Molecular characteristics and immune microenvironment of gastrointestinal stromal tumours: targets for therapeutic strategies.

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours, arising mainly from the interstitial cells of Cajal (ICCs) of the gastrointestinal tract. As radiotherapy and chemotherapy are generally ineffective for GISTs, the current primary treatment is surgical resection. However, surgical resection is not choice for most patients. Therefore, new therapeutic strategies are urgently needed. Targeted therapy, represented by tyrosine kinase inhibitors (TKIs), and immunotherapy, represented by immune checkpoint inhibitor therapies and chimeric antigen receptor T-cell immunotherapy (CAR-T), offer new therapeutic options in GISTs and have shown promising treatment responses. In this review, we summarize the molecular classification and immune microenvironment of GISTs and discuss the corresponding targeted therapy and immunotherapy options. This updated knowledge may provide more options for future therapeutic strategies and applications in GISTs.

Exercise preconditioning inhibits doxorubicin-induced cardiotoxicity via YAP/STAT3 signaling.

Doxorubicin (DOX) possesses strong anti-tumor effects but is limited by its irreversible cardiac toxicity. The relationship between exercise, a known enhancer of cardiovascular health, and DOX-induced cardiotoxicity has been a focus of recent research. Exercise has been suggested to mitigate DOX's cardiac harm by modulating the Yes-associated protein (YAP) and Signal transducer and activator of transcription 3 (STAT3) pathways, which are crucial in regulating cardiac cell functions and responses to damage. This study aimed to assess the protective role of exercise preconditioning against DOX-induced cardiac injury. We used Sprague-Dawley rats, divided into five groups (control, DOX, exercise preconditioning (EP), EP-DOX, and verteporfin + EP + DOX), to investigate the potential mechanisms. Our findings, including echocardiography, histological staining, Western blot, and q-PCR analysis, demonstrated that exercise preconditioning could alleviate DOX-induced cardiac dysfunction and structural damage. Notably, exercise preconditioning enhanced the nuclear localization and co-localization of YAP and STAT3. Our study suggests that exercise preconditioning may counteract DOX-induced cardiotoxicity by activating the YAP/STAT3 pathway, highlighting a potential therapeutic approach for reducing DOX's cardiac side effects.

A Photoelectrochemical Sensor for the Detection of Hypochlorous Acid with a Phenothiazine-Based Photosensitizer.

This paper presents the development of a photoelectrochemical sensor for hypochlorous acid (HOCl) detection, employing a phenothiazine-based organic photosensitizer (Dye-PZ). The designed probe, Dye-PZ, follows a D-π-A structure with phenothiazine as the electron-donating group and a cyano-substituted pyridine unit as the electron-accepting group. A specific reaction of the phenothiazine sulfur atom with HOCl enables selective recognition. The covalent immobilization of Dye-PZ onto a titanium dioxide nanorod-coated fluorine-doped tin oxide electrode (FTO/TiO2) using bromo-silane coupling agent (BrPTMS) resulted in the fabrication of the photoanode FTO/TiO2/BrPTMS/Dye-PZ. The photoanode exhibited a significant photoresponse under visible-light irradiation, with a subsequent reduction in photocurrent upon reaction with HOCl. The oxidation of the phenothiazine sulfur atom to a sulfoxide diminished the internal charge transfer (ICT) effect. Leveraging this principle, the successful photoelectrochemical sensing of HOCl was achieved. The sensor showed high stability, excellent reproducibility, and selective sensitivity for HOCl detection. Our study provides a novel approach for the development of efficient photoelectrochemical sensors based on organic photosensitizers, with promising applications in water quality monitoring and biosensing.

Transthoracic single-port-assisted laparoscopic gastrectomy versus laparoscopic transhiatal approach for Siewert type II adenocarcinoma of the esophagogastric junction: a single-center retrospective study.

BACKGROUND: The surgical approach for patients with Siewert type II AEG remains controversial. Several studies have described a new laparoscopic radical resection approach of Siewert type II AEG through the left diaphragm. However, the technical safety and feasibility of the new surgical approach compared with the transhiatal approach have not yet been tested. STUDY DESIGN: We retrospectively reviewed patients with AEG who underwent TSLG and LTH operations in the Guangdong Provincial Hospital of Chinese Medicine between January 2017 and April 2021. Histologically confirmed AEG and D2 lymphadenectomy with curative R0 patients were included, and patients with Siewert I/III AEG or distant metastasis were excluded. Blood loss, the amount of harvested lymph node, and complications related to surgery were evaluated. RESULTS: A total of 99 patients with Siewert type II AEG were analyzed, 44 in the TSLG group and 55 in the LTH group. There was no difference in clinicopathological features between the two groups. The more harvested lymph node (23.33 ± 11.41 vs. 32.18 ± 12.85, p < 0.01), lower mediastinal lymph node (1.07 ± 2.08 vs. 3.25 ± 3.31, p < 0.01), and longer proximal margin length (3.08 ± 1.19 vs. 4.47 ± 0.95 cm, p < 0.01) were observed in the TSLG group. The rate of cure (R0 gastrectomy) in the TSLG group was higher than that in the LTH group (100% vs. 89.09%, p = 0.03). CONCLUSION: The TSLG approach is associated with improved surgical views, simplified lymphatic dissection in the inferior mediastinum, and more reliable margins. TSLG surgery may be an effective addition to LTH surgery, particularly when lower mediastinal lymph node metastases are suspected.

Hand-sewn esophagojejunostomy in transthoracic single-port assisted laparoscopic esophagogastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction with esophageal invasion > 3 cm.

BACKGROUND: An optimal method for digestive tract reconstruction (DTR) in laparoscopic radical resection of Siewert type II adenocarcinoma of esophagogastric junction (AEG) has not yet been standardized. The aim of this study was to evaluate the safety and feasibility of a hand-sewn esophagojejunostomy (EJ) technique during transthoracic single-port assisted laparoscopic esophagogastrectomy (TSLE) for Siewert type II AEG with esophageal invasion > 3 cm. METHODS: The perioperative clinical data and short-term outcomes for patients who underwent TSLE using hand-sewn EJ for Siewert type II AEG with esophageal invasion > 3 cm between March 2019 and April 2022 have been retrospectively reviewed. RESULTS: A total of 25 patients were eligible. All 25 patients were successfully operated. None was converted to open surgery or mortality. 84.00% of patients were male and 16.00% were female. The mean age, body mass index (BMI), and the American Society of Anesthesiologists (ASA) score were 67.88 ± 8.10 years, 21.30 ± 2.80 kg/m2, and 2.08, respectively. The average incorporated operative and hand-sewn EJ procedural times were 274.92 ± 57.46 and 23.36 ± 3.00 min, respectively. The length of extracorporeal esophageal involvement and proximal margin was 3.31 ± 0.26 cm and 3.12 ± 0.12 cm, respectively. The average time for the first oral feeding and hospital stay were 6 (3-14) and 7 (3-18) days, respectively. Two patients (8.00%) developed postoperative grade IIIa complications according to the Clavien-Dindo classification, including 1 case of pleural effusion and 1 case of anastomotic leakage, both of whom were cured by puncture drainage. CONCLUSION: Hand-sewn EJ in TSLE is safe and feasible for Siewert type II AEG. This method can ensure safe proximal margins and could be a good option with an advanced endoscopic suture technique for type II tumor with esophageal invasion > 3 cm.

A near-infrared ratiometric fluorescent probe for hydrazine and its application for gaseous sensing and cell imaging.

Hydrazine (N2H4) is a widely used raw material in the chemical industry, but at the same time hydrazine has extremely high toxicity. Therefore, the development of efficient detection methods is crucial for monitoring hydrazine in the environment and evaluating the biological toxicity of hydrazine. This study reports a near-infrared ratiometric fluorescent probe (DCPBCl2-Hz) for the detection of hydrazine by coupling a chlorine-substituted D-π-A fluorophore (DCPBCl2) to the recognition group acetyl. Due to the halogen effect of chlorine substitution, the fluorophore has an elevated fluorescence efficiency and a lowered pKa value and is suitable for physiological pH conditions. Hydrazine can specifically react with the acetyl group of the fluorescent probe to release the fluorophore DCPBCl2, so the fluorescence emission of the probe system significantly shifted from 490 nm to 660 nm. The fluorescent probe has many advantages, such as good selectivity, high sensitivity, large Stokes shift, and wide applicable pH range. The probe-loaded silica plates can realize convenient sensing gaseous hydrazine with content down to 1 ppm (mg/m3). Subsequently, DCPBCl2-Hz was successfully applied to detect hydrazine in soils. In addition, the probe can also penetrate living cells and allow the visualization of intracellular hydrazine. It can be anticipated that probe DCPBCl2-Hz will be a useful tool for sensing hydrazine in biological and environmental applications.

Whether the infracardiac bursa protect right pleura during laparoscopic radical operation of Siewert type II adenocarcinoma of esophagogastric junction?

BACKGROUND: Transthoracic single-port assisted laparoscopic five-step maneuver inferior mediastinal lymphadenectomy for Siewert type II adenocarcinoma of esophagogastric junction (AEG) has superiority in lower mediastinal lymph nodes dissection and digestive tract reconstruction. However, the right pleura was probably ruptured in this surgical technique. The aim of this study was to explore whether the infracardiac bursa (ICB) exposed could protect right pleura. METHODS: We retrospectively collected and evaluated the clinical and pathological data of patients who underwent five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymphadenectomy for Siewert II AEG at Guangdong Provincial Hospital of Chinese Medicine between May 2017 and February 2022. RESULTS: A total of 49 patients were eligible, including 31 patients in ICB exposed group (group A) and 18 patients in ICB unexposed group (group B). There were no statistically significant differences in baseline characteristics between the two groups. 4 patients (12.9%) had right pleura rupture in group A, while 14 patients (77.8%) in group B, and the difference was statistically significant (p < 0.001). Compared with group B, the extubation time of endotracheal intubation (10.0 (6.0 ~ 12.0) vs. 13.0 (8.0 ~ 15.0) min, p = 0.003) and thoracic drainage tube stay (6.0 (5.0 ~ 7.0) vs. 8.0 (6.0 ~ 10.5) days, p = 0.041) were significantly shorted in the group A. The drainage volume of thorax (351.61 ± 125.00 vs. 418.61 ± 207.86 mL, p = 0.146) was non-significant less and the rate of complications (3.2% vs. 11.1%, p = 0.074) was non-significant lower in group A compared with group B. The postoperative hospital stay (9.0 (8.0,13.0) vs. 9.0 (8.0,12.0) days, p = 0.983) were similar in two groups. No serious adverse event occurred in any patient. CONCLUSIONS: The ICB exposed could protect the right pleura and may promote postoperative recovery, which may be used as an anatomical marker in inferior mediastinal lymphadenectomy.

Fabrication of porous gehlenite coating on Al2O3-ZrO2-SiC composite ceramics and its in vitro biological activities.

Porous gehlenite coatings on Al2O3-ZrO2-SiC composite ceramics were prepared by electro-spraying technique combined with reactive sintering method. The influences of gehlenite coating on the mechanical property of the ceramics and biological activity of the coating were investigated. The results indicated that the gehlenite coating has limited influences on flexural strength and fracture toughness of the ceramics, and the coating has elastic modulus of 82 GPa, hardness of 2.2 GPa, and adhesive strength of 1512 mN, suggesting its potential application in load-bearing ceramic implants. Simulated body fluid soaking test, CCK-8 and alkaline phosphatase activity assay demonstrated that the porous gehlenite coating has strong mineralization ability, which promotes proliferation and differentiation of MC3T3-E1 cells. These excellent biological performances can be attributed to the synergistic effect of the porous surface of the coating and its release of Ca2+ and Si4+.

Fabrication of hexagonal boron carbonitride nanoplates using for in vitro photodynamic therapy and chemo therapy.

Carbon nanomaterials and boron nitride nanomaterials have been proved to be very potential for biomedical applications. However, as an analog of them, boron carbonitride nanomaterials are rarely reported in biomedical field. In this study, the fabrication of visible light-responsive boron carbonitride nanoplates (BCNNPs) and their application in photodynamic therapy and chemo therapy were demonstrated. BCNNPs with an average size of 46 nm were fabricated via hydrogen peroxide treatment from bulk BCN. Cytotoxicity tests showed that the as-prepared BCNNPs are biocompatible and have no cytotoxicity to human breast cancer cells and human hepatocyte carcinoma cells. After conjunction with doxorubicin and folic acid, the BCNNPs were adopted as a targeted drug carrier, presenting pH-responsive release and tumor-targeting property for chemo therapy. Moreover, under certain intensity of visible light irradiation (45 mW/cm2), the BCNNPs can generate reactive oxygen species including superoxide radical, hydroxyl radical and singlet oxygen, so that synergistic photodynamic/chemo therapy effects were achieved. This work may be a groundbreaking discovery for utilizing BCNNPs as photosensitizer for photodynamic therapy and drug carrier for chemo therapy.

Feasibility and efficacy of transthoracic single-port assisted laparoscopic esophagogastrectomy for Siewert type II adenocarcinoma of the esophagogastric junction.

BACKGROUND: The surgical treatment of Siewert type II adenocarcinoma of the esophagogastric junction (AEG) is controversial, and no systematic technology has been established. The aim of this retrospective study is to introduce the technology of transthoracic single-port assisted laparoscopic esophagogastrectomy. METHODS: Data from patients with Siewert type II AEG who underwent transthoracic single-port assisted laparoscopic esophagogastrectomy in Guangdong Provincial Hospital of Chinese Medicine from May 2017 to December 2020 were analyzed. RESULTS: A total of 35 patients, including 30 males and 5 females, were enrolled in this study. Eight patients underwent proximal gastrectomy while the other 27 patients underwent total gastrectomy. The median operative times were 247.5 (195.0-275.0) min and 290.0 (173.0-530.0) min for proximal and total gastrectomy, respectively. The median lower mediastinal lymph node dissection (LMLD) time was 41.5 (20.0-57.0) min and the median estimated blood loss was 100.0 (20.0-200.0) mL. The median number of harvested mediastinal lymph nodes was 5 [2-13]. Lower mediastinal lymph node metastasis occurred in 9 patients (25.7%). The lower mediastinal lymph node metastasis rate was significantly higher in patients with esophageal involvement exceeding 2 cm [>2 vs. ≤2 cm: 55.6% (5/9) vs. 15.4% (4/26), P=0.03]. The median postoperative hospital stay was 10 [6-73] days. Overall morbidity was 11.8% (4 patients), including 2 cases of pleural effusion, 1 case of pancreatic fistula, and 1 case of anastomotic leakage. CONCLUSIONS: Transthoracic single-port assisted laparoscopic esophagogastrectomy is safe and feasible. It has the advantages of reducing the difficulty of LMLD and digestive tract reconstruction.

Nomogram for Predicting Risk of Esophagogastric Junction (EGJ) Resection During Laparoscopic Resection of Gastrointestinal Stromal Tumors in EGJ: A Retrospective Multicenter Study.

Background: The established criteria for determining whether to excise the cardia during laparoscopic surgery for gastrointestinal stromal tumors in the esophagogastric junction (EGJ-GISTs) remain controversial. This retrospective multicenter study was conducted to develop a nomogram for predicting the risk of the cardia excision during laparoscopic surgery for EGJ-GISTs. Material and Methods: We reviewed data from 2,127 gastric-GISTs (g-GISTs) patients without distant metastases in four hospital between June 2012 and June 2020. Of those, according to the including criteria, 184 patients [Guangdong Provincial Hospital of Chinese Medicine (n = 81), Nanfang Hospital of Southern Medical University (n = 60), Guangdong General Hospital (n = 34), and The Third Affiliated Hospital of Southern Medical University (n = 9)] with EGJ-GISTs were identified and included in this study. Factors contributing to risk of cardia excision were identified and used to create a nomogram. Nomogram performance was assessed using a bootstrapped concordance index (c-index) and calibration plots. Results: According to the multivariate analysis, the distance from the margin of the tumor to the esophagogastric line (EG-line) (cm) (OR = 0.001, 95% CI: 0.00001~0.056, P = 0.001) and tumor size (cm) (OR = 14.969, 95% CI: 1.876~119.410, P = 0.011) were significantly related to likelihood of cardia structure excision in laparoscopic surgery for EGJ-GISTs. These two factors were used to generate a nomogram for predicting risk of cardia excision using a logistic regression model; a bootstrapped C-index of 0.988 (calibrated C-index = 0.987) indicated strong predictive ability, with broad calibration. Conclusions: This nomogram based on distance from tumor margin to EG-line and tumor size may serve as a tool for predicting risk of cardia damage during laparoscopic removal of EGJ-GISTs to aid in selection of surgical methods and preoperative neoadjuvant therapy.

Anatomical observation and clinical significance of the left gastric vein in laparoscopic radical gastrectomy.

BACKGROUND: The left gastric vein (LGV) plays an important role in laparoscopic radical gastrectomy (LRG). However, the anatomy of the LGV is complicated with significant variation, and it is often damaged and bleeding during LRG. The purpose of this study was to observe and analyze the anatomic types of the LGV in patients undergoing LRG and to explore its clinical significance. METHODS: A total of 217 patients who underwent LRG from June 2016 to December 2020 were included. LGVs were divided into four types according to the relationship between the LGV and peripheral arteries [celiac artery (CA)/common hepatic artery (CHA)/splenic artery (SA)] and the pancreas during LRG. If a LGV was damaged during surgery (resulting in bleeding), it was included in the bleeding group. Non-bleeding groups were included if there was no impairment to the LGV. RESULTS: A total of four types of LGVs were observed, of which type I was the most prevalent, accounting for 58.8% (n=121). In 21 patients (9.7%), the LGV was injured and hemorrhagic during LRG; and the type IV LGV injury bleeding rate was as high as 41.7% (5/12). Univariate analysis revealed that the extent of lymph node dissection (LND), pathological stage, tumor (T) stage, and type of LGV were significantly associated with LGV injury and hemorrhage (P<0.05). Multivariate analysis showed that enlarged LND, late T stage, late pathological stage, and type IV LGV were independent risk factors for LGV injury hemorrhage. CONCLUSIONS: LGVs that run between the CHA (posterior) and the CA into the portal venous system were the most common anatomical type. A LGV that runs between the SA (posterior) and the CA into the portal venous system is easily injured (resulting in bleeding). LGV injury and hemorrhage are affected by a variety of factors, and therefore, careful intraoperative dissection is necessary to avoid damage to the LGV.

Synthesis of boron carbonitride nanosheets using for delivering paclitaxel and their antitumor activity.

As a structural analog of graphene and boron nitride, hexagonal boron carbonitride nanosheets (BCNNSs) are supposed to be a potential drug deliverer. In the present work, an improved solid-state reaction method combined with ultrasonic exfoliating was reported for preparing BCNNSs. Vapor-solid (VS) mechanism was proposed to be responsible for the formation of BCNNSs. The BCNNSs were further modified by DSPE-mPEG-5000 to improve their dispersion in aqueous solution. It was found that the BCNNSs-PEG nanocomplex could be efficiently taken in by MDA-MB-231 breast cancer cells evidenced by inverted fluorescence microscopy. The PEGylated BCNNSs showed an outstanding ability to load paclitaxel through π-π interaction and hydrophobic interaction, and BCNNSs-PEG-loaded paclitaxel presented higher cytotoxicity in comparison with free paclitaxel. BCNNSs may become a promising candidate for delivering paclitaxel and other hydrophobic drugs.

Safety and Feasibility of No.12a Lymph Node Dissection by Portal Vein Approach in Radical Laparoscopic Gastrectomy for Gastric Cancer.

BACKGROUND: Traditional laparoscopic No.12a lymph node dissection in radical gastrectomy for gastric cancer may damage the peripheral blood vessels, and is not conducive to the full exposure of the portal vein and the root ligation of the left gastric vein. We recommend a new surgical procedure, the portal vein approach, to avoid these problems. METHODS: 25 patients with advanced gastric cancer underwent radical laparoscopic gastrectomy and No.12a lymph node were dissected by portal vein approach, including 7 cases with total gastrectomy, 18 cases with distal gastric resection, 14 males and 11 females. Operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay, number of total lymph node dissection and No.12a lymph node dissection, No.12a lymph node metastasis rate and postoperative complications were statistically observed. RESULTS: All the patients were operated successfully and No.12a lymph node were cleaned by portal vein approach. A total of 683 lymph nodes were dissected, with the average number of lymph nodes dissection and positive lymph nodes were (27.3 ± 12.7) and (3.8 ± 5.6) respectively. The average number of No.12a lymph node dissection was (2.4 ± 1.95) and the metastasis rate of No.12a lymph node was 16% (4/25). The average operation time of radical laparoscopic distal and total gastrectomy were (239.2 ± 51.4) min and (295.1 ± 27.7) min respectively. The mean intraoperative blood loss was (134.0 ± 65.7) ml, and postoperative first anal exhaust time was (2.24 ± 0.86) d. The mean time to fluid intake was (4.2 ± 1.7) d, and postoperative hospitalization time was (9.6 ± 5.0) d. Without portal vein injure, anastomotic leakage, gastrointestinal bleeding, intestinal obstruction and other complications were observed in all patient. CONCLUSION: Our results show that the laparoscopic No.12a lymph node dissection by portal vein approach for gastric cancer is safe, feasible and has certain clinical application value.

Targeted delivery of Auristatin PE to Hep G2 cells using folate - conjugated boron nitride nanotubes.

Auristatin PE (PE) as an anti-microtubule agent possesses good anticancer activity. However, the poor target effect and strong side effect limit its clinical applications. Targeted delivery of PE may overcome the disadvantages associated with PE, being very conducive to continuing clinical trials of PE. Boron nitride nanotubes (BNNTs) with unique physical and chemical properties have attracted considerable attention in drug delivery. Herein, a targeted drug delivery strategy based on folate-conjugated boron nitride nanotubes (BNNTs-FA) was used to improve the efficacy of PE. It was found that PE was successfully loaded onto BNNTs-FA via π-π stacking and hydrogen bonding interactions. BNNTs-FA@PE exhibited stronger cytotoxicity to Hep G2 cells than free PE and BNNTs@PE complexes due to the increased cellular uptake of PE mediated by the FA receptor. BNNTs-FA@PE showed excellent antiproliferative activities in a dose- and time-dependent manner. Furthermore, BNNTs-FA@PE induced apoptosis of Hep G2 cells via an intrinsic mitochondria-mediated pathway by reducing the mitochondrial membrane potential, activating Caspase-9 and Caspase-3. The construction of BNNTs-FA@PE system successfully improves the target effect of PE and may be very promising for the treatment of liver cancer in the future.

Structural and mechanical evolution of Tridacna gigas during permineralization.

Mollusk shells have highly complex hierarchical structures and unique mechanical properties, which have been widely studied, especially in fresh shells. However, few studies have revealed differences in the structure-property correlations of shells during the permineralization process, which occurs after organism death. To better understand the effect of permineralization on the microstructure and mechanical properties of shells, this study investigated and compared the compositions, microstructures, and mechanical properties of Tridacna gigas and permineralized J-Tridacna gigas. The results showed that permineralized J-Tridacna gigas possessed coarsened aragonite minerals, less anisotropy and organic matter, and higher hardness and strength than Tridacna gigas. The toughening mechanisms of Tridacna gigas, including crack deflection, aragonite platelet pull-out, and mineral bridges, were discovered during Vickers hardness tests. Moreover, the permineralization mechanism comprised three main steps: organic matter dissolution, aragonite plate compaction, and recrystallization. This work further elaborates the permineralization mechanism, which can help increase the crystal size and improve the strength and hardness of materials. Moreover, this study provides valuable insights into the design of bioinspired advanced materials with outstanding hardness and strength.

A highly Li+-conductive HfNb24O62 anode material for superior Li+ storage.

Highly Li+-conductive HfNb24O62 is explored as a new intercalation-type niobium-based oxide anode material for superior Li+ storage. HfNb24O62 owns a Wadsley-Roth shear structure with a large unit-cell volume, leading to a large Li+ diffusion coefficient. HfNb24O62 shows a large capacity, safe operating potential, high rate performance and good cyclability.

Loading Auristatin PE onto boron nitride nanotubes and their effects on the apoptosis of Hep G2 cells.

Auristatin PE (PE) as an anti-microtubule agent possesses good anticancer activity. However, the poor target effect and strong side effect limit the clinical application of PE. Boron nitride nanotubes (BNNTs) represent an outstanding carrier candidate providing a wise choice for liver-targeted drug delivery. A drug delivery system based on BNNTs and PE (BNNTs-PE) against liver cancer cells was designed and constructed in this study. Firstly, BNNTs were prepared and hydroxylated, subsequently, PE was loaded onto BNNTs by noncovalent conjugation and was stable at neutral pH but released at pH 4.49. It was found that BNNTs-PE demonstrates an enhanced anticancer activity against Hep G2 cells in comparison with free PE. BNNTs-PE kills cancer cells in a manner of mitochondria-mediated apoptosis pathway through reducing the mitochondrial membrane potential, activating caspase cascade. This BNNTs-PE system may be very promising for the treatment of liver cancer in the future.