Colon cancer is one of the leading causes of cancer-related death worldwide, and the therapeutic application of 5-fluorouracil (5-FU) is limited due to its nonspecificity, low bioavailability, and overdose. The present study is an attempt to improve the chemotherapeutic efficacy of 5-FU in colon cancers. Therefore, we have prepared 5-FU-loaded hyaluronic acid (HA)-conjugated silica nanoparticles (SiNPs) to target to colon cancer cells. In this study, we have showed the specific binding and intracellular accumulation of targeted nanoparticles based on HA surface modifications in colon carcinoma cells. The particles had spherical shapes with sizes of approximately 130 nm. HA-conjugated nanoparticles showed a sustained release pattern for 5-FU and continuously released for 120 hours. We have further investigated the cytotoxicity potential of targeted and nontargeted nanoparticles in colo-205 cancer cells. IC50 value of 5-FU/hyaluronic acid-conjugated silica nanoparticles (HSNP) was 0.65 µg/mL compared with ~2.8 µg/mL for 5-FU/SNP after 24 hours of incubation. The result clearly showed that HA-conjugated NP was more effective in inducing apoptosis in cancer cells than nontargeted NP. The 5-FU/HSNP showed ~45% of cell apoptosis (early and late apoptosis stage) compared with only 20% for 5-FU/silica nanoparticles (SNP)-treated group. The HA-conjugated nanoparticles provide the possibility of efficient drug transport into tumors that could effectively reduce the side effects in the normal tissues. 5-FU/HSNP was highly efficient in suppressing the tumor growth in xenograft tumor model. The proportion of Ki67 in 5-FU/HSNP-treated group was significantly lower than that of either free drug or nontargeted SiNPs. Altogether, we have showed that conjugation of HA to SiNPs could result in enhanced uptake of 5-FU through CD44-mediated endocytosis uptake and could result in significant antitumor efficacy. Thus, 5-FU/HSNP could be a promising drug delivery system for colon cancer therapy.

Background Recent studies suggest that routine laboratory tests are not required within 1 day after partial knee arthroplasty. In this study, we evaluated the utility of routine postoperative laboratory tests after initial unilateral total knee arthroplasty (TKA) in an Asian population. In addition, we explored risk factors associated with abnormal test results. Methods Clinical data of patients who underwent original unilateral TKA between 2015 and 2020 were retrospectively analyzed. Patient characteristics and laboratory test results were recorded. Multivariate binary logistic regression analysis was performed to identify risk factors associated with 3 abnormal laboratory results. Results A total of 713 patients, who underwent relevant laboratory tests within 3 days of TKA surgery, were enrolled. Among them, 8.1%, 9.9%, and 3.4% patients with anemia, hypoalbuminemia, and abnormal serum potassium levels required clinical intervention after surgery. Binary logistic regression analysis revealed that preoperative hemoglobin levels, estimated blood loss, and age were independent risk factors of postoperative blood transfusion in TKA patients. On the other hand, preoperative albumin levels, intraoperative blood loss, and operation time were risk factors associated with postoperative albumin supplementation. In addition, lower body mass index (BMI) and preoperative hypokalemia were potential risk factors of postoperative potassium supplementation. Conclusion Considering that more than 90% of abnormal postoperative laboratory tests do not require clinical intervention, we believe that routine laboratory tests after surgery have little significance in patients with primary unilateral TKA. However, postoperative laboratory testing is necessary for patients with established risk factors.

BackgroundRecent studies suggest that routine laboratory tests are not required within 1 day after partial knee arthroplasty. This study aimed to evaluate the utility of routine postoperative laboratory tests after initial unilateral total knee arthroplasty(TKA) in an Asian population and to identify risk factors associated with abnormal test results.MethodsThe clinical data of patients who underwent original unilateral TKA from 2015 to 2020 were retrospectively analyzed. Patient characteristics and laboratory test values were recorded. Multivariate binary logistic regression analysis was also performed to identify risk factors associated with 3 abnormal laboratory values.ResultsA total of 713 patients were included in this study and underwent relevant laboratory tests within 3 days of TKA surgery. However, only a small proportion of patients with anemia (8.1 %), hypoalbuminemia (9.9 %), and abnormal serum potassium levels (3.4 %) required clinical intervention after surgery. Binary logistic regression analysis revealed that independent risk factors for postoperative blood transfusion in TKA patients included preoperative hemoglobin level, estimated blood loss, and age. Related risk factors for postoperative albumin supplementation were preoperative albumin level, intraoperative blood loss and operation time. In addition, lower body mass index (BMI) and preoperative hypokalemia were found to be potential risk factors for postoperative potassium supplementation.ConclusionSince more than 90% of abnormal postoperative laboratory tests do not require clinical intervention, the authors believe that it is of little significance for patients with primary unilateral TKA to receive routine laboratory tests after surgery. However, in patients with established risk factors, postoperative laboratory testing is still necessary.