Fenofibrate-Loaded Biodegradable Nanoparticles for the Treatment of Neovascular Age-Related Macular Degeneration

Fenofibrate-Loaded Biodegradable Nanoparticles for the Treatment of Neovascular Age-Related Macular Degeneration Russell Simmers, Depts. of Physics and Chemistry, with Dr. Qingguo Xu, VCU School of Pharmacy Background: Neovascular age-related macular degeneration (AMD) is a leading cause of visual impairment in the elderly population in the industrialized world. The current treatment for neovascular AMD is anti-vascular endothelial growth factor (anti-VEGF) therapy; however, nearly 40-50% of patients do not fully respond to anti-VEGF therapy. Therefore, non-VEGF therapeutics are required for neovascular AMD treatment. Fenofibrate is a peroxisome proliferator-activated receptor alpha (PPARα) agonist and has demonstrated robust therapeutic effects on neovascular AMD in animal models; however, it must be delivered frequently via intravitreal injection due to quick clearance of the drug from the eye, and may induce injection associated side effects such as retinal detachment, ocular hemorrhage and endophthalmitis. Purpose: To develop and optimize fenofibrate-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles (Feno-NP) with high-drug loading and long-lasting drug release profile to effectively treat neovascular AMD for 6-months with one single intravitreal injection. Methods: Feno-NPs were prepared by emulsification method and were fully characterized in terms of particle size, surface charge, morphology and in vitro drug release profiles and the ocular pharmacokinetics studies were performed in rats following intravitreal injection. Efficacy on neovascular-AMD was determined by measuring vascular leakage, vascular permeability, and the numbers of subretinal neovascular (SRNV) and intraretinal neovascular (IRNV) lesions after intravitreal injection of Feno-NPs in a laser-induced choroid neovascularization (CNV) rat model.https://scholarscompass.vcu.edu/uresposters/1387/thumbnail.jp

Subretinal echinococcosis: a case report

Abstract Background Echinococcosis is a dangerous zoonotic parasitic disease. Ocular echinococcosis is very rare, especially the hydatid cysts in subretinal space. We present a case of subretinal echinococcosis and management. Case presentation A 37-year-old man with subretinal echinococcosis who developed panuveitis and visual impairment. The patient lives on agriculture and animal husbandry, which made him susceptible to parasitic infection. He had severe panuveitis and blurred vision on arrival at hospital. According to his ocular examination and systemic review, the subretinal echinococcosis diagnosis was made. The patient received pars plana lensectomy and pars plana vitrectomy. The lesion underneath his retina was removed, and histopathology examination confirmed the subretinal echinococcosis diagnosis. Conclusions Echinococcosis is a dangerous zoonotic parasitic disease in pastoral areas. Ocular echinococcosis is usually secondary to systemic infection. Although the incidence is rare, the disease could lead to destructive visual function impairment

Application of Contrast-Enhanced Ultrasound in Cystic Pancreatic Lesions Using a Simplified Classification Diagnostic Criterion

Objective. Classification diagnosis was performed for cystic pancreatic lesions using ultrasound (US) and contrast-enhanced ultrasound (CEUS) to explore the diagnostic value of CEUS by comparison with enhanced CT. Methods. Sixty-four cases with cystic pancreatic lesions were included in this study. The cystic lesions of pancreas were classified into four types by US, CEUS, and CT: type I unilocular cysts; type II microcystic lesions; type III macrocystic lesions; and type IV cystic lesions with solid components or irregular thickening of the cystic wall or septa. Results. Eighteen type I, 7 type II, 10 type III, and 29 type IV cases were diagnosed by CT. The classification results by US were as follows: 6 type I; 5 type II; 4 type III; and 49 type IV cases. Compared with the results by enhanced CT, the kappa value was 0.36. Using CEUS, 15, 6, 12, and 31 cases were diagnosed as types I–IV, respectively. The kappa value was 0.77. Conclusion. CEUS has obvious superiority over US in the classification diagnostic accuracy in cystic pancreatic lesions and CEUS results showed substantial agreement with enhanced CT. CEUS could contribute to the differential diagnosis of cystic pancreatic diseases

A surgical Decision-making scoring model for spontaneous ventilation- and mechanical ventilation-video-assisted thoracoscopic surgery in non-small-cell lung cancer patients

Abstract Backgrounds Spontaneous ventilation-video-assisted thoracoscopic surgery (SV-VATS) has been applied to non-small cell lung cancer (NSCLC) patients in many centers. Since it remains a new and challenging surgical technique, only selected patients can be performed SV-VATS. We aim to conduct a retrospective single-center study to develop a clinical decision-making model to make surgery decision between SV-VATS and MV (mechanical ventilation) -VATS in NSCLC patients more objectively and individually. Methods Four thousand three hundred sixty-eight NSCLC patients undergoing SV-VATS or MV-VATS in the department of thoracic surgery between 2011 and 2018 were included. Univariate and multivariate regression analysis were used to identify potential factors influencing the surgical decisions. Factors with statistical significance were selected for constructing the Surgical Decision-making Scoring (SDS) model. The performance of the model was validated by area under the receiver operating characteristic curve (AUC), calibration curves and decision curve analysis (DCA). Results The Surgical Decision-making Scoring (SDS) model was built guided by the clinical judgment and statistically significant results of univariate and multivariate regression analyses of potential predictors, including smoking status (p = 0.03), BMI (p < 0.001), ACCI (p = 0.04), T stage (p < 0.001), N stage (p < 0.001), ASA grade (p < 0.001) and surgical technique (p < 0.001). The AUC of the training group and the testing group were 0.72 and 0.70, respectively. The calibration curves and the DCA curve revealed that the SDS model has a desired performance in predicting the surgical decision. Conclusions This SDS model is the first clinical decision-making model developed for an individual NSCLC patient to make decision between SV-VATS and MV-VATS

Correlation between Pre-treatment Anemia and Prognosis in Non-small Cell Lung Cancer Patients

Background and objective The patients with non-small cell lung cancer (NSCLC) might contract anemia, however, whether anemia is one of the independent prognostic factors to the patients with NSCLC is still controversial. So the aim of this study is to investigate the correlation between anemia and overall survival (OS) in patients with NSCLC. Methods 1 018 patients with operable NSCLC were retrospectively analyzed in our hospital from January 2000 to December 2008. Results The occurrence of anemia before operation was 252/1 018 (24.1%). The OS in NSCLC patients without anemia was (2 425.98±50.03) days, and the OS in patients with anemia was (2 107.15±93.86) days. There was significant difference in the OS between them (P=0.001). The patients with anemia in stage I had shorter survival time than those without anemia (P &lt; 0.001). But there was no difference in other stage patients. TNM stage, gender, tumor size and lymph nodes metastasis were correlated with OS using Cox regression analysis. Conclusion Anemia is correlated with survival in operable NSCLC patients. Moreover, it is an independent prognostic factor in NSCLC patients with stage I