The rapid development of nanotechnology has a great influence on the fields of biology,
physiology, and medicine. Over recent years, nanoparticles have been widely presented as nanocarriers
to help the delivery of gene, drugs, and other therapeutic agents with cellular targeting ability. Advances
in the understanding of gene delivery and RNA interference (RNAi)-based therapy have brought increasing
attention to understanding and tackling complex genetically related diseases, such as cancer,
cardiovascular and pulmonary diseases, autoimmune diseases and infections. The combination of nanocarriers
and DNA/RNA delivery may potentially improve their safety and therapeutic efficacy. However,
there still exist many challenges before this approach can be practiced in the clinic. In this review,
we provide a comprehensive summary on the types of nanoparticle systems used as nanocarriers, highlight
the current use of nanocarriers in recombinant DNA and RNAi molecules delivery, and the current
landscape of gene-based nanomedicine-ranging from diagnosis to therapeutics. Finally, we briefly discuss
the biosafety concerns and limitations in the preclinical and clinical development of nanoparticle
gene systems.
When compared with the median sternotomy approach, the RT approach shows comparable results in short-term efficacy and safety. On relatively increasing cardiopulmonary bypass time and operation time, the RT approach shortens the patient's intensive care unit stay and reduces the need for blood transfusion. Pulmonary function may be affected shortly post-surgery in the RT approach, with insignificant difference in haemodynamics.
Background: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction. However, the effects of rhBNP on patients carried out CPB surgery is unknown. Methods: We retrospect 357 patients carried out CPB surgery between Jan 1st 2014 and Dec 31st 2015 of our department. And according the use of rhBNP, these patients were divided into two groups: rhBNP group and control group. Patients in rhBNP group were received continuous intravenous rhBNP (0.0075-0.01 μg/kg/min) in 6 hours after CPB surgery, for a period of 72 h. Hemodynamic parameters were measured immediately after CPB surgery, and then at 2, 4, 8, 12 and 24 h after surgery. Blood samples were obtained immediately after surgery and thereafter once a day at 6:00 AM within the first 3 days after surgery. The daily urine volume as well as the time of tracheal intubation, ICU stay and chest drainage were also recorded.
Background: Whether the benefits of early prophylactic anticoagulation by low molecular weight heparin (LMWH) would outweigh its possible harms in patients after minimally invasive cardiac surgery (MICS) remains contentious. The aims of this study were to define the incidence of venous thromboembolism (VTE) and to assess whether early prophylactic anticoagulation by LMWH postoperatively was indeed effective in reducing VTE without increasing risk of complications after MICS.Methods: This investigation was a single-center, retrospective, propensity score-matched analysis study. A total of 473 patients underwent MICS, of whom 257 received prophylactic anticoagulation with LMWH (LMWH group) in the early postoperative period and 216 were not treated with LMWH (Control group).The main outcome measurements included the incidence of embolism events and major bleeding events, the volume of erythrocyte transfusion, the volume of drainage and the duration of drainage after MICS.In addition, the incidence of poor wound healing, the mechanical ventilation time, ICU stay time and postoperative hospitalization time were also documented.Results: There were fewer embolic events (P=1.000) and a higher rate of major bleeding events (P=0.008) in the LMWH group than the Control group, and their magnitude and significance were maintained in the propensity matched analysis. In the matched cohorts, there was no significant difference in the total volume of red blood cell transfusion (P=0.552), assisted mechanical ventilation time (P=0.542), and the ICU stay time (P=0.166) between the two groups; while the volume of drainage (P<0.001) and the duration of drainage (P<0.001) in the LMWH group were significantly more than the Control group, and the incidence of poor wound healing (P=0.009) and the postoperative hospitalization time (P<0.001) were significantly increased in the LMWH group.Conclusions: Early prophylactic anticoagulation with LMWH could not reduce the incidence of embolism events after MICS. Instead, it might increase postoperative major bleeding events and prolong drainage tube indwelling time and the length of hospital stay.
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