The design of nanoscale drug delivery systems for the targeted codelivery of multiple therapeutic drugs still remains a formidable challenge (ACS Nano, 2013, 7, 9558-9570; ACS Nano, 2013, 7, 9518-9525). In this article, both mitomycin C (MMC) and methotrexate (MTX) loaded DSPE-PEG micelles (MTX-M-MMC) were prepared by self-assembly using the dialysis technique, in which MMC-soybean phosphatidylcholine complex (drug-phospholipid complex) was encapsulated within MTX-functionalized DSPE-PEG micelles. MTX-M-MMC could coordinate an early phase active targeting effect with a late-phase synergistic anticancer effect and enable a multiple-responsive controlled release of both drugs (MMC was released in a pH-dependent pattern, while MTX was released in a protease-dependent pattern). Furthermore, MTX-M-MMC could codeliver both drugs to significantly enhance the cellular uptake, intracellular delivery, cytotoxicity, and apoptosis in vitro and improve the tumor accumulation and penetration and anticancer effect in vivo compared with either both free drugs treatment or individual free drug treatment. To our knowledge, this work provided the first example of the systemically administrated, orthogonally functionalized, and self-assisted nanoscale micelles for targeted combination cancer chemotherapy. The highly convergent therapeutic strategy opened the door to more simplified, efficient, and flexible nanoscale drug delivery systems.

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Lipid–MMC in cooperation with pegylated lipid–MTX based on PEG–PE–PLA hybrid NPs can coordinate an early-phase targeting effect with a late-phase anticancer effect.

Our overall results suggested that compared with traditional care, fast-track program could result in shorter postoperative hospital stay, less medical costs, and lower level of CRP, with no more complications occurring in both laparoscopic and open surgery for gastric cancer.

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Dressing change and physical therapy are extremely painful procedures for burn patients. Adjunctive virtual reality therapy reportedly reduces pain when added to analgesics, but a summary analysis of the data has yet to be performed. We conducted this systematic review and meta‐analysis of randomized controlled trials to verify the pain‐reducing efficacy of virtual reality among burn patients undergoing dressing change or physical therapy. We searched MEDLINE (via PubMed), EMBASE (via OVID), and the Cochrane Central Register of Controlled Trials (via OVID) for relevant trials based on predetermined eligibility criteria from database establishment to February 2018. Two reviewers screened citations and extracted data independently. The quality of the included studies was evaluated according to the Cochrane Handbook, whereas statistical heterogeneity was assessed using chi‐square tests and I2 statistics. Review Manager 5.3 was used for statistical analysis. Thirteen randomized controlled trials with 362 patients who underwent 627 burn dressing change or physical therapy sessions were included. The additional use of virtual reality significantly reduced pain intensity, time spent thinking about pain, and unpleasantness, and was more fun compared with that of using analgesics alone. Virtual reality is an effective pain reduction measurement added to analgesics for burn patients undergoing dressing change or physical therapy. However, multicenter, parallel group design randomized controlled trials are still required.

Meningiomas are common and mostly benign intracranial tumors, but malignant meningioma is a rare subtype with high recurrence rate and poor prognosis. Also, most meningiomas grow intracranially, and extracranial growth of meningiomas has rarely been reported. We present here a rare case of a giant malignant meningioma with multiple recurrences. The patient was a 73-year-old woman who was evaluated to have a malignant meningioma of the frontal part of the skull 3 years before being admitted to our hospital and received surgical treatment. The tumor recurred 3 years after the first surgery and was classified as a giant meningioma on admission to our hospital. We performed total resection of the giant meningioma and reconstructed the defect with artificial dura, skull, and a local rotating flap. The patient recovered and lived well for 1 year. However, 15 months after surgery, the patient died of the recurrent tumor after refusing any treatment. Meningiomas are usually common and benign intracranial tumors; however, the anaplastic subtype of meningiomas is rare and malignant. Despite the high rates of recurrence and metastasis, surgery is still an option. For giant invasive tumors, the cooperation of neurosurgeons and plastic surgeons is essential.

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