected through subsequent physicochemical and biological characterizations. The results implied DOPA coating successfully formed stable connections between SCPP fibers and CPC matrix, which simultaneously reinforced biomechanical strength and tenacity (5% SCPP/D/CPC samples exhibited more prominent mechanical property than others). In addition, 5% D/SCPP fibers doped composite cements were characterized as markedly-improved cytocompatibility: Sr²⁺ introduction induced cytoactive and significantly accelerated proliferation, attachment and spreading of osteoblasts. Besides, it also stimulated the secretion of OT, Col-I and ALP from seeded MG63, which was a critical character for further inducing osteogenic process, mineralization and bone tissues formation. The promoted cytocompatibility and improved osteogenesis-related growth factors' secretion could be attributed to constant and controllable release of Sr²⁺ and this deduction was approved by ICP analysis. In addition, Sr doping made this novel cement had a potential efficacy to inhibit aseptic loosening. In a word, present studies all demonstrated 5% SCPP/D/CPC composites could be a potential candidate material employed in bone regeneration and reconstruction for excellent mechanical property and cytocompatibility.

288Thrombotic events in bleeding patients treated with andexanet alpha: an ANNEXA-4 sub-study

Background/Introduction

Andexanet alfa (“andexanet”) was developed as a specific reversal agent for patients with major bleeding while using factor Xa (FXa) inhibitors. While thrombotic events (TEs) have been reported in patients receiving andexanet, the scope, nature, and timing of these events have not been fully characterized.

Purpose

The ANNEXA-4 study was a prospective, single-arm, open-label clinical trial that evaluated the safety and efficacy of andexanet in patients with acute major bleeding. In this secondary analysis, the occurrence of TEs was investigated.

Methods

Patients presenting with acute major bleeding within 18 hours after their last dose of FXa inhibitor were treated with andexanet. Safety outcomes, including TEs (reviewed by an adjudication committee), were evaluated at 30 days.

Results

Among 352 patients treated with andexanet, 34 (9.7%) experienced one or more TEs (Table). Strokes and deep vein thromboses were the most frequent TE types. Compared to patients with arterial TEs, patients with venous TEs were more likely to have been originally anticoagulated for venous thromboembolism. Median time to first TE was 10.5 days (Figure); time to event was shorter for arterial TEs than for venous TEs. TEs were nonfatal for most patients. Subgroups by age, bleed type, baseline anti-fXa activity, FXa inhibitor dose, and andexanet dose were not associated with the occurrence of TEs. Of the 34 TE patients, 26 (76.4%) had TEs before restart of any (full or prophylactic) anticoagulation; all first TEs occurred in patients not receiving oral anticoagulation. No TEs occurred after resumption of oral anticoagulation (N=100).

Table 1. Thrombotic event characteristics Characteristic Result (n/N [%]) TE type   Strokes 14/352 (4.0%)   Deep vein thromboses 13/352 (3.7%)   Myocardial infarctions 7/352 (2.0%)   Pulmonary embolisms 5/352 (1.4%)   Transient ischemic attacks 1/352 (0.3%) Bleed type   Intracranial 23/227 (10.1%)   Gastrointestinal 7/90 (7.8%)   Other 4/35 (11.4%) Arterial TEs   Anticoagulated for AF 17/22 (77.3%)   Anticoagulated for VTE 6/22 (27.3%) Venous TEs   Anticoagulated for AF 11/18 (61.1%)   Anticoagulated for VTE 8/18 (44.4%)   Median time to first TE 10.5 days   Arterial 6 days   Venous 15 days Outcome   Fatal 7/34 (20.6%)   Nonfatal 27/34 (79.4%) AF = atrial fibrillation; n = number of patients with TEs; N = total number of patients for each characteristic; TE = thrombotic event; VTE = venous thromboembolism.

Figure 1. Thrombotic Events Over Time

Conclusions

In patients with FXa inhibitor-associated acute major bleeding treated with andexanet, TEs occurred a rate not unexpected given the high thrombotic risk of the population. No factors predictive of TEs were identified. Resumption of anticoagulation was associated with fewer TEs.

Acknowledgement/Funding

Study funded by Portola Pharmaceuticals, Inc.

Novel redispersible nanosuspensions stabilized by co-processed nanocrystalline cellulose-sodium carboxymethyl starch for enhancing dissolution and oral bioavailability of baicalin

BACKGROUND

To improve the dissolution and bioavailability of poorly soluble drugs, novel nanosuspensions using co-processed nanocrystalline cellulose-sodium carboxymethyl starch (NCCS) as a synergetic stabilizer were first designed.

METHODS

Co-processed NCCS was prepared by means of homogenization. Poorly soluble baicalin (BCA) was used as a model drug. BCA nanosuspension (BCA-NS/NCCS) using co-processed NCCS as a dispersant was prepared via homogenization and further converted into the dried BCA nanosuspension particle (BCA-NP/NCCS) via spray drying. The influence of NCCS on the dispersion efficiency of BCA-NS/NCCS was investigated. Morphology and crystal characteristic of NCCS and BCA-NP were analyzed. The dissolution and bioavailability evaluation were performed to investigate the feasibility of NCCS as a stabilizer for BCA-NS/NCCS and BCA-NP.

RESULTS

The optimum 50% concentration of NCCS (nanocrystalline cellulose [NCC]:sodium carboxymethyl starch [SCS]=60:40) could be mostly beneficial for formation and stability of BCA-NS/NCCS. NCCS could completely prevent aggregation of BCA-NP during spray drying and enhance the redispersibility as well as dissolution of spray-dried BCA-NP, which might be attributed to "brick-concrete"-based barrier effect of NCCS and the swelling capacity of superdisintegrant SCS. The crystal state of NCC and BCA presented in BCA-NP/NCCS remained unchanged during the homogenization. The BCA-NP/NCCS exhibited a fast dissolution rate and significantly enhanced bioavailability of BCA. The AUC(0-∞) of the BCA-NP/NCCS (8,773.38±718.18 µg/L·h) was 2.01 times (P<0.05) as high as that of the crude BCA (4,354.61±451.28 µg/L·h).

CONCLUSION

This study demonstrated that novel surfactant-free nanosuspensions could be prepared using co-processed NCCS as a synergetic stabilizer and also provided a feasible strategy to improve the dissolution and oral bioavailability of poorly soluble drug.

Development and characterization of bladder acellular matrix cross-linked by dialdehyde carboxymethyl cellulose for bladder tissue engineering

In order to address the disadvantage of rapid degradation and serious immune response of bladder acellular matrix (BAM) tissues in clinical application, in this study, oxidized carboxymethyl cellulose (DCMC) was developed to replace glutaraldehyde (GA), a most common synthetic crosslinking reagent in clinical practice, to fix BAM tissues for lower cytotoxicity. The aim of this work was to evaluate feasibility of DCMC as a crosslinking reagent for BAM fixation and developing DCMC fixed-BAM (D-BAM) tissues for tissue engineering. For the preparation of DCMC, the results showed that when DCMC was prepared using a specific concentration of sodium periodate solution (the mass ratio of NaIO₄/CMC is 1 : 1) and a specific reaction time (4 hours), its cytotoxicity was the lowest and its fixation effect was better. The critical crosslinking characteristics and cytocompatibility of optimum D-BAM tissues were also investigated. The results demonstrated that DCMC-fixation (especially 30 mg ml⁻¹ DCMC-fixation) not only formed stable cross-linking bonds but also preserved well the original ultrastructure of the BAM tissues, which simultaneously increased the mechanical strength and capacity of the enzymatic hydrolytic resistance. The DCMC-fixation could also reduce the expression of α-Gal in BAM tissues and preserve the useful growth factors such as GAGs, KGF and TGF-β in bladder tissues. In addition, 30 mg ml⁻¹ D-BAM tissues had excellent cytocompatibility. Moreover, it could stimulate the secretion of PDGF and EGF from seeded bladder transitional epithelial cells (BTECs), which is a critical feature for further re-epithelialization. Its anti-calcification ability was also prominent, which is necessary in bladder repair. The present studies demonstrated that DCMC could be a potential biological crosslinking agent for BAM fixation due to its excellent crosslinking effects, and the D-BAM tissues were suitable to be used as a substitute for the bladder due to their resistance to enzymatic degradation, anticalcification and cytocompatibility.

To address the disadvantage of rapid degradation and serious immune response of bladder acellular matrix tissues in clinical application, oxidized carboxymethyl cellulose was developed to replace commonly used glutaraldehyde, to fix BAM tissues for lower cytotoxicity.

The Shielding Effect of Microcrystalline Cellulose on Drug Nanocrystal Particles During Compaction

To elucidate the compaction behavior of drug nanocrystals based composite particles (NP) during tabletting, the compaction behavior of binary mixtures of microcrystalline cellulose (MCC) and nanocrystal particles was investigated. The force-displacement correlation of mixtures containing different ratios of MCC and micronized NP was studied in order to explain the nature on densification of NP during compaction, and the resultant compaction curves (pressure as function of in-die thickness) were systemically analyzed to elucidate the most important mechanisms of volume reduction for MCC and NP in different stages of compaction. The results showed that the close compaction of individual MCC was relatively quickly achieved, and the drug NP particles could slide into the intrinsic void spaces between MCC microparticles. This was the reason that the particles size of MCC used in this study was significantly larger compared to that of drug NP. This interstitial rearrangement phenomenon of NP occurred on a typical time scale and was strongly dependent on the speed of compaction. This migration behavior occurred on void spaces of MCC inter-particles might be identified as an elastic stress relaxation mechanism and be helpful to dissolution of NP. MCC can effectively shield the NP from significant aggregation during compaction process.

Novel nanocrystal-based solid dispersion with high drug loading, enhanced dissolution, and bioavailability of andrographolide

Objective

The current study sought to design a quickly dissolving, high drug loading nanocrystal-based solid dispersion (NC-SD) in order to improve the dissolution of poorly soluble drugs.

Methods

The NC-SD was prepared by means of combination of homogenization and spray-drying. Polymer hydroxypropylmethylcellulose (HPMC) was used as baseline dispersant for NC-SD of the model drug – andrographolide (AG). Three superdisintegrants cohomogenized with HPMC were used as codispersant for AG-NC-SD and compared to common water-soluble dispersants – mannitol and lactose. The dissolution characterization and oral bioavailability of AG-NC-SD were evaluated.

Results

The AG-NC-SD with the higher concentration of HPMC exhibited fast dissolution due to the enhanced wettability of HPMC. The water-soluble codispersants (mannitol and lactose) did not completely prevent AG-NC from aggregation during spray-drying. To achieve much faster AG release, cohomogenized superdisintegrants at a level of 20% must be used along with 25% HPMC. Compared with water-soluble dispersants like mannitol and lactose, superdisintegrants with high swelling capacity were much more effective dispersants for enhancing fast redispersion/dissolution of AG-NC-SD via a swelling-triggered erosion/disintegration mechanism. Surfactant-free AG-NC-SD with 15% cohomogenized sodium carboxymethyl starch combined with 15% HPMC and 10% lactose enhanced the dissolution further, without comprising drug loading, exhibited a barely compromised dissolution rate compared to precursor NC suspensions (f₂>50), and possessed drug loading up to 67.83%±1.26%. The pharmacokinetics results also demonstrated that the AG-NC-SD significantly improved the bioavailability in vivo of AG (P<0.05), compared with to the coarse AG.

Conclusion

This study illustrates that a quickly dissolving, high drug load, surfactant-free NC-SD can be prepared by using a superdisintegrant as codispersant, and provides a feasible strategy to improve the oral bioavailability of poorly soluble drugs.

[Traditional nasal therapy in Uighur medicine]

Nasal therapy, extensively documented in the ancient Uighur medical literature, is one of the external therapies of Uighur medicine. Based on the relevant records of 14 Uighur medical works, the application, classification, clinical features, and medications characteristics of nasal therapy were preliminarily sorted out. The results show that the nasal therapy can be divided into 7 categories, covering more than 200 kinds of common medicinal herbs, 8 kinds of processing methods and 10 kinds of preparations. Clinically, there is a large number of nasal therapy prescriptions, with flexible administration of prescriptions and medications, significant features of comprehensive therapy, with significance of application for further development.

Apolipoproteins adsorption and brain-targeting evaluation of baicalin nanocrystals modified by combination of Tween80 and TPGS

To help baicalin pass across BBB and improve its targeting in brain, we designed a novel formulation strategy of baicalin nanocrystals that preferentially adsorbing apolipoprotein E (ApoE) and repelling protein adsorption of opsonins. Intravenous baicalin nanocrystals suspensions (BCL-NS) modified by different surfactant were prepared by high-pressure homogenization. The targeting potential of surface-modified BCL-NS with mean particles size of about 250nm was assessed by in vitro protein adsorption studies using two-dimensional polyacrylamide gel electrophoresis (2-D PAGE), and further evaluated in vivo pharmacokinetics. The protein adsorption results showed that BCL-NS/TPGS, BCL-NS/TW80 and BCL-NS/TPGS+TW80 adsorbed very high amounts of apolipoproteins (ApoA-I, ApoA-Ⅱ, ApoA-IV, ApoC-III, ApoE, ApoJ) and relative low amounts of opsonins (fibrinogen, immunoglobulin heavy chain gamma, immunoglobulin light chain). The pharmacokinetics results demonstrated the AUC _(0-∞) in brain of the BCL-NS/TW80+TPGS was 6.67 times as high as that of the BCL solution, and 2.59 times as high as that of the BCL-NS/TW80. It could be attributed to the most ApoE and Apo J adsorption indicative of strong BBB penetration, and least IgG γ and fibrinogen loading minimizing the risk of hepatic uptake. Combination of TW80 and TPGS can be rational choice of surfactants of baicalin nanocrystals for brain-targeting mediated by ApoE adsorption.

A Natural Triterpenoid Saponin as Multifunctional Stabilizer for Drug Nanosuspension Powder

The objective of this study is to prepare a novel drug nanosuspension modified by a natural triterpenoid saponin (glycyrrhizin (GZ)) and evaluate its stability and redispersibility. A poorly soluble drug (andrographolide (AGE)) was used as a model drug. AGE nanosuspensions (AGE-NS) using GZ as natural stabilizer with mean particle size of 487 nm were firstly prepared by homogenization and converted into dried AGE nanosuspension powder (AGE-NP) by freeze-drying. It was found that GZ was able to prevent the aggregation of AGE nanocrystals and the freeze-dried AGE-NP could easily redisperse back to AGE-NS. It was related with special properties of GZ that possessed the interfacial property (37.02 ± 0.29 N/m) and electrostatic effect (-43.6 ± 0.9 mV) and could entrap AGE nanocrystals into its network structure. The freeze-dried AGE-NP/GZ exhibited excellent performance, compared with those combined with trehalose as matrix formers. The powder X-ray diffraction result demonstrated that GZ did not alter the AGE crystal state. The dissolution of AGE-NP/GZ (99.87%) was significantly enhanced, compared with the coarse AGE (42.35%). This study demonstrated that GZ could be used as a novel multifunctional stabilizer for production of drug nanosuspensions and provided a promising basis for further formulation development of poorly soluble drug.