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Studies on chronic total occlusion (CTO) treatment strategy in stable patients have reported conflicting results. We focused on stable diabetic patients with a single CTO (other vessels have been successfully treated before). We attempted to identify which strategy (percutaneous coronary intervention [PCI] or medical therapy [MT]) is optimal; 545 patients were selected from a total of 39 952 patients. Based on the initial treatment strategy, we assigned patients to either the PCI or MT group. The primary end point was a major adverse cardiac event (MACE). After a median follow-up of 45 months (interquartile range: 25.7-79.2 months), we observed (1) no difference in MACE and myocardial infarction between groups, (2) multivariate analysis showed that PCI group was superior to MT group in cardiac death (hazard ratio: 4.758 (1.698-13.334); P =.003) and all-cause death (2.767 [1.157-6.618]; P =.022). The superiority was consistent in propensity score–matched analysis, and (3) a failed PCI group was not associated with higher risks in the clinical end points, except for target vessel revascularization, compared with MT. We concluded that for stable patients with diabetes and one single CTO, initial PCI strategy tended to offer patients survival benefits compared with MT. [ABSTRACT FROM AUTHOR]

Combination of chemotherapy and small interfering RNA (siRNA)-based nanotherapeutics could cooperatively and effectively suppress multiple drug resistance in cancer development. Particularly, nano-delivery systems that efficiently encapsulate two or more therapeutic payloads to the tumor-targeted sites have been proven significantly. Here, we prepared a micellar nanoparticle formed by monomethoxy poly (ethylene glycol)–block–poly(ε-caprolactone)-block-poly(L-lysine)/cholesterol (mPEG-b-PCL-b-PLL/Chol, further abbr. as "P"). In this work, PCL as the hydrophobic core to encase doxorubicin and PLL as the cationic moiety to bind with negatively charged siRNA are used to achieve the co-delivery of therapies in one platform. The results showed that the micellar nanoparticle is capable of delivering siRNA and doxorubicin simultaneously to the same tumor cells, and consequently displays enhanced inhibition efficiency on MCF-7/ADR cells. Moreover, real-time polymerase chain reaction (RT-PCR) and Western blot experiments indicated that the co-delivery of micelleplex-delivering B-cell lymphoma 2 specific siRNA (siBcl) successfully down-regulated the expression of Bcl-2 protein, which triggers chemotherapy to be more sensitive to the cancer cells. Therefore, the strategy of co-delivering anticancer drug and siRNA showed promising potential in reversing drug resistance of tumor cells. [ABSTRACT FROM AUTHOR]