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Jia-Yu Zhang,1,2 Jia Huang,2 Su-Ya Zhao,3 Xin Liu,4 Zhen-Cheng Xiong,5 Zhi-Ying Yang1,2 1Graduate School of Peking Union Medical College, Beijing, 100730, People’s Republic of China; 2Department of General Surgery, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China; 3Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 4Graduate School of Tianjin Medical University, Tianjin, 300041, People’s Republic of China; 5Institute of Medical Technology, Peking University Health Science Center, Beijing, 100029, People’s Republic of ChinaCorrespondence: Zhi-Ying YangDepartment of General Surgery, China-Japan Friendship Hospital, 2 Cherry Blossom East Street, Beijing, 100029, People’s Republic of ChinaEmail yangzhy@aliyun.comAim: In order to find the risk factors of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) according to the latest definition and grading system of International Study Group of Pancreatic Surgery (ISGPS) (version 2016) and propose a nomogram for predicting POPF.Methods: We conducted a retrospective analysis of 232 successive cases of PD performed at our hospital by the same operator from August 2012 to June 2020. POPF was diagnosed in accordance with the latest definition of pancreatic fistula from the ISGPS. The risk factors of POPF were analyzed by univariate and multivariate logistic regression analysis. A nomogram model to predict the risk of POPF was constructed based on significant factors.Results: There were 18 cases of POPF, accounting for 7.8% of the total. Among them, 17 cases were classified into ISGPF grade B and 1 case was classified into ISGPF grade C. In addition, 35 cases were classified into biochemical leak. Univariate and multivariate analysis showed that hypertension, non-diabetes, no history of abdominal surgery, antecolic gastrojejunostomy and soft pancreas were independent risk factors of POPF. Based on significant factors, a nomogram is plotted to predict the risk of POPF. The C-index of this nomogram to assess prediction accuracy was 0.916 (P < 0.001) indicating good prediction performance.Conclusion: Hypertension, non-diabetes, no history of abdominal surgery, antecolic gastrojejunostomy and soft pancreas were independent risk factors of POPF. Meanwhile, a nomogram for predicting POPF with good test performance and discriminatory capacity was constituted.Keywords: pancreaticoduodenectomy, pancreatic fistula, International Study Group of Pancreatic Surgery, prediction model

Objective: The impact of comprehensive risk factor control on heart failure (HF) risk and HF-free survival time in individuals with type 2 diabetes (T2D) was evaluated in this study., Research Design and Methods: This prospective study included 11,949 individuals diagnosed with T2D, matched with 47,796 non-T2D control study participants from the UK Biobank cohort. The degree of comprehensive risk factor control was assessed on the basis of the major cardiovascular risk factors, including blood pressure, BMI, LDL cholesterol, hemoglobin A1c, renal function, smoking, diet, and physical activity. Cox proportional hazards models were used to measure the associations between the degree of risk factor control and HF risk. Irwin's restricted mean was used to evaluate HF-free survival time., Results: During a median follow-up of 12.3 years, 702 individuals (5.87%) with T2D and 1,402 matched control participants (2.93%) developed HF. Each additional risk factor controlled was associated with an average 19% lower risk of HF. Optimal control of at least six risk factors was associated with a 67% lower HF risk (hazard ratio [HR] 0.33; 95% CI 0.20, 0.54). BMI was the primary attributable risk factor for HF. Notably, the excess risk of HF associated with T2D could be attenuated to levels comparable to those of non-T2D control participants when individuals had a high degree of risk factor control (HR 0.66; 95% CI 0.40, 1.07), and they exhibited a longer HF-free survival time., Conclusions: Comprehensive management of risk factors is inversely associated with HF risk, and optimal risk factor control may prolong HF-free survival time among individuals with T2D., (© 2024 by the American Diabetes Association.)

Background: Intraindividual variability in lipid profiles is recognized as a potential predictor of cardiovascular events. However, the influence of early adulthood lipid profile variability along with mean lipid levels on future coronary artery calcium (CAC) incidence remains unclear., Methods: A total of 2395 participants (41.6% men; mean±SD age, 40.2±3.6 years) with initial CAC =0 from the CARDIA study (Coronary Artery Risk Development in Young Adults) were included. Serial lipid measurements were obtained to calculate mean levels and variability of total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides. CAC incidence was defined as CAC >0 at follow-up., Results: During a mean follow-up of 9.0 years, 534 individuals (22.3%) exhibited CAC incidence. Higher mean levels of total cholesterol, LDL-C, and non-HDL-C were associated with a greater risk of future CAC incidence. Similarly, 1-SD increment of lipid variability, as assessed by variability independent of the mean, was associated with an increased risk of CAC incidence (LDL-C: hazard ratio, 1.139 [95% CI, 1.048-1.238]; P =0.002; non-HDL-C: hazard ratio, 1.102 [95% CI, 1.014-1.198]; P =0.022; and triglycerides: hazard ratio, 1.480 [95% CI, 1.384-1.582]; P <0.001). Combination analyses demonstrated that participants with both high lipid levels and high variability in lipid profiles (LDL-C and non-HDL-C) faced the greatest risk of CAC incidence. Specifically, elevated variability of LDL-C was associated with an additional risk of CAC incidence even in low mean levels of LDL-C (hazard ratio, 1.396 [95% CI, 1.106-1.763]; P =0.005). These findings remained robust across a series of sensitivity and subgroup analyses., Conclusions: Elevated variability in LDL-C and non-HDL-C during young adulthood was associated with an increased risk of CAC incidence in midlife, especially among those with high mean levels of atherogenic lipoproteins. These findings highlight the importance of maintaining consistently low levels of atherogenic lipids throughout early adulthood to reduce subclinical atherosclerosis in midlife., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005130., Competing Interests: None.

Aim: To investigate the association between cardiovascular health metrics defined by Life's Essential 8 (LE8) scores and vascular complications among individuals with type 2 diabetes (T2D)., Materials and Methods: This prospective study included 11 033 participants with T2D, all devoid of macrovascular diseases (including cardiovascular and peripheral artery disease) and microvascular complications (e.g. diabetic retinopathy, neuropathy and nephropathy) at baseline from the UK Biobank. The LE8 score comprised eight metrics: smoking, body mass index, physical activity, non-high-density lipoprotein cholesterol, blood pressure, glycated haemoglobin, diet and sleep duration. Cox proportional hazards models were established to assess the associations of LE8 scores with incident macrovascular and microvascular complications., Results: During a median follow-up of 12.1 years, we identified 1975 cases of incident macrovascular diseases and 1797 cases of incident microvascular complications. After adjusting for potential confounders, each 10-point increase in the LE8 score was associated with an 18% lower risk of macrovascular diseases and a 15% lower risk of microvascular complications. Comparing individuals in the highest and lowest quartiles of LE8 scores revealed hazard ratios of 0.55 (95% confidence interval 0.47-0.62) for incident macrovascular diseases, and 0.61 (95% confidence interval 0.53-0.70) for incident microvascular complications. This association remained robust across a series of sensitivity analyses and nearly all subgroups., Conclusion: Higher LE8 scores were associated with a lower risk of incident macrovascular and microvascular complications among individuals with T2D. These findings underscore the significance of adopting fundamental strategies to maintain optimal cardiovascular health and curtail the risk of developing diabetic vascular complications., (© 2024 John Wiley & Sons Ltd.)

Solar energy-driven water evaporation technology is a promising, low-cost and sustainable approach to alleviate the global clean water shortage, but usually suffers from low water evaporation rate and severe salt deposition on the water evaporation surface. In this work, a hydrophilic bilayer photothermal paper-based three-dimensional (3D) cone flowing evaporator was designed and prepared for stable high-performance seawater desalination with excellent salt-rejecting ability. The as-prepared bilayer photothermal paper consisted of MXene (Ti 3 C 2 T x ) and HAA (ultralong hydroxyapatite nanowires, poly(acrylic acid), and poly(acrylic acid-2-hydroxyethyl ester)). The accordion-like multilayered MXene acted as the efficient solar light absorber, and ultralong hydroxyapatite (HAP) nanowires served as the thermally insulating and supporting skeleton with a porous networked structure. A siphon effect-driven unidirectional fluid transportation unit in the 3D cone flowing evaporator could guide the concentrated saline flowing away from the evaporating surface to prevent salt deposition on the evaporation surface, avoiding severe deterioration of the performance in solar water evaporation. Furthermore, combining high solar light absorption and high photothermal conversion efficiencies, low water evaporation enthalpy (1838 ± 11 J g -1 ), and additional energy taken from the ambient environment, the as-prepared cone flowing evaporator exhibited a high water evaporation rate of 3.22 ± 0.20 kg m -2 h -1 for real seawater under one sun illumination (1 kW m -2 ), which was significantly higher than many values reported in the literature. This study provides an effective approach for designing high-performance solar energy-driven water evaporators for sustainable seawater desalination and wastewater purification., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Skin wounds accompanied by bacterial infections threaten human health, and conventional antibiotic treatments are ineffective for drug-resistant bacterial infections and chronically infected wounds. The development of non-antibiotic-dependent therapeutics is highly desired but remains a challenging issue. Recently, 2D silicene nanosheets with considerable biocompatibility, biodegradability, and photothermal-conversion performance have received increasing attention in biomedical fields. Herein, copper-containing nanoparticles-loaded silicene (Cu 2.8 O@silicene-BSA) nanosheets with triple enzyme mimicry catalytic (peroxidase, catalase, and oxidase-like) activities and photothermal function are rationally designed and fabricated for efficient bacterial elimination, angiogenesis promotion, and accelerated wound healing. Cu 2.8 O@silicene-BSA nanosheets display excellent antibacterial activity through synergistic effects of reactive oxygen species generated from multiple catalytic reactions, intrinsic bactericidal activity of released Cu 2+ ions, and photothermal effects, achieving high antibacterial efficiencies on methicillin-resistant Staphylococcus aureus (MRSA) of 99.1 ± 0.7% in vitro and 97.2 ± 1.6% in vivo. In addition, Cu 2.8 O@silicene-BSA nanosheets exhibit high biocompatibility for promoting human umbilical vein endothelial cell (HUVEC) proliferation and angiogenic differentiation. In vivo experiments reveal that Cu 2.8 O@silicene-BSA nanosheets with synergistic photothermal/chemodynamic therapeutics effectively accelerate MRSA-infected wound healing by eliminating bacteria, alleviating inflammation, boosting collagen deposition, and promoting angiogenesis. This research presents a promising strategy to engineer photothermal-assisted nanozyme catalysis for bacteria-invaded wound healing., (© 2023 Wiley‐VCH GmbH.)

Ultralong nanowires with ultrahigh aspect ratios exhibit high flexibility, and they are promising for applications in various fields. Herein, a cadmium oleate precursor hydrothermal method is developed for the synthesis of ultralong nanowires of cadmium phosphate hydroxide. In this method, water-soluble cadmium salt is used as the cadmium source, water-soluble phosphate is used as the phosphorus source, and sodium oleate is adopted as a reactant to form cadmium oleate precursor and as a structure-directing agent. By using this method, ultralong nanowires of cadmium phosphate hydroxide are successfully synthesized using CdCl 2 , sodium oleate, and NaH 2 PO 4 as reactants in an aqueous solution by hydrothermal treatment at 180 °C for 24 h. In addition, a new type of flexible fire-resistant inorganic paper with good electrical insulation performance is fabricated using ultralong nanowires of cadmium phosphate hydroxide. As an example of the extended application of this synthetic method, ultralong nanowires of cadmium phosphate hydroxide can be converted to ultralong CdS nanowires through a convenient sulfidation reaction. In this way, ultralong CdS nanowires are successfully synthesized by simple sulfidation of ultralong nanowires of cadmium phosphate hydroxide under mild conditions. The as-prepared ultralong nanowires of cadmium phosphate hydroxide are promising for applications as the precursors and templates for synthesizing other inorganic ultralong nanowires and have wide applications in various fields.

Background & Aims: Individuals with high blood pressure (BP) have varying risks of cardiovascular events due to other coexisting factors. We aimed to identify the predictors of long-term absence of coronary artery calcium (CAC) in individuals with high BP, which is an indicator of healthy arterial aging and can guide preventive strategies., Methods: We analyzed data from participants with high BP (≥120/80 mm Hg) in the Multi-Ethnic Study of Atherosclerosis who had baseline CAC = 0 and underwent a second CAC scanning after 10 years. We used multivariable logistic regression to evaluate the association between various risk factors for atherosclerotic cardiovascular disease (ASCVD) and long-term CAC = 0. We also calculated the area under the receiver operating characteristic curve (AUC) to predict the phenotype of healthy arterial aging in this population., Results: We included 830 participants (37.6% male, mean ± SD age of 59.4 ± 8.7 years). During follow-up, 46.5% of participants ( n  = 386) had CAC = 0, and they were younger and had fewer metabolic syndrome components. Adding ASCVD risk factors to the demographic model (age, sex, and ethnicity) moderately increased the predictive value for long-term CAC = 0 (AUC: demographic model + ASCVD risk factors vs. demographic model alone, 0.653 vs. 0.597, p  < .001; category net reclassification improvement = 0.104, p  = .044; integrated discrimination improvement = 0.040, p  < .001)., Conclusion: In individuals with high BP and initial CAC = 0, over 40% maintained CAC = 0 during a 10-year follow-up, which was associated with fewer ASCVD risk factors. These findings may have implications for preventive strategies in individuals with high BP. Clinical Trial registration number: The MESA was registered at clinical trials. gov as NCT00005487. KEY MESSAGES Nearly half (46.5%) of individuals with high blood pressure (BP) maintained a long-term absence of coronary artery calcium (CAC) during a 10-year follow-up, and this was associated with a 66.6% lower risk of atherosclerotic cardiovascular disease (ASCVD) events compared to those who developed incident CAC.Individuals with high BP, who are usually assumed to have an increased risk of ASCVD, exhibit significant heterogeneity in their ASCVD risk; those who maintain CAC = 0 have a lower ASCVD risk.Adding overall ASCVD risk factors to demographic information resulted in a moderate improvement in predicting long-term CAC = 0.

Background: Reduced lung function has been linked to cardiovascular disease, but population-based evidence on the relationship between lung function decline and coronary artery calcium (CAC) progression is rare., Methods: A total of 2694 participants (44.7% men) with a mean ± standard deviation age of 40.4 ± 3.6 years from the Coronary Artery Risk Development in Young Adults (CARDIA) were included. The rates of decline in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) over a 20-year period were calculated for each participant and categorized into quartiles. The primary outcome was CAC progression., Results: During a mean follow-up of 8.9 years, 455 (16.9%) participants had CAC progression. After adjusting for traditional cardiovascular risk factors, the hazard ratios (95% confidence intervals [CIs]) for CAC progression were higher for participants in the 2nd (Q2), 3rd (Q3), and highest quartiles (Q4) of FVC decline compared with those in the lowest quartile (Q1): 1.366 (1.003-1.861), 1.412 (1.035-1.927), and 1.789 (1.318-2.428), respectively. Similar trends were observed for the association between FEV1 and CAC progression. The association remained robust across a series of sensitivity analyses and all subgroups., Conclusions: A faster decline in FVC or FEV1 during young adulthood is independently associated with an increased risk of CAC progression in midlife. Maintaining optimal lung function during young adulthood may improve future cardiovascular health., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Excess aldosterone is implicated in vascular calcification (VC), but the mechanism by which aldosterone-MR (mineralocorticoid receptor) complex promotes VC is unclear. Emerging evidence indicates that long-noncoding RNA H19 (H19) plays a critical role in VC. We examined whether aldosterone-induced osteogenic differentiation of vascular smooth muscle cells (VSMCs) through H19 epigenetic modification of Runx2 (runt-related transcription factor-2) in a MR-dependent manner., Methods: We induced in vivo rat model of chronic kidney disease using a high adenine and phosphate diet to explore the relationship among aldosterone, MR, H19, and VC. We also cultured human aortic VSMCs to explore the roles of H19 in aldosterone-MR complex-induced osteogenic differentiation and calcification of VSMCs., Results: H19 and Runx2 were significantly increased in aldosterone-induced VSMC osteogenic differentiation and VC, both in vitro and in vivo, which were significantly blocked by the MR antagonist spironolactone. Mechanistically, our findings reveal that the aldosterone-activated MR bound to H19 promoter and increased its transcriptional activity, as determined by chromatin immunoprecipitation, electrophoretic mobility shift assay, and luciferase reporter assay. Silencing H19 increased microRNA-106a-5p (miR-106a-5p) expression, which subsequently inhibited aldosterone-induced Runx2 expression at the posttranscriptional level. Importantly, we observed a direct interaction between H19 and miR-106a-5p, and downregulation of miR-106a-5p efficiently reversed the suppression of Runx2 induced by H19 silencing., Conclusions: Our study clarifies a novel mechanism by which upregulation of H19 contributes to aldosterone-MR complex-promoted Runx2-dependent VSMC osteogenic differentiation and VC through sponging miR-106a-5p. These findings highlight a potential therapeutic target for aldosterone-induced VC., Competing Interests: Disclosures None.

Objective: This study aimed to investigate the reliability of a deep neural network (DNN) model trained only on contrast-enhanced T1 (T1CE) images for predicting intraoperative cerebrospinal fluid (ioCSF) leaks in endoscopic transsphenoidal surgery (EETS)., Methods: 396 pituitary adenoma (PA) cases were reviewed, only primary PAs with Hardy suprasellar Stages A, B, and C were included in this study. The T1CE images of these patients were collected, and sagittal and coronal T1CE slices were selected for training the DNN model. The model performance was evaluated and tested, and its interpretability was explored., Results: A total of 102 PA cases were enrolled in this study, 51 from the ioCSF leakage group, and 51 from the non-ioCSF leakage group. 306 sagittal and 306 coronal T1CE slices were collected as the original dataset, and data augmentation was applied before model training and testing. In the test dataset, the DNN model provided a single-slice prediction accuracy of 97.29%, a sensitivity of 98.25%, and a specificity of 96.35%. In clinical test, the accuracy of the DNN model in predicting ioCSF leaks in patients reached 84.6%. The feature maps of the model were visualized and the regions of interest for prediction were the tumor roof and suprasellar region., Conclusion: In this study, the DNN model could predict ioCSF leaks based on preoperative T1CE images, especially in PAs in Hardy Stages A, B, and C. The region of interest in the model prediction-making process is similar to that of humans. DNN models trained with preoperative MRI images may provide a novel tool for predicting ioCSF leak risk for PA patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Chang, Zhao, Qiu, Ji, Chen, Li, Lv, Xiong, Chen and Shu.)

Solar energy-driven water evaporation is a promising sustainable strategy to purify seawater and contaminated water. However, developing solar evaporators with high water evaporation rates and excellent salt resistance still faces a great challenge. Herein, inspired by the long-range ordered structure and water transportation capability of lotus stem, a biomimetic aerogel with vertically ordered channels and low water evaporation enthalpy for high-efficiency solar energy-driven salt-resistant seawater desalination and wastewater purification is developed. The biomimetic aerogel consists of ultralong hydroxyapatite nanowires as heat-insulating skeletons, polydopamine-modified MXene as a photothermal material with broadband sunlight absorption and high photothermal conversion efficiency, polyacrylamide, and polyvinyl alcohol as reagents to lower the water evaporation enthalpy and as glues to enhance the mechanical performance. The honeycomb porous structure, unidirectionally aligned microchannels, and nanowire/nanosheet/polymer pore wall endow the biomimetic aerogel with excellent mechanical properties, rapid water transportation, and excellent solar water evaporation performance. The biomimetic aerogel exhibits a high water evaporation rate (2.62 kg m -2  h -1 ) and energy efficiency (93.6%) under one sun irradiation. The superior salt-rejecting ability of the designed water evaporator enables stable and continuous seawater desalination, which is promising for application in water purification to mitigate the global water crisis., (© 2023 Wiley-VCH GmbH.)

To address the issue of not having enough labeled fault data for planetary gearboxes in actual production, this research develops a simulation data-driven deep transfer learning fault diagnosis method that applies fault diagnosis knowledge from a dynamic simulation model to an actual planetary gearbox. Massive amounts of different fault simulation data are collected by creating a dynamic simulation model of a planetary gearbox. A fresh deep transfer learning network model is built by fusing one-dimensional convolutional neural networks, attention mechanisms, and domain adaptation methods. The network model is used to learn domain invariant features from simulated data, thereby enabling fault diagnosis on real data. The fault diagnosis experiment is verified by using the Drivetrain Diagnostics Simulator test bench. The validity of the proposed means is evaluated by comparing the diagnostic accuracy of various means on various diagnostic tasks., (© 2022. The Author(s).)

Calcific aortic valve disease (CAVD) is a highly prevalent condition that comprises a disease continuum, ranging from microscopic changes to profound fibro-calcific leaflet remodeling, culminating in aortic stenosis, heart failure, and ultimately premature death. Ferroptosis has been hypothesized to contribute to the pathogenesis of CAVD. We aimed to study the association between ferroptosis genes and CAVD and reveal the potential roles of ferroptosis in CAVD. CAVD-related differentially expressed genes (DEGs) were identified via bioinformatic analysis of Datasets GSE51472 and GSE12644 obtained from Gene Expression Omnibus. A ferroptosis dataset containing 259 genes was obtained from the Ferroptosis Database. We then intersected with CAVD-related DEGs to identify the ferroptosis DEGs. Subsequently, protein-protein interaction networks and functional enrichment analyses were performed for ferroptosis DEGs. Then, we used miRWalk3.0 to predict the target pivotal microRNAs. An in vitro model of CAVD was constructed using human aortic valve interstitial cells. The qRT-PCR and western blotting methods were used to validate the ferroptosis DEGs identified by the microarray data. A total of 21 ferroptosis DEGs in CAVD containing 12 upregulated and nine downregulated genes were identified. The results of the Gene Set Enrichment Analysis (GSEA) and analysis of the KEGG pathway by WebGestalt indicated that the ferroptosis DEGs were enriched in six signaling pathways among which NAFLD (including IL-6, BID, and PRKAA2 genes) and HIF-1 (including IL-6, HIF-1, and HMOX1 genes) signaling pathways were also verified by DAVID and/or Metascape. Finally, the in vitro results showed that the mRNA and protein expression levels of IL-6, HIF-1α, HMOX1, and BID were higher, while the levels of PRKAA2 were lower in the Pi-treated group than those in the control group. However, the addition of ferrostatin-1 (a selective ferroptosis inhibitor) significantly reversed the above changes. Therefore, IL-6, HIF-1α, HMOX1, BID, and PRKAA2 are potential key genes closely associated with ferroptosis in CAVD. Further work is required to explore the underlying ferroptosis-related molecular mechanisms and provide possible therapeutic targets for CAVD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Li, Xiong, Zhang, Hao, Gao, Wang, Gao and Liu.)

A primary liver cancer patient complicated by hepatic cystic echinococcosis was reported. The case was admitted to the hospital due to intermittent upper abdominal discomfort for more than half a month, and an auxiliary examination revealed primary liver cancer complicated by hepatic cystic echinococcosis. Then, hepatic artery infusion and chemoembolization was performed, and no treatment was given to cystic echinococcosis lesions. Following treatment, the patient had remarkable improvements in the liver functions.

Cellulose fiber (CF) paper is a low-cost, sustainable, and flexible substrate, which has gained increasing interest recently. Before practical usage, the functionalization of the pristine CF paper is indispensable to meet requirements of specific applications. Different from conventional surface modification or physical mixing methods, we report in situ growth of ultralong hydroxyapatite nanowires (HAPNWs) with lengths larger than 10 μm on the CF paper. HAPNWs are radially aligned on the surface of CFs, creating a micro/nanoscale hierarchical structure. By means of the excellent ion exchange ability of HAP and the hierarchical structure, the functions of the CF paper can be easily customized. As a proof-of-concept, we demonstrate two kinds of functional CF paper: (1) the photoluminescent CF paper by doping Eu 3+ and Tb 3+ ions into the crystal lattice of HAPNWs and (2) the superhydrophobic CF paper by coating poly(dimethylsiloxane) on the HAPNW hierarchical structure, which can be applied for self-cleaning and oil/water separation. It is expected that an in situ growth of ultralong HAPNWs will provide an instructive guideline for designing a CF paper with specific functions.

Vapor generation using solar energy is emerging as an efficient technology for wastewater purification and seawater desalination to relieve global water crisis. However, salt deposition on the evaporation surface seriously impairs the long-term steady water evaporation performance. Herein, the flexible salt-rejecting photothermal paper comprising reduced graphene oxide (rGO) and ultralong hydroxyapatite nanowires (HNs) has been developed for high-performance solar energy-driven water evaporation and stable desalination of seawater. The rGO/HN photothermal paper has advantages such as the hierarchical porous structure, interconnected channels, high mechanical strength, high efficiencies of solar light absorption and photothermal conversion, fast water transportation, and good heat insulation and salt-rejecting properties. Furthermore, the hydrophilicity and hydrophobicity of the rGO/HN photothermal paper can be adjusted by regulating the thermal treatment time. The water evaporation rate and energy efficiency of the hydrophilic rGO/HN photothermal paper are 1.48 kg m -2 h -1 and 89.2%, respectively, under 1 sun illumination (1 kW m -2 ). The hydrophobic rGO/HN photothermal paper shows a long-time stable water evaporation and salt-rejecting performance in the process of seawater desalination. The flexible salt-rejecting rGO/HN photothermal paper can produce clean water from wastewater and seawater with high rejection rates of organic dyes, metal ions, and salt ions, and it is promising for applications in water purification and seawater desalination.

Solar energy-driven interfacial water evaporation is a promising energy utilization technology in the field of seawater desalination and water purification. However, the accumulation of salt on the heating surface severely impairs the water evaporation performance and long-time stability. Herein, we demonstrate a new kind of photothermal paper comprising a high-temperature-resistant paper made from ultralong hydroxyapatite nanowires and glass fibers and black nickel oxide (NiO) nanoparticles for solar energy-driven desalination. Owing to the high photothermal conversion ability, fast water transportation in the air-laid paper, and good heat insulation, the hydrophilic HN/NiO photothermal paper can achieve efficient, stable and recyclable water evaporation performance. In addition, a Janus HN/NiO photothermal paper based on hydrophobic sodium oleate-modified ultralong hydroxyapatite nanowires has been developed, and it has a high water evaporation efficiency of 83.5% under 1 kW m -2 irradiation. In particular, with the bottom hydrophobic ultralong hydroxyapatite nanowire layer and water-transporting channels in the air-laid paper to facilitate salt exchange, the as-prepared Janus evaporator exhibits no salt accumulation on the surface, high performance and long-time stable desalination using simulated seawater (3.5 wt% NaCl). Furthermore, the Janus evaporator with the hydrophobic ultralong hydroxyapatite nanowire substrate can be extended to support other photothermal materials such as black titanium oxide (Ti 2 O 3 ) and Ketjen black carbon. The as-prepared Janus HN/Ti 2 O 3 and Janus HN/KB photothermal paper also exhibit salt-resistant desalination function. The as-prepared Janus salt-resistant photothermal paper with efficient, stable and recyclable merits has great potential in solar energy-driven desalination and water purification.

The direct transformation of external energy into mechanical work by the self-propelled motor inspires and promotes the development of miniaturized machines. Several strategies have been utilized to realize the self-driven motion, but in some cases multiple power sources are needed, and this would complicate the operation in diverse environments. In this regard, the dual-mode self-propelled system based on a single power source is highly desirable. In this work, single-light-actuated dual-mode propulsion at the liquid/air interface is realized by using flexible, superhydrophobic, and thermostable photothermal paper made from flexible ultralong hydroxyapatite nanowires, titanium sesquioxide (Ti 2 O 3 ) particles, and poly(dimethylsiloxane) coating. The superhydrophobic surface enables the thermostable photothermal paper to float on the water surface spontaneously and significantly reduces the drag force. In the usual situation, the heat power produced by the photothermal effect is utilized to trigger the Marangoni propulsion. While the Marangoni effect is quenched in water containing the surfactant, the propulsion mode can be directly switched into the vapor-enabled propulsion mode by simply increasing the light power density. Particularly, the light-driven motion in a linear, curvilinear, or rotational manner can be realized by designing the self-propelled machines with appropriate shapes by using the processable photothermal paper. It is expected that the as-prepared dual-mode self-propelled, flexible, superhydrophobic, and thermostable photothermal paper-based devices have promising applications in various fields such as microrobots, biomedicine, and environmental monitoring.

Background: The purpose of this study was to investigate the anti-tumor activities and the mechanisms of the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib, combined with the anti-angiogenic target drug apatinib, in the treatment of lung adenocarcinoma. We investigated the effects of these drugs in vitro in PC9 (E19 del) and H1975 (E21 L858R/E20 T790M) cell lines, as well as in vivo in both mouse and human experiments., Methods: PC9 and H1975 cells were cultured in 96-well plates and incubated with osimertinib (1-100 nmol/L), or apatinib (100-1,000 nmol/L), or a combination of the two agents, for 48 h. Cell viability was determined using a Cell Counting Kit-8. The protein expression of EGFR and its downstream signaling pathway members (AKT and ERK) was detected by western blot. For in vivo experiments, BALB/c nude mice were subcutaneously inoculated with H1975 cells in a xenograft model of adenocarcinoma. Mice bearing tumors were treated with osimertinib alone or in combination with apatinib, and tumor growth curves were obtained. Furthermore, we evaluated the efficacy and safety of combined osimertinib and apatinib therapy in three patients with EGFR T790M positive lung adenocarcinoma, who had been previously sensitized to osimertinib but developed an acquired resistance., Results: In vitro experiments revealed that osimertinib combined with apatinib increased the growth inhibition of PC9 and H1975 cells, simultaneously reducing the protein expression of phosphorylated EGFR and its downstream signaling pathway members in H1975 cells, compared to osimertinib treatment alone. In vivo experiments revealed that the combination of osimertinib and apatinib decreased tumor volume in an H1975 cell xenograft model, compared to osimertinib monotherapy at different dosages. All three patients with T790M positive lung adenocarcinoma that progressed following osimertinib treatment responded to continuous osimertinib in combination with apatinib, with a progression-free survival (PFS) range of 5-7 months., Conclusions: Apatinib can enhance the anti-tumor activity of osimertinib in the treatment of T790M positive lung adenocarcinoma. Further clinical studies are needed to confirm these results., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr.2019.09.35). The authors have no conflicts of interest to declare., (2019 Translational Cancer Research. All rights reserved.)

Security inks based on photoluminescent materials are mostly investigated for security applications, such as information encryption and decryption, anti-counterfeiting, and data storage. Although they are invisible to the naked eye under ambient light, they can be detected under ultraviolet or near-infrared light. Herein, a new kind of secret paper made from network-structured ultralong hydroxyapatite nanowires and cellulose fibers has been developed. White vinegar, a common cooking ingredient, is used as an invisible security ink. Covert information on the secret paper written with white vinegar is totally invisible under natural light, but it can be decrypted and clearly read after exposure to fire; the response time to fire is short (<10 s). The ways of writing on the secret paper are diverse by using various pens loaded with white vinegar., (© 2019 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

A variety of biological materials in natural organisms supply a rich source of structural design guidelines and inspirations for the construction of advanced structural materials with excellent mechanical properties. In this work, inspired by the natural nacre and human bone, a kind of flexible macroscopic ribbon fiber made from highly ordered alignment of ultralong hydroxyapatite (HAP) nanowires and sodium polyacrylate (PAAS) with a "brick-and-mortar" layered structure has been developed by a scalable and convenient wet-spinning method. The quasi-long-range orderly liquid crystal of one-dimensional ultralong hydroxyapatite nanowires is employed and spun into the continuous flexible macroscopic ribbon fiber. In this work, highly ordered ultralong HAP nanowires act as the hard "brick" and PAAS acts as the soft "mortar", and the nacre-mimetic layered architecture is obtained. The as-prepared flexible macroscopic HAP/PAAS ribbon fiber exhibits superior mechanical properties, and the maximum tensile strength and Young's modulus are as high as 203.58 ± 45.38 MPa and 24.56 ± 5.35 GPa, respectively. In addition, benefiting from the excellent flexibility and good knittability, the as-prepared macroscopic HAP/PAAS ribbon fiber can be woven into various flexible macroscopic architectures. Additionally, the as-prepared flexible macroscopic HAP/PAAS ribbon fiber can be further functionalized by incorporation of various functional components, such as magnetic and photoluminescent constituents. The as-prepared flexible macroscopic HAP/PAAS ribbon fiber has potential applications in various fields such as smart wearable devices, optical devices, magnetic devices, and biomedical engineering.

Efficient utilization of abundant solar energy for clean water generation is considered a sustainable and environment friendly approach to mitigate the global water crisis. For this purpose, this study reports a flexible fire-resistant photothermal paper by combining carbon nanotubes (CNTs) and fire-resistant inorganic paper based on ultralong hydroxyapatite nanowires (HNs) for efficient solar energy-driven water steam generation and water purification. Benefiting from the structural characteristics of the HN/CNT photothermal paper, the black CNT surface layer exhibits a high light absorbability and photothermal conversion capability, the HN-based inorganic paper acts as a thermal insulator with a high temperature stability, low thermal conductivity, and interconnected porous structure. By combining these advantages, high water evaporation efficiencies of 83.2% at 1 kW m -2 and 92.8% at 10 kW m -2 are achieved. In addition, the HN/CNT photothermal paper has a stable water evaporation capability during recycling and long-time usage. The promising potential of the HN/CNT photothermal paper for efficient production of drinkable water from both actual seawater and simulative wastewater samples containing heavy metal ions, dyes, and bacteria is also demonstrated. The highly flexible HN/CNT photothermal paper is promising for application in highly efficient solar energy-driven seawater desalination and wastewater purification., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The development of multifunctional dental-restorative biomaterials with antibacterial activity and remineralization effect for damaged tooth repair is urgent since dental caries is still one of the most common tooth diseases in human beings. Herein, we report a facile strategy for the synthesis of gluey silver-calcium phosphate (GSCP) composites using the rapid microwave-assisted solvothermal method. The as-prepared GSCP composite is an organic-inorganic hybrid, and Ag + ions display a significant influence on the formation of GSCP by interacting with adenosine triphosphate biomolecules. The as-prepared GSCP composite shows good antibacterial properties, in addition, it exhibits a great effect on sheltering dentinal canaliculi and improving the remineralization of dentine in the simulated saliva. The as-prepared GSCP composite is promising for various applications such as oral healthcare, especially, remineralization of dentine, and antibacterial applications.

Wallpaper with multiple functions, such as fire resistance and an automatic alarm in fire disasters, will be attractive for the interior decoration of houses. Herein, we report a smart fire alarm wallpaper prepared using fire-resistant inorganic paper based on ultralong hydroxyapatite nanowires (HNs) and graphene oxide (GO) thermosensitive sensors. At room temperature, the GO thermosensitive sensor is in a state of electrical insulation; however, it becomes electrically conductive at high temperatures. In a fire disaster, high temperature will rapidly remove the oxygen-containing groups of GO, leading to the transformation process of GO from an electrically insulated state into an electrically conductive one. In this way, the alarm lamp and alarm buzzer connected with the GO thermosensitive sensor will send out the alerts to people immediately for taking emergency actions. After the surface modification with polydopamine of GO (PGO), the sensitivity and flame retardancy of the GO thermosensitive sensor are further improved, resulting in a low responsive temperature (126.9 °C), fast response (2 s), and sustained working time in the flame (at least 5 min). Compared with combustible commercial wallpaper, the smart fire alarm wallpaper based on HNs and GO (or PGO) is superior owing to excellent nonflammability and high-temperature resistance of HNs, which can protect the GO (or PGO) thermosensitive sensor from the flames. The smart fire alarm wallpaper can be processed into various shapes, dyed with different colors, and printed with the commercial printer and thus has promising applications in high-safety interior decoration of houses.

Inorganic aerogels have been attracting great interest owing to their distinctive structures and properties. However, the practical applications of inorganic aerogels are greatly restricted by their high brittleness and high fabrication cost. Herein, inspired by the cancellous bone, we have developed a novel kind of hydroxyapatite (HAP) nanowire-based inorganic aerogel with excellent elasticity, which is highly porous (porosity ≈ 99.7%), ultralight (density 8.54 mg/cm 3 , which is about 0.854% of water density), and highly adiabatic (thermal conductivity 0.0387 W/m·K). Significantly, the as-prepared HAP nanowire aerogel can be used as the highly efficient air filter with high PM 2.5 filtration efficiency. In addition, the HAP nanowire aerogel is also an ideal candidate for continuous oil-water separation, which can be used as a smart switch to separate oil from water continuously. Compared with organic aerogels, the as-prepared HAP nanowire aerogel is biocompatible, environmentally friendly, and low-cost. Moreover, the synthetic method reported in this work can be scaled up for large-scale production of HAP nanowires, free from the use of organic solvents. Therefore, the as-prepared new kind of HAP nanowire aerogel is promising for the applications in various fields.

To date, the scaled-up production and large-area applications of superhydrophobic coatings are limited because of complicated procedures, environmentally harmful fluorinated compounds, restrictive substrates, expensive equipment, and raw materials usually involved in the fabrication process. Herein, the facile, low-cost, and green production of superhydrophobic coatings based on hydroxyapatite nanowire bundles (HNBs) is reported. Hydrophobic HNBs are synthesised by using a one-step solvothermal method with oleic acid as the structure-directing and hydrophobic agent. During the reaction process, highly hydrophobic C-H groups of oleic acid molecules can be attached in situ to the surface of HNBs through the chelate interaction between Ca 2+ ions and carboxylic groups. This facile synthetic method allows the scaled-up production of HNBs up to about 8 L, which is the largest production scale of superhydrophobic paint based on HNBs ever reported. In addition, the design of the 100 L reaction system is also shown. The HNBs can be coated on any substrate with an arbitrary shape by the spray-coating technique. The self-cleaning ability in air and oil, high-temperature stability, and excellent mechanical durability of the as-prepared superhydrophobic coatings are demonstrated. More importantly, the HNBs are coated on large-sized practical objects to form large-area superhydrophobic coatings., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

How to survive under various harsh working conditions is a key challenge for flexible electronic devices because their performances are always susceptible to environments. Herein, we demonstrate the novel design and fabrication of a new kind of the all-weather flexible electrically conductive paper based on ultralong hydroxyapatite nanowires (HNs) with unique combination of the superhydrophobic surface, electrothermal effect, and flame retardancy. The superhydrophobic surface with water repellency stabilizes the electrically conductive performance of the paper in water. For example, the electrical current through the superhydrophobic paper onto which water droplets are deposited shows a little change (0.38%), and the electrical performance is steady as well even when the paper is immersed in water for 120 s (just 3.65% change). In addition, the intrinsic electrothermal effect of the electrically conductive paper can efficiently heat the paper to reach a high temperature, for example, 224.25 °C, within 10 s. The synergistic effect between the electrothermal effect and superhydrophobic surface accelerates the melting and removal of ice on the heated electrically conductive paper. Deicing efficiency of the heated superhydrophobic electrically conductive paper is ∼4.5 times that of the unheated superhydrophobic electrically conductive paper and ∼10.4 times that of the heated superhydrophilic paper. More importantly, benefiting from fire-resistant ultralong HNs, thermally stable Ketjen black, and Si-O backbone of poly(dimethylsiloxane), we demonstrate the stable and continuous service of the as-prepared electrically conductive paper in the flame for as long as 7 min. The electrical performance of the electrically conductive paper after flame treatment can maintain as high as 90.60% of the original value. The rational design of the electrically conductive paper with suitable building materials and structure demonstrated here will give an inspiration for the development of new kinds of all-weather flexible electronic devices that can work under harsh conditions.

Counterfeiting of valuable certificates, documents, and banknotes is a serious issue worldwide. As a result, the need for developing novel anticounterfeiting materials is greatly increasing. Herein, we report a new kind of ultralong hydroxyapatite nanowire (HAPNW)-based paper with luminescence, fire resistance, and waterproofness properties that may be exploited for anticounterfeiting applications. In this work, lanthanide-ion-doped HAPNWs (HAPNW:Ln 3+ ) with lengths over 100 μm have been synthesized and used as a raw material to fabricating a free-standing luminescent, fire-resistant, water-proof paper through a simple vacuum filtration process. It is interesting to find that the luminescence intensity, structure, and morphology of HAPNW:Ln 3+ highly depend on the experimental conditions. The as-prepared HAPNW:Ln 3+ paper has a unique combination of properties, such as high flexibility, good processability, writing and printing abilities, luminescence, tunable emission color, waterproofness, and fire resistance. In addition, a well-designed pattern can be embedded in the paper that is invisible under ambient light but viewable as a luminescent color under ultraviolet light. Moreover, the HAPNW:Ln 3+ paper can be well-preserved without any damage after being burned by fire or soaked in water. The unique combination of luminescence, fire resistance, and waterproofness properties and the nanowire structure of the as-prepared HAPNW:Ln 3+ paper may be exploited toward developing a new kind of multimode anticounterfeiting technology for various high-level security antiforgery applications, such as in making forgery-proof documents, certificates, labels, and tags and in packaging.

Hydroxyapatite is a kind of biocompatible, environmentally friendly, and versatile inorganic biomaterial. Herein, the preparation of ultralong hydroxyapatite nanowires (HAPNWs)-based antibacterial paper co-loaded with silver nanoparticles (AgNPs) and antibiotic is reported. HAPNWs are used to prepare AgNPs in situ using an aqueous solution containing AgNO 3 under the sunlight without added reducing agent at room temperature. Subsequently, ciprofloxacin (CIP) as an antibiotic is loaded on the HAPNWs@AgNPs. The resultant HAPNWs@AgNPs-CIP paper possesses several unique properties, including high flexibility, high Brunauer-Emmett-Teller (BET) specific surface area (47.9 m 2 g -1 ), high drug loading capacity (447.4 mg g -1 ), good biocompatibility, sustained and pH-responsive drug release behavior (5.40-6.75% of Ag + ions and 37.7-76.4% of CIP molecules at pH values of 7.4-4.5 at day 8, respectively), and reusable recycling. In the antibacterial tests against Escherichia coli and Staphylococcus aureus, the HAPNWs@AgNPs-CIP paper exhibits large diameters of inhibition zones and low minimum inhibitory concentrations (30 and 40 μg mL -1 ), revealing the high antibacterial activity. Besides, the consecutive agar diffusion tests (8 cycles), long-term stability tests (over 56 days), and continuous contamination tests (5 cycles) demonstrate the excellent recycling performance and long-term antibacterial activity of the HAPNWs@AgNPs-CIP paper. These results indicate a promising potential of the HAPNWs@AgNPs-CIP bactericidal paper for tackling public health issues related to bacterial infections.

Purpose: The purpose of this meta-analysis was to explore the influences of pretreatment de novo and posttreatment-acquired epidermal growth factor receptor ( EGFR ) T790M mutations in patients with advanced non-small cell lung cancer (NSCLC) who had received tyrosine kinase inhibitors (TKIs)., Methods: We searched PubMed, Embase, and the China National Knowledge Infrastructure database for eligible literature. Data were extracted to assess the hazard ratios (HRs) for progression-free survival (PFS), overall survival (OS), and post-progression survival (PPS) and the relative ratios (RRs) for objective response rate (ORR)., Results: This meta-analysis included 22 studies comprising 1,462 patients with NSCLC who harbored activating EGFR mutations and were treated with EGFR-TKIs. Compared to pretreatment T790M mutation-negative NSCLC, pretreatment T790M mutation-positive NSCLC was associated with decreased PFS (HR 2.23, P <0.001) and OS (HR 1.55, P =0.003). A trend toward significance of worsening ORR (RR 0.86, P =0.051) was evident. The acquired T790M mutation was correlated with improved PFS (HR 0.75, P =0.006) and PPS (HR 0.57, P <0.001), compared to patients without the T790M mutation who progressed after EGFR-TKI treatment. There were no significant differences in OS or ORR between patients with acquired T790M mutation-positive and T790M mutation-negative NSCLC. However, in the tumor tissue rebiopsy subgroup, patients with acquired T790M mutation had improved OS (HR 0.60, P <0.001) compared to T790M mutation-negative patients. In the plasma ctDNA subgroup, acquired T790M mutation decreased the OS (HR 1.87, P <0.001)., Conclusion: Pretreatment T790M mutation was associated with worse PFS and OS in patients with advanced NSCLC treated with EGFR-TKIs, while acquired T790M mutation was associated with longer PFS and PPS than T790M mutation-negative NSCLC. The effects on OS were different between acquired T790M mutation detected from rebiopsy of tumor tissue and that detected from plasma ctDNA., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Layered materials with open interlayer channels enable various applications such as tissue engineering, ionic and molecular sieving, and electrochemical devices. However, most reports focus on the two-dimensional nanosheets-assembled layered materials, whose interlayer spacing is limited at the nanometer scale. Herein, we demonstrate that one-dimensional inorganic nanowires are the ideal building blocks for the construction of layered materials with open interlayer channels as well, which has not aroused much attention before. It is found that the relatively long inorganic nanowires are capable of assembling into free-standing layered paper with open interlayer channels during the filtration process. The spacings of interlayer channels between adjacent layers are up to tens of micrometers, which are much larger than those of the two-dimensional nanosheets-assembled layered materials. But the closed interlayer channels are observed when the relatively short inorganic nanowires are used as building blocks. The mechanism based on the relationship between the structural variation and the nanowires used is proposed, including the surface charge amplified effect, surface charge superimposed effect, and pillarlike supporting effect. According to the proposed mechanism, we have successfully fabricated a series of layered paper sheets whose architectures (including interlayer channels of cross section and pores on the surface) show gradient changes. The as-prepared layered paper sheets are employed as the valves for controlling water transportation. Tunable water transportation is achieved by the synergistic effect between in-plane interlayer channels (horizontal transportation) from the open to the closed states, and through-layer pores (vertical transportation) without surface modification or intercalation of any guest species.

The templated synthesis of hydroxyapatite (HAP) nanowires@metal-organic framework (MOF) core/shell nanofibers (named HAP@MIL-100(Fe) nanofibers) is demonstrated. The ultralong hydroxyapatite nanowires are adopted as a hard template for the nucleation and growth of MIL-100(Fe) (a typical MOF) through the layer-by-layer method. The Coulombic and chelation interactions between Ca 2+ ions on the surface of the HAP nanowires and the COO - organic linkers of MIL-100(Fe) play key roles in the formation process. The as-prepared, water-stable HAP@MIL-100(Fe) nanofibers exhibit peroxidase-like activity toward the oxidation of different peroxidase substrates in the presence of H 2 O 2 , accompanied by a clear color change of the solution. Furthermore, a flexible, recyclable HAP@MIL-100(Fe) test paper is prepared successfully by using HAP@MIL-100(Fe) nanofibers as building blocks. A simple, low-cost, and sensitive colorimetric method for the detection of H 2 O 2 and glucose is established based on the as-prepared, flexible, recyclable HAP@MIL-100(Fe) test paper. More importantly, the HAP@MIL-100(Fe) test paper can be recovered easily for reuse by simply dipping in absolute ethanol for just 30 min, thus showing excellent recyclability. With its combination of advantages such as easy transportation, easy storage and use, rapid recyclability, light weight, and high flexibility, this HAP@MIL-100(Fe) test paper is promising for wide applications in various fields., (© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Purpose: Our previous study suggested that some pulmonary artery (PA) dosimetric parameters were associated with mortality in unresectable non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. The present study aims to analyze the impact of both PA and heart dosimetric parameters on survival of patients with NSCLC treated with definitive conventional fractionated radiotherapy (CFRT) in another independent research center and further determine whether the PA should be considered a dose-limiting organ at risk (OAR) for patients receiving thoracic CFRT., Methods: We performed a retrospective analysis of successive patients with medically inoperable or unresectable NSCLC treated with definitive radiotherapy or chemoradiotherapy from August 2010 to September 2014. Clinical and pathological information, PA and heart dosimetric factors, and follow-up data were collected from each patient's records and evaluated as potential prognostic factors for survival. Survival probabilities were estimated by the Kaplan-Meier method and compared by the log rank test. Cox proportional hazards regression models were performed to determine the independent predicators of survival. The optimal cutoff points of continuous dosimetric variables were determined by Youden index in receiver operating characteristic (ROC) analysis., Results: This study analyzed the records of 141 patients, 50.4% had adenocarcinoma, 71.6% had stage III disease, and 55% patients received concurrent chemoradiotherapy. Radiation dose ranged from 60 to 76 Gy in 30-38 fractions. Median follow up was 16.9 months. Median overall survival (OS) was 20.5 months (95% confidence interval [CI] 10.3-30.7 months), and 1-, 2-, 3-year OS rates were 75.2%, 58.2% and 56%, respectively. Univariate and multivariate analysis showed that Karnofsky Performance Status (KPS) score, Charlson's Comorbidity Index (CCI), T and N stage, PA invasion grade and the percentage of PA volume that received 40 to 55 Gy (PA V40-55) were significantly associated with OS. No significant associations were found between heart dosimetric factors and OS. Median OS of patients with PA invasion grade 0, 1, 2, and 3 were 41.8, 27.8, 12.7 and 7.5 months, respectively (P < 0.001). PA V40, V45, V50 and V55, using thresholds of 80%, 68%, 45%, and 32%, respectively, were independent predictors for OS., Conclusions: PA invasion grade and PA V40-55 appear associated with OS in patients with NSCLC treated with definitive CFRT. We propose that PA be considered as a dose-limiting OAR for such patients.

S-1 is a new oral fluoropyrimidine formulation that comprises tegafur, 5-chloro-2,4-dihydroxypyridine, and potassium oxonate. S-1 is designed to enhance antitumor activity and to reduce gastrointestinal toxicity. Several studies have demonstrated that both S-1 monotherapy and S-1 combination regimens showed encouraging efficacies and mild toxicities in the treatment of lung squamous cell carcinoma and adenocarcinoma. However, it is unclear whether S-1 can be used as standard care in advanced non-small cell lung cancer (NSCLC). The purpose of this meta-analysis was to assess the efficacy and safety of S-1-based chemotherapy, compared with standard chemotherapy, in patients with locally advanced or metastatic NSCLC. Thirteen randomized controlled trials (RCTs) involving 2,134 patients with a similar ratio of different pathological types were included. In first-line or second-line chemotherapy, compared with standard chemotherapy, S-1-based chemotherapy showed similar efficacy in terms of median overall survival (mOS), median progression free survival (mPFS), and objective response rate (ORR) (all P > 0.1), and significantly reduced the incidence of grade ≥ 3 hematological toxicities. In patients with locally advanced NSCLC receiving concurrent chemoradiotherapy, compared with standard chemoradiotherapy, significantly improved survival in the S-1-based chemotherapy was noted in terms of mOS and mPFS (risk radio [RR] = 1.289, P = 0.009; RR = 1.289, P = 0.000, respectively) with lower incidence of grade ≥ 3 neutropenia (RR = 0.453, P = 0.000). The present meta-analysis demonstrates that S-1-based chemotherapy shows similar benefits in advanced NSCLC and improves survival in locally advanced NSCLC, compared with standard treatment.

Traditional paper made from plant cellulose fibers is easily destroyed by either liquid or fire. In addition, the paper making industry consumes a large amount of natural trees and thus causes serious environmental problems including excessive deforestation and pollution. In consideration of the intrinsic flammability of organics and minimizing the effects on the environment and creatures, biocompatible ultralong hydroxyapatite nanowires are an ideal building material for inorganic fire-resistant paper. Herein, a new kind of free-standing, highly flexible, superhydrophobic, and fire-resistant layered inorganic paper has been successfully prepared using ultralong hydroxyapatite nanowires as building blocks after the surface modification with sodium oleate. During the vacuum filtration, ultralong hydroxyapatite nanowires assemble into self-roughened setalike microfibers, avoiding the tedious fabrication process to construct the hierarchical structure; the self-roughened microfibers further form the inorganic paper with a nacrelike layered structure. We have demonstrated that the layered structure can significantly improve the resistance to mechanical destruction of the as-prepared superhydrophobic paper. The as-prepared superhydrophobic and fire-resistant inorganic paper shows excellent nonflammability, liquid repellency to various commercial drinks, high thermal stability, and self-cleaning property. Moreover, we have explored the potential applications of the superhydrophobic and fire-resistant inorganic paper as a highly effective adsorbent for oil/water separation, fire-shielding protector, and writing paper.

A highly flexible and free-standing paper with high antibacterial activity made from silver nanoparticle (AgNP)-decorated ultralong hydroxyapatite nanowires (HAPNWs) is reported. The HAPNWs@AgNPs nanocomposites were obtained from a facile one-step solvothermal process and utilized for the construction of highly flexible and free-standing inorganic paper through a simple vacuum-filtration procedure. The structure and properties of the HAPNWs@AgNPs paper were characterized in detail. Scanning electron microscope (SEM) and transmission electron microscope (TEM) micrographs show that AgNPs are highly dispersed and stabilized in the nanocomposite and exhibit a narrow particle size distribution. The effects of the concentration of silver nitrate, solvothermal temperature and time on the product were systematically investigated. This method is simple, convenient and reproducible. The as-prepared HAPNWs@AgNPs paper shows long-time sustained silver-ion release, high antibacterial activity against both Gram-negative and Gram-positive bacteria, and good biocompatibility. Overall, this work provides a novel pathway for the preparation of a new type of highly flexible, free-standing and antibacterial inorganic paper made from silver nanoparticle-decorated hydroxyapatite nanowires for various applications, as a promising functional biomaterial., (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Background: A key to the East Palaearctic and northern Oriental species of Rhysipolis Foerster, 1862 (Hymenoptera: Braconidae: Rhysipolinae) is presented. Rhysipolis longicaudatus Belokobylskij, 1994 (stat. nov.) is redescribed, the first host records are given and it is reported new for China., New Information: Rhysipolis longicaudatus was reared from Taleporia sp. (Lepidoptera: Psychidae) in Inner Mongolia Autonomous Region and from Bazaria turensis Ragonot (Lepidoptera: Pyralidae) in Qinghai Province.

A new species of Metopiinae, Trieces etuokensis Sheng, sp. n. , is described and illustrated. Specimens were reared from two species of Lepidoptera: Bazaria turensis (Ragonot, 1887) (Pyralidae) from Balong, Dulan, Qinghai Province, and an unidentified psychid (Psychidae) from Mukainor, Etuoke, Inner Mongolia Autonomous Region, China. The new species is characterized by a yellow face and clypeus, fore and middle femora and hind tibia mainly black, antennae slightly longer than head and mesosoma combined, with 17 flagellomeres, occipital carina entirely absent, and the hind femur being compressed, 2.5 times as its long as maximum width.

A virtual screen of our in-house database using various fingerprint techniques returned several triazine hits which were found to be mTOR inhibitors with a slight selectivity over PI3Kα. Using structure-guided lead optimization the inhibitory activity towards mTOR and PI3Kα was increased to the low nanomolar range. Exploiting shape differences in the binding-site allowed for the design of mTOR selective inhibitors. Focus on ligand efficiency ensured the inhibitors retained a low molecular weight and desirable drug-like properties., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

In order to improve filler dispersion and phase compatibility between poly(D,L-lactide) (PDLLA) and inorganic bioactive glass (BG) particles, and to enhance the mechanical properties of PDLLA/BG composites, the silane coupling agent 3-glycidoxypropyltrimethoxysilane (KH570) was used to modify the surface of BG particles (represented by KBG). The structure and properties of PDLLA/BG and PDLLA/KBG composites were investigated by mechanical property testing and scanning electron microscopy (SEM). This study demonstrated that the Guth and Gold models can be combined to predict the Young's modulus of the composites. The Pukanszky modulus showed that the interaction parameter B of PDLLA/KBG composites was higher than that of the PDLLA/BG, which indicates that there is a higher interfacial interaction between the PDLLA and KBG. The composites were incubated in simulated body fluid (SBF) at 37 degrees C to study the in vitro degradation and bioactivity of the composites and to detect bone-like apatite formation on their surfaces.

The most commonly used anti-adhesion device for separation and isolation of wounded tissues after surgery is the polymeric membrane. In this study, a new anti-adhesion membrane from polylactide-polyethylene glycol tri-block copolymer (PELA) has been synthesized. The synthesized copolymers were characterized by gel permeation chromatography and (1)H nuclear magnetic resonance spectroscopy. PELA membrane was prepared by electrospun. The prepared copolymer membranes were more flexible than the control poly-d-l-lactic acid (PDLLA) membrane, as investigated by the measurements of glass transition temperature. Its biocompatibility and anti-adhesion capabilities were also evaluated. In vitro cell adhesions on the PELA copolymer membrane and PDLLA membrane were compared by the culture of mouse fibroblasts L929 on the surfaces. For in vivo evaluation of tissue anti-adhesion potential, the PDLLA and PELA copolymer membranes were implanted between cecum and peritoneal wall defects of rats and their tissue adhesion extents were compared. It was observed that the PELA copolymer membrane was very effective in preventing cell or tissue adhesion on the membrane surface, probably owing to the effects of hydrophilic polyethylene glycol.

The aim of this study was to prepare and characterize a scaffold with an ionically crosslinked hydrogel coating layer containing a water-soluble drug, vancomycin, via a novel drug loading method for sustained drug delivery and surface modification. The poly(D,L-lactide acid) (PDLLA)/biphasic calcium phosphate (BCP) scaffold with a highly inter-connected porous structure was fabricated by a particle-leaching/thermally induced phase separation (TIPS) method. The pre-vacuumized scaffold was immersed into an alginate/vancomycin solution. Following impregnation by the solution, the scaffold was removed and immersed in a CaCl(2) solution for 30 min to allow gelation of the alginate solution. In this way, the drug was not exposed to organic solvents or detrimental temperature conditions and it could avoid loss of drug during the leaching process. The water contact angles of the scaffold surface decreased after being coated with the hydrogel. The in vitro drug release profile showed sustained release properties which were influenced by the alginate concentration and the dissolution medium. A standardized bacterial assay showed that the drug was still active after association with the scaffold by this gentle method of drug loading. The in vitro osteoblast culture experiments confirmed the biocompatibility of the scaffold for attachment and proliferation of osteoblasts.