Nanoparticle based inner ear therapy

Synthetic nanoparticles can be used to carry drugs, genes, small interfering RNA （siRNA） and growth fac-tors into the inner ear, to repair, restore and induce cellular regeneration. Nanoparticles （NPs） have been developed which are targetable to selected tissue, traceable in vivo, and equipped with controlled drug/gene release. The NPs are coated with a “stealth” layer, and decorated with targeting ligands, markers, transfection agents and endosomal escape peptides. As payloads, genes such as the BDNF -gene, Math1 -gene and Prestin -gene have been constructed and delivered in vitro. Short-hairpin RNA has been used in vitro to silence the negative regulator of Math1, the in-hibitors of differentiation and DNA binding. In order to facilitate the passage of cargo from the middle ear to the inner ear, the oval window transports gadolinium chelate more effciently than the round window and is the key element in introducing therapeutic agents into the vestibule and cochlea. Depending upon the type of NPs, different migration and cellular internalization pathways are employed, and optimal carriers should be designed depending on the cargo. The use of NPs as drug/gene/siRNA carriers is fascinating and can also be used as an intraoperative adjunct to cochlear implantation to attract the peripheral processes of the cochlear nerve.

Emphysematous sloughed floating ball after prostate water vaporization Rezum:A case report

BACKGROUND Rezūm™water vapor therapy is a new minimally invasive endoscopic technology for the management and treatment of benign prostatic hyperplasia.CASE SUMMARY A 63-year-old male presented to our department with severe dysuria,frequency,urgency,and interrupted stream 2 mo after receiving Rezūm™therapy.The symptoms were caused by a retained floating emphysematous necrotic sloughed tissue.We also discovered a persistent bacterial infection that was resistant to parenteral antimicrobial therapy.The treatment of the patient included surgical removal of the necrotic tissue.CONCLUSION Despite the good safety profile and minimal adverse events related to Rezūm™therapy,major complications can still occur.

Evidence and Expert Opinions:Drying Needling versus Acupuncture(Ⅱ)--The American Alliance for Professional Acupuncture Safety(AAPAS)White Paper 2016

In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding（1） acupuncture as dry needling and（2） acupuncture points as trigger points（dry needling points）. Dry needling simply using English biomedical terms（especially using ＂fascia＂ hypothesis） in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain（dry needling promoters redefined it as ＂myofascial pain＂）. Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy（a surgical procedure） instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture＇s local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients＇ safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.