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Guiqing Liu,1 Yuanyuan Yi,1 Yanni Wang,1 Yuru Feng,1 Minyi Lin,1 Xu Yan,1 Jinghua Wang,2 Xianjia Ning,2 Nan Ma1 1Department of Liver Surgery (Liver Transplantation), Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China; 2Center of Clinical Epidemiology, Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Nan Ma, Department of Liver Surgery (Liver Transplantation), Shenzhen Third People’s Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, People’s Republic of China, Tel +86-755-61222333, Fax +86-755-61238928, Email manan133@163.comObjective: We aimed to explore the status of nutritional and frailty in patients undergoing liver transplantation and the associated influencing factors.Methods: We conducted a follow-up analysis of 44 patients who underwent liver transplantation between 2021 and 2022. We followed up and recorded the nutritional status and risk of weakness at different time-points (days 1, 2, 3, 6, 9, and 12) postoperatively. Patient information regarding demographics, physical examination, medical history, and perioperative blood tests were collected. Binary logistic regression was applied to identify risk factors for weakness after liver transplantation.Results: The cohort comprised 44 liver transplant recipients, with a mean age of 47.66 years (standard deviation=9.49 years). Initial analysis revealed that, compared to the group without nutritional risks, the group with nutritional risks displayed elevated age and preoperative blood ammonia levels one week post-surgery. Moreover, this group had reduced levels of albumin and total bile acid preoperatively. Patients with preoperative nutritional risks were also prone to similar risks 2 weeks postoperatively. Further, a correlation was observed between preoperative pulmonary infections and increased frailty risk 6 days postoperatively. At both 9 and 12 days postoperatively, patients with frailty risk exhibited higher preoperative white blood cell counts and ammonia levels than those without. Multivariable analysis, controlling for confounding factors, indicated a significant association between preoperative nutritional status and nutritional risk 2 weeks postoperatively, as well as a link between preoperative white blood cell count and frailty risk at 12 days postoperatively.Conclusion: There was a significant correlation between preoperative nutritional status and nutritional risk 2 weeks after liver transplantation, and preoperative white blood cell count was an independent risk factor for weakness 12 days postoperatively. Preoperative nutritional management for patients could potentially mitigate the likelihood of adverse clinical outcomes.Keywords: malnutrition, frailty, liver transplantation, risk factors, epidemiology

Ning Ma,1 Liwei Bai,2 Qiang Lu1 1Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, People’s Republic of China; 2Qinhuangdao Hospital for Maternal and Child Health, Hebei, Qinhuangdao, 066000, People’s Republic of ChinaCorrespondence: Qiang Lu, Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, People’s Republic of China, Tel +86 13933909066, Email 13933909066@126.comPurpose: This study seeks to assess the potential of early pregnancy Triglyceride Glucose Index (TyG), triglyceride to High-Density Lipoprotein Cholesterol ratio (TG/HDL-c), Low-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol ratio (LDL-C/HDL-C), and Total Cholesterol to High-Density Lipoprotein Cholesterol ratio (TC/HDL-C) in predicting Gestational Diabetes Mellitus (GDM).Patients and Methods: A total of 1073 adults singleton pregnant women were enrolled from June 2017 to September 2019. Complete anthropometric data and lipid profiles were measured in the first trimester (before 12 weeks gestation) and a 75g oral glucose tolerance test (OGTT) at 24– 28 weeks was performed. Based on OGTT results, participants were categorised into Normal Glucose Tolerance (NGT) group (n=872) and GDM group (n=201). General data, laboratory test results, and surrogate insulin resistance indicators such as TyG index, TG/HDL-C, LDL-C/HDL-C, and TC/HDL-C were documented and compared. To compare differences between the two groups, t-test was used, Spearman correlation analysis and linear regression analysis were performed to establish associations between these indicators and insulin resistance in GDM. Receiver Operating Characteristic (ROC) curves were generated to compare the thresholds of these indicators for predicting GDM during pregnancy and to quantify overall diagnostic accuracy.Results: Individuals with GDM had higher TyG, TG/HDL-C, and LDL-C/HDL-C levels (P < 0.001), but with no significant difference observed in TC/HDL-C. All four ratios were positively correlated with Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), yet only TyG emerged as an independent risk factor for HOMA-IR. The Area under the Curve (AUC) of TyG index (0.692) was comparable to that of HOMA-IR (0.703). The cut-off points for TyG index, TG/HDL-C, and HOMA-IR in predicting GDM were 7.088, 0.831, and 1.8, respectively. HOMA-IR exhibited the highest sensitivity (79.1%), while TyG index (64.3%) and TG/HDL-C ratio (64.3%) demonstrated better specificity compared to HOMA-IR (56.3%). LDL-C/HDL-C and TC/HDL-C offered no discernible predictive advantage.Conclusion: Early pregnancy TyG index and TG/HDL-C can aid in identifying pregnant women at risk for GDM, potentially facilitating early and effective intervention to improve prognosis. TyG index exhibited superior predictive capability compared to TG/HDL-C.Keywords: TyG, gestational diabetes mellitus, glucose and lipid metabolism, insulin resistance

Na Qi,1,&ast; Xiantai Zhou,2,&ast; Ningzhu Ma,2 Jianguo Zhang,2 Zhenlin Wang,2 Xin Zhang,1 Aimin Li1 1Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510315, People’s Republic of China; 2Department of Pharmacy, Guilin Medical University, Guilin, 541004, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Aimin Li; Xin Zhang, Cancer Center, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangzhou, 510315, People’s Republic of China, Email liaimin2005@163.com; 252089553@qq.comIntroduction: The high mortality rate of malignant ovarian cancer is attributed to the absence of effective early diagnosis methods. The LHRH receptor is specifically overexpressed in most ovarian cancers, and the integrin αvβ 3 receptor is also overexpressed on the surface of ovarian cancer cells. In this study, we designed LHRH analogues (LHRHa)/RGD co-modified paclitaxel liposomes (LHRHa-RGD-LP-PTX) to target LHRH receptor-positive ovarian cancers more effectively and enhance the anti-ovarian cancer effects.Methods: LHRHa-RGD-LP-PTX liposomes were prepared using the thin film hydration method. The morphology, physicochemical properties, cellular uptake, and cell viability were assessed. Additionally, the cellular uptake mechanism of the modified liposomes was investigated using various endocytic inhibitors. The inhibitory effect of the formulations on tumor spheroids was observed under a microscope. The co-localization with lysosomes was visualized using confocal laser scanning microscopy (CLSM), and the in vivo tumor-targeting ability of the formulations was assessed using the IVIS fluorescent imaging system. Finally, the in vivo anti-tumor efficacy of the formulations was evaluated in the armpits of BALB/c nude mice.Results: The results indicated that LHRHa-RGD-LP-PTX significantly enhanced cellular uptake in A2780 cells, increased cytotoxicity, and hand a more potent inhibitory effect on tumor spheroids of A2780 cells. It also showed enhanced co-localization with endosomes or lysosome in A2780 cells, improved tumor-targeting capability, and demonstrated an enhanced anti-tumor effect in LHRHR-positive ovarian cancers.Conclusion: The designed LHRHa-RGD-LP-PTX liposomes significantly enhanced the tumor-targeting ability and therapeutic efficacy for LHRH receptor-positive ovarian cancers. Keywords: modified liposome, LHRHa, RGD, paclitaxel, ovarian cancer

Panpan Zi,1,&ast; Ming Fang,2,&ast; Hongfu Yang,1 Jiahao Zheng,3 Ning Ma,1 Qilong Liu1 1Department of Critical Care Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2Institute for Infection Disease Control, Shandong Center for Disease Control and Prevention, Jinan, People’s Republic of China; 3Institute of Animal Quarantine, Chinese Academy of Inspection and Quarantine, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Panpan Zi, Department of Critical Care Medicine, the First Affiliated Hospital of Zhengzhou University, No. 1 Longhu Zhonghuan Road, Jinshui District, Zhengzhou, Henan, People’s Republic of China, Tel +86-0371-66271356, Email zipanda123456@163.comPurpose: The continuous rise in carbapenemase-producing Enterobacteriaceae infections is a major public health concern. However, there is limited information available on New Delhi metallo-β-lactamase-1 (NDM-1) producing Citrobacter koseri. In this study, we isolated a blaNDM-1-carrying C. koseri from a stool sample of an inpatient. Our aim was to investigate the phenotypic and genomic features of this clinically derived carbapenem-resistant C. koseri isolate and to characterize the transmission pattern of the IncFII/IncN plasmid that carries the blaNDM-1 gene.Methods and Results: S1-PFGE, Southern blot and conjugation assay confirmed the presence of blaNDM-1 gene in a conjugative plasmid. C. koseri L2395 and transconjugant L2395-EC600 strains showed similar resistance spectrum. Whole-genome analysis revealed that pL2395_NDM is an IncFII/IncN plasmid with a length of 67,839 bp. Moreover, blaNDM-1 gene was found encoded in the ISKpn19-blaNDM-1-ble-tnpF-dsbD-cutA-ISKpn19 cassette array. Phylogenetic analysis revealed that strain L2395 was close to an IMP-4-bearing C. koseri from Australia.Conclusion: Ongoing surveillance will be essential to control and prevent the spread of carbapenem-resistant Citrobacter spp. in the future.Keywords: Citrobacter koseri, carbapenem-resistant, NDM-1, whole-genome sequencing

Ning Ma,1– 3,&ast; Lei Zhang,4,&ast; Wufang Zhang,1– 3 Yingying He,1– 3 Chong Ye,4 Xin Li4 1Peking University Sixth Hospital, Beijing, People’s Republic of China; 2Peking University Institute of Mental Health, Beijing, People’s Republic of China; 3NHC Key Laboratory of Mental Health (Peking University), Beijing, People’s Republic of China; 4Xi’an Janssen Pharmaceutical Ltd, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ning Ma, Peking University Sixth Hospital, NO. 51 Huayuan North Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +86 010 82801939, Email maning@bjmu.edu.cnAbstract: Evidence of comparative benefits of long-acting injectable (LAI) antipsychotics in Asian patients with schizophrenia has been inconsistent. This scoping review aimed to synthesize the current evidence in the past ten years and provide an overview of efficacy, safety, treatment adherence, patient attitudes, and healthcare resource utilization of LAI in this population. A systematic search was conducted with a pre-defined search strategy in six electronic databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Embase, CINAHL, and PsycArticles. A total of 46 studies were included, including 15 cohort studies, 13 single-arm trials, 10 randomized controlled trials, four mirror-image studies, three cross-sectional studies, and one controlled clinical trial. Paliperidone palmitate once-monthly injection (27/46) and risperidone LAI (14/46) were the most frequently investigated LAIs. Compared with oral antipsychotic medications (OAMs), LAIs demonstrated a lower rate of relapse/hospitalization and comparable improvement in efficacy. Adverse events (AEs) were similar between LAIs and OAMs, although types and incidence varied. Significant reduction in the length of hospitalization and number of outpatient visits/inpatient admission was observed after initiation of LAIs. These findings suggest that LAI demonstrated comparable efficacy and safety among Asian populations with schizophrenia in comparison to OAMs. Better adherence and lower relapse were observed in patients receiving LAIs from published evidence. Future research is warranted to better understand the comprehensive performance of LAI in specific population or context.Plain Language Summary: LAI antipsychotic drugs for the maintenance treatment of schizophrenia have been considered the therapy of choice in case of poor adherence to treatment and frequent relapses. Few review studies focused on the benefits of LAI antipsychotics for schizophrenia in the Asian population have been conducted to date. Therefore, we conducted this scoping review to comprehensively summarize the current published evidence in terms of LAI efficacy, safety, treatment adherence, patient attitudes, and healthcare resource utilization in Asia.Keywords: long-acting injectable antipsychotics, schizophrenia, Asian, scoping review

Yang He,1 Huili Li,2 Rui Wang,3 Ning Ma,3 Lianyuan Liu,4 Rui Shi,5 Bohua Zhang,3 Ningning Lin,6 Yiming Tian3 1Hemodialysis Room, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 2Department of Endocrinology, The First Hospital of Qinhuangdao Affiliated to Hebei Medical University, Qinhuangdao, 066000, People’s Republic of China; 3Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 4Functional Examination Department, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 5Rheumatology and Immunology Department, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of China; 6Department of Dermatology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, People’s Republic of ChinaCorrespondence: Yiming Tian, Department of Endocrinology, The First Hospital of Qinhuangdao, No. 258, Wenhua Road, Qinhuangdao, Hebei Province, 066000, People’s Republic of China, Email Yiming_Tian@foxmail.comBackground: Diabetic nephropathy (DN) is one of the most devastating microvascular complications of diabetes, with a high prevalence and poor prognosis. Early intervention is crucial to improve the outcomes of DN. CXCL8 is related to podocyte damage in incipient DN; however, the role and expression level of CXCL8 have never been elucidated, especially in those with undiminished creatinine clearance.Methods: Consecutive inpatients with type 2 diabetes were included in this study. Patients were assigned into four groups based on the Mogensen stage, reflecting pathological features through clinical manifestations: non-DN group, hyperfiltration group, microalbuminuria group and overt DN group. Clinical and laboratory data were retrospectively collected and analyzed. Urinary CXCL8 (uCXCL8) was measured using an enzyme-linked immunosorbent assay (ELISA) method and adjusted for urinary creatinine (Cr) from the same urine sample.Results: In total, 88 eligible consecutive inpatients with type 2 diabetes were included in this study. uCXCL8 was differentially expressed in different stages of incipient DN; it decreased in the hyperfiltration phase of incipient DN (1.40± 1.01 pg/μmol Cr) and was highly expressed in patients in the microalbuminuria stage (5.01± 4.01 pg/μmol Cr). uCXCL8 was positively correlated with age, diabetes course, cystatin C and urinary albuminuria-to-creatinine ratio, but negatively correlated with estimated glomerular filtration rate (P< 0.05). uCXCL8 was a risk factor for classic DN after adjusting for age, diabetes course and cystatin C (OR= 1.17, 95% CI 0.98– 1.4, P=0.045).Conclusion: CXCL8 played an important role in the progression of incipient DN. The unique expression profile of uCXCL8 may provide a reference for understanding the prognosis and mechanisms of incipient DN progression. uCXCL8 was an independent risk factor for the development of classic DN.Keywords: type 2 diabetes, diabetic nephropathies, interleukin-8, inflammation

Numerous studies have demonstrated that the phenomenological optical potential of tightly bound nuclear systems presents a threshold anomaly phenomenon in the near-Coulomb barrier energy region, where the relationship between the real and imaginary potentials can be well described by the dispersion relation. However, for some weakly bound nuclear systems, the phenomenological optical potential seems to manifest differently, and the dispersion relation struggles to describe the behavior between real and imaginary potentials. Recently, we measured the angular distributions of the transfer reaction 207Pb(7Li,6Li)208Pb in both near and deep barrier energy regions, as well as the elastic scattering angular distributions of the entrance channel 7Li+207Pb. Optical potentials of the 6Li+208Pb system were extracted.The current results indicate that the optical potentials exhibit an abnormal threshold anomaly, and the dispersion relation is not applicable. Possible explanations are discussed, yet further investigations into the underlying physics are required.

Ma C, Ma N, Qin L, Miao C, Luo M, Liu S. Cancer Manag Res. 2020;12:10035–10046. We, the Editors and Publisher of Cancer Management and Research, have retracted the published article. Since publication, concerns have been raised about the integrity of the data in the article. When approached for an explanation, the authors did not respond to our queries, nor did they provide original data for their study. As verifying the validity of the published work is core to the integrity of the scholarly record, we are therefore retracting the article and the authors were notified of this. We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as ‘Retracted’.

Deconfined quantum critical points govern continuous quantum phase transitions at which fractionalized (deconfined) degrees of freedom emerge. Here we study dynamical signatures of the fractionalized excitations in a quantum magnet (the easy-plane J-Q model) that realize a deconfined quantum critical point with emergent O(4) symmetry. By means of large-scale quantum Monte Carlo simulations and stochastic analytic continuation of imaginary-time correlation functions, we obtain the dynamic spin-structure factors in the Sx and Sz channels. In both channels, we observe broad continua that originate from the deconfined excitations. We further identify several distinct spectral features of the deconfined quantum critical point, including the lower edge of the continuum and its form factor on moving through the Brillouin zone. We provide field-theoretical and lattice model calculations that explain the overall shapes of the computed spectra, which highlight the importance of interactions and gauge fluctuations to explain the spectral-weight distribution. We make further comparisons with the conventional Landau O(2) transition in a different quantum magnet, at which no signatures of fractionalization are observed. The distinctive spectral signatures of the deconfined quantum critical point suggest the feasibility of its experimental detection in neutron scattering and nuclear magnetic resonance experiments.

Lijuan Zhang,1,&ast; Shengan Zhang,2,&ast; Min Jiang,1 Lu Lu,3 Yue Ding,3 Ninghui Ma,1 Yuan Zhao,4 Sihan Xuchen,1 Nailian Zhang1 1School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 3Experiment Center for Teaching and Learning, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Center of Science and Technology, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lu Lu; Yue DingExperiment Center for Teaching and Learning, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaEmail yjll66@outlook.com; dingyue-2001@hotmail.comIntroduction: As high cholesterol level has been reported to be associated with cancer cell growth and cholesterol is vulnerable to oxidation, the conventional liposomes including cholesterol in the formulation seem to be challenged. Timosaponin AIII (TAIII), as a steroid saponin from Anemarrhena asphodeloides Bunge, possesses a similar structure with cholesterol and exhibits a wide range of antitumor activities, making it possible to develop a TAIII-based liposome where TAIII could potentially stabilize the phospholipid bilayer as a substitution of cholesterol and work as a chemotherapeutic drug as well. Meanwhile, TAIII could enhance the uptake of doxorubicin hydrochloride (DOX) in human hepatocellular carcinoma (HCC) cells and exhibit synergistic effect. Thus, we designed a novel thermally sensitive multifunctional liposomal system composed of TAIII and lipids to deliver DOX for enhanced HCC treatment.Methods: The synergistic effects of DOX and TAIII were explored on HCC cells and the tumor inhibition rate of TAIII-based liposomes carrying DOX was evaluated on both subcutaneous and orthotopic transplantation tumor models. TAIII-based multifunctional liposomes were characterized.Results: Synergistic HCC cytotoxicity was achieved at molar ratios of 1:1, 1:2 and 1:4 of DOX/TAIII. TAIII-based liposomes carrying a low DOX dose of 2 mg/kg exhibited significantly enhanced antitumor activity than 5 mg/kg of DOX without detected cardiotoxicity on both subcutaneous and orthotopic transplantation tumor models. TAIII-based liposomes were characterized with smaller size than cholesterol liposomes but exhibited favorable stability. Mild hyperthermia generated by laser irradiation accelerated the release of DOX and TAIII from liposomes at tumor site, and cell permeability of TAIII enhanced uptake of DOX in HCC cells.Conclusion: The innovative application of TAIII working as bilayer stabilizer and chemotherapeutic drug affords a stable multifunctional liposomal delivery system for synergistic therapy against HCC, which may be referred for the development of other types of saponins with similar property.Keywords: doxorubicin, timosaponin AIII, liposomes, hepatocellular carcinoma, cholesterol

Accurate simulation of energy, water, and carbon fluxes exchanging between the land surface and the atmosphere is beneficial for improving terrestrial ecohydrological and climate predictions. We systematically assessed the Noah land surface model (LSM) with mutiparameterization options (Noah-MP) in simulating these fluxes and associated variations in terrestrial water storage (TWS) and snow cover fraction (SCF) against various reference products over 18 United States Geological Survey two-digital hydrological unit code regions of the continental United States (CONUS). In general, Noah-MP captures better the observed seasonal and interregional variability of net radiation, SCF, and runoff than other variables. With a dynamic vegetation model, it overestimates gross primary productivity by 40% and evapotranspiration (ET) by 22% over the whole CONUS domain; however, with a prescribed climatology of leaf area index, it greatly improves ET simulation with relative bias dropping to 4%. It accurately simulates regional TWS dynamics in most regions except those with large lakes or severely affected by irrigation and/or impoundments. Incorporating the lake water storage variations into the modeled TWS variations largely reduces the TWS simulation bias more obviously over the Great Lakes with model efficiency increasing from 0.18 to 0.76. Noah-MP simulates runoff well in most regions except an obvious overestimation (underestimation) in the Rio Grande and Lower Colorado (New England). Compared with North American Land Data Assimilation System Phase 2 (NLDAS-2) LSMs, Noah-MP shows a better ability to simulate runoff and a comparable skill in simulating Rn but a worse skill in simulating ET over most regions. This study suggests that future model developments should focus on improving the representations of vegetation dynamics, lake water storage dynamics, and human activities including irrigation and impoundments.

Chenxi Hou,1,* Ning Ma,1,* Ziyan Shen,1 Guanyu Chi,1 Shuang Chao,1 Yuxin Pei,1 Lan Chen,2 Yuchao Lu,2 Zhichao Pei1 1Shaanxi Key Laboratory of Natural Products & Chemical Biology, College of Chemistry and Pharmacy, Northwest A&F University, Yangling, Shaanxi 712100, People’s Republic of China; 2Analysis Center of College of Science & Technology, Hebei Agricultural University, Huanghua, Hebei 061100, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhichao Pei; Yuchao Lu Tel +86 29 87091196Fax +86 29 87092769Email peizc@nwafu.edu.cn; luyuchao@hebau.edu.cnBackground: Conventional chemotherapy using small molecular antitumor drugs suffers from several limitations, for instance poor water solubility, high toxicity, and lack of specificity. However, prodrugs constructed by covalent modification of anticancer drugs can overcome these limitations, which are able to release its active form after entering the tumor tissues by specific stimulus response.Methods: A GSH-responsive glyco-nanoprodrug system has been constructed by self-assembled of amphiphilic lactosemodified camptothecin prodrug molecular (Lac-SS-CPT) for targeting drug delivery and combination therapy.Results: Using HL7702 cells as experimental models, the cytotoxic effects of Lac-SS-CPT were investigated to 10– 30 μmol/L for 48 hours. Notably, the cell viability of Lac-SS-CPT to HL7702 cells was higher compared with free CPT which indicated that Lac-SS-CPT can reduce side-effects. Simultaneously, we have evaluated the anticancer efficiency of doxorubicin hydrochloride (DOX)-loaded Lac-SS-CPT glyco-nanoprodrug system (Lac-SS-CPT@DOX), where Lac-SS-CPT@DOX and free DOX incubated with HpeG2 cells and HL7702 cells for 24, 48, and 72 hours, respectively. It turned out that Lac-SS-CPT@DOX encapsulated anticancer drug (DOX) could decrease DOX side-effect on HL7702 cells and increase DOX anticancer efficiency. More importantly, the CPT and DOX were released from Lac-SS-CPT@DOX in HepG2 cells where a higher GSH concentration exists. Moreover, combination therapy efficiency was evaluated, where free DOX and Lac-SS-CPT@DOX incubated with DOX-resistance HepG2 cells (HepG2-ADR cells), respectively.Conclusion: The results revealed that the Lac-SS-CPT@DOX could enhance the cytotoxicity of DOX for HepG2-ADR cells and provided a new idea for designing an advanced nano-prodrug system toward combination therapy.Keywords: nanoprodrug, target, GSH-responsive, drug delivery, combination chemotherapy