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Imaging-guided percutaneous microwave thermotherapy has been regarded as an important alternative nonsurgical therapeutic strategy for hepatocellular carcinoma (HCC) that provides excellent local tumor control and favorable survival benefit. However, providing a high-resolution, real-time, and noninvasive imaging technique for intraoperative guidance and controlling postoperative residual tumor recurrence are urgent needs for the clinical setting. In this study, a cisplatin (CDDP)-loaded nanocapsule (NPs@CDDP) with microwave responsive property was prepared to simultaneously serve as a contrast agent of emerging thermoacoustic imaging and a sensitizing agent of microwave thermo-chemotherapy. Accompanying the enzymolysis in the tumor microenvironment, the NPs@CDDP responsively release l-arginine (l-Arg) and CDDP. l-Arg with excellent microwave-absorbing property allowed it to serve as a thermoacoustic imaging contrast agent for accurately delineating the tumor and remarkably increasing tumor temperature under ultralow power microwave irradiation. Apart from the chemotherapeutic effect, CDDP elevated the intracellular H2O2level through cascade reactions and further accelerated the continuous transformation of l-Arg to nitric oxide (NO), which endowed the NPs@CDDP with NO-generation capability. Notably, the high concentration of intracellular NO was proved to aggravate lipid peroxidation and greatly improved the efficacy of microwave thermo-chemotherapy. Thereby, NPs@CDDP was expected to serve as a theranostic agent integrating the functions of tumor microenvironment-responsive drug delivery system, contrast agent of thermoacoustic imaging, thermal sensitizing agent, and NO nanogenerator, which was promising to provide a potential imaging-guided therapeutic strategy for HCC.

ObjectivesDabigatran-induced oesophagitis has emerged in recent years. However, the incidence and clinical characteristics of patients with dabigatran-induced oesophagitis have not yet been clarified. The aim of this study was to examine the clinical characteristics of the disease.MethodsA retrospective analysis was undertaken of the literature on dabigatran-induced oesophagitis in Chinese and English from 2008 onwards.ResultsThere were 20 men (74.07%) and seven women (25.93%) in the study; their median age was 75 years (range 37–90). The main clinical symptoms were dysphagia (42.31%), odynophagia (26.92%), retrosternal pain (23.08%) and heartburn (23.08%). Endoscopy mainly showed sloughing mucosal casts (14 cases, 56%), ulcers (8 cases, 32%) and erosion (6 cases, 24%). The main injury sites were the mid to lower oesophagus (32%) and the mid oesophagus (32%). Withdrawal of dabigatran or giving the correct medication regimen resulted in rapid recovery of clinical symptoms from 1 day in some patients and up to 4 weeks, and mucosal recovery (2–5 weeks) in a median time of 3 weeks (range 0.29–48) in all patients.ConclusionsOesophagitis is a rare complication of dabigatran with a good prognosis. Patients should be given proper medication instructions to prevent the occurrence of dabigatran-induced oesophagitis.

A broad-spectrum polymeric antimicrobial, PEoS-PHMG, was developed to achieve dual-modality bacterial inhibition viaphotodynamic inactivation and physical damage. Compared with native PHMG, current photosensitizer conjugate-functionalized PHMG exhibited excellent bacterial inhibition and enhanced biocompatibility with minimal cytotoxicity toward mammalian cells.

Ferroptosis, characterized by the accumulation of reactive oxygen species and lipid peroxides, has emerged as an attractive strategy to reverse drug resistance. Of particular interest is the ferroptosis–apoptosis combination therapy for cancer treatment. Herein, a nanoplatform is reported for effective co‐delivery of the anticancer drug sorafenib (S) and the ferroptosis inducer hemin (H), toward synergistic ferroptosis–apoptosis therapy of advanced hepatocellular carcinoma (HCC) as a proof‐of‐concept study. Liposome is an excellent delivery system; however, it is not sufficiently responsive to the acidic tumor microenvironment (TME) for tumor‐targeted drug delivery. The pH‐sensitive vesicles are therefore developed (SH‐AD‐L) by incorporating amphiphilic dendrimers (AD) into liposomes for controlled and pH‐stimulated release of sorafenib and hemin in the acidic TME, thanks to the protonation of numerous amine functionalities in AD. Importantly, SH‐AD‐L not only blocked glutathione synthesis to disrupt the antioxidant system, but also increased intracellular Fe2+and ·OH concentrations to amplify oxidative stress, both of which contribute to enhanced ferroptosis. Remarkably, high levels of ·OH also augmented sorafenib‐mediated apoptosis in tumor cells. This study demonstrates the efficacy of ferroptosis–apoptosis combination therapy, as well as the promise of the AD‐doped TME‐responsive vesicles for drug delivery in combination therapy to treat advanced HCC. This research reports a pH‐sensitive hybrid liposomal vesicle (SH‐AD‐L) based on amphiphilic dendrimer, 1,2‐dipalmitoyl‐sn‐glycero‐3‐phosphocholine, 1,2‐distearoyl‐sn‐glycero‐3‐phosphoethanolamine‐N‐[methoxy (polyethylene glycol)‐2000], and cholesterol, with sorafenib and hemin co‐encapsulation. Hemin synergizes with sorafenib to disturb redox homeostasis and amplify oxidative stress via triggering GSH depletion, iron overloading, and ·OH production, which further induce efficient tumor suppression via synergistic ferroptosis–apoptosis for advanced hepatocellular carcinoma therapy.