Highly Tunable Cellulosic Hydrogels with Dynamic Solar Modulation for Energy-Efficient Windows.

Smart windows that can passively regulate incident solar radiation by dynamically modulating optical transmittance have attracted increasing scientific interest due to their potential economic and environmental savings. However, challenges remain in the global adoption of such systems, given the extreme variability in climatic and economic conditions across different geographical locations. Aiming these issues, a methylcellulose (MC) salt system is synthesized with high tunability for intrinsic optical transmittance (89.3%), which can be applied globally to various locations. Specifically, the MC window exhibits superior heat shielding potential below transition temperatures, becoming opaque at temperatures above the Lower Critical Solution Temperature and reducing the solar heat gain by 55%. This optical tunability is attributable to the particle size change triggered by the temperature-induced reversible coil-to-globular transition. This leads to effective refractive index and scattering modulation, making them prospective solutions for light management systems, an application ahead of intelligent fenestration systems. During the field tests, MC-based windows demonstrated a 9 °C temperature decrease compared to double-pane windows on sunny days and a 5 °C increase during winters, with simulations predicting an 11% energy savings. The ubiquitous availability of materials, low cost, and ease-of-manufacturing will provide technological equity and foster the ambition toward net-zero buildings.

Redesigning Natural Materials for Energy, Water, Environment, and Devices.

The United Nations Framework Convention on Climate Change (UNFCCC) acknowledges that global cooperation is paramount to mitigate climate change and further warming. The global community is committed to renewable energy and natural materials to tackle this challenge for all humankind. The widespread use of natural materials is embraced as one such action to reach net-zero carbon emissions. Given the hierarchical framework and earth abundance, cellulose-based materials extend their negative carbon benefits to our daily products and accelerate our pace toward carbon neutrality. Here, we present an overview of recent developments of cellulose-based materials in upsurging applications in radiative cooling, thermal insulation, nanofluidics, and wearable devices. We also highlight various modifications and functionalized processes that transform massive amounts of cellulose into green products. The prosperous development of functionalized cellulose materials aligns with a circular economy. Expedited interdisciplinary fundamental investigations are expected to make fibrillated cellulose penetrate more into carbon downdraw at speed and scale.

Comparative analyses of functional traits based on metabolome and economic traits variation of Bletilla striata: Contribution of intercropping.

The intercropping practice has been regarded as a practical land-use selection to improve the management benefits of Bletilla striata plantations. The reports about the variety of economic and functional traits of Bletilla pseudobulb under intercropping systems were limited. The present study investigated the variation of economic and functional traits of Bletilla pseudobulb under different intercropping systems (the deep-rooted intercropping system: B. striata - Cyclocarya paliurus, CB; and the shallow-rooted intercropping system: B. striata - Phyllostachys edulis, PB). The functional traits were analyzed through non-targeted metabolomics based on GC-MS. The results indicated that the PB intercropping system significantly decreased the yield of Bletilla pseudobulb while significantly increasing the total phenol and flavonoids compared with the control (CK). However, there were no significant differences in all economic traits between CB and CK. The functional traits among CB, PB, and CK were separated and exhibited significant differences. Under different intercropping systems, B. striata may adopt different functional strategies in response to interspecific competition. The functional node metabolites (D-galactose, cellobiose, raffinose, D-fructose, maltose, and D-ribose) were up-regulated in CB, while the functional node metabolites (L-valine, L-leucine, L-isoleucine, methionine, L-lysine, serine, D-glucose, cellobiose, trehalose, maltose, D-ribose, palatinose, raffinose, xylobiose, L-rhamnose, melezitose, and maltotriose) were up-regulated in PB. The correlation between economic and functional traits depends on the degree of environmental stress. Artificial neural network models (ANNs) accurately predicted the variation in economic traits via the combination of functional node metabolites in PB. The correlation analysis of environmental factors indicated that Ns (including TN, NH4 +-, and NO3 --), SRI (solar radiation intensity), and SOC were the main factors that affected the economic traits (yield, total phenol, and total flavonoids). TN, SRI, and SOC were the main factors affecting the functional traits of the Bletilla pseudobulb. These findings strengthen our understanding of the variation of economic and functional traits of Bletilla pseudobulb under intercropping and clarify the main limiting environmental factors under B. striata intercropping systems.

Measles, mumps, and rubella revaccination in children after completion of chemotherapy and hematopoietic stem cell transplantation: a single-center prospective efficacy and safety analysis.

BACKGROUND: Chemotherapy and hematopoietic stem cell transplantation (HSCT) can damage the immune system, and may result in a loss of protection from infectious diseases. This study aimed to evaluate the impact of these treatments on the decrease in antibody titers of the measles, mumps, and rubella (MMR) vaccine and seroconversion post-revaccination of MMR. METHODS: After completion of treatment for primary diseases, participants received an MMR revaccination. Antibody titers for MMR before revaccination were analyzed for all 110 children. After revaccination, 68 participants received a follow-up evaluation of  antibody titer and adverse reaction. RESULTS: Multivariable analysis showed that therapeutic schedules were the only factor correlated with lack of antibody titers for measles after completing treatment (P = 0.008), while for mumps and rubella, no statistically significant difference was observed. Importantly, our study clearly demonstrated positive seroconversion rates for measles (97.5%), mumps (81.0%), and rubella (93.2%), with antibody levels rising across the board and peaking at around 6 months following revaccination. However, 6 months after revaccination, a downtrend of antibody titer levels was observed, which is comparatively earlier than the waning immunity observed in healthy children. Furthermore, we found MMR revaccination to be safe, with only a single adverse reaction (local pain at the injection site) reported. CONCLUSIONS: MMR revaccination is immunogenic for the population. We suggest periodic monitoring of antibody titers, in addition to a booster vaccination, although the optimal timing of booster vaccination remains to be investigated further.

How does green credit reduce carbon emissions? Dynamic spatial interactions and regional disparities.

Green credit is an important green financial policy tool to promote green development. However, research is needed to explore how green credit reduces carbon emissions, especially with respect to its dynamic spatial interactions and regional disparities. Based on a theoretical analysis, this paper empirically tests the carbon emission reduction effect of green credit and its three mechanisms by combining a Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model, dynamic spatial Durbin model (SDM), and the mediation model, including their dynamic spatial interactions and regional disparities. The study concludes that green credit can reduce carbon emission intensity based on strong spatio-temporal interactions in China. Green credit mainly reduces carbon emission intensity through scale and technology mechanisms with different spatio-temporal interactions. The tertiary industry in China does not currently have completely clean production; as such, the upgrading of the industrial structure as stimulated by green credit in the long term cannot yet effectively reduce carbon emissions. In addition, the carbon emission reduction effect of green credit and its three mechanisms have different levels of performance and dynamic spatial interactions in different regions of China. Finally, targeted policy recommendations are proposed to apply green credit to effectively reduce the carbon emission intensity.

Self-Powered Smart Textile Based on Dynamic Schottky Diode for Human-Machine Interactions.

The growing demand for sustained self-powered devices with multifunctional sensing networks is one of the main challenges for smart textiles, which are the critical elements for the future Internet of Things (IoT) and Point of Care (POC). Here, cellulose-based smart textile is integrated with dynamic Schottky diode (DSD) to generate sustained power source (current density of 8.9 mA m⁻2 ) for self-powered built-in sensing network. In response to normal and shear motions, a pressure sensor with a sensitivity of 0.12 KPa⁻1 and an impact sensor are demonstrated, respectively. The woven structure of the textile contributes to signal amplification, which can also form a matrix of sensing elements for distributed sensing. The proposed strategy of fabricating self-powered and multifunctional sensing networks with smart textiles shows tremendous potential for future intelligent society.

STAT3 inhibitor BBI608 reduces patient-specific primary cell viability of cervical and endometrial cancer at a clinical-relevant concentration.

PURPOSE: Aberrant activation of STAT3 signal pathway promotes tumor progression in many solid tumor types, including cervical cancer and endometrial cancer. BBI608, the STAT3 inhibitor had been reported in previous studies for restraining cancer stem cells. However, whether BBI608 is available for inhibiting the proliferation of cervical cancer or endometrial cancer remains poorly understood. This study investigated the anti-tumor effect and molecular mechanism of BBI608 on the patient-specific primary cells (PSPC) generated from cervical and endometrial cancer in vitro. METHODS: PSPCs were obtained from four patients via biopsy. The cell viability was analyzed by the CCK8 assay. The PSPCs were treated with various concentrations of BBI608 or/and paclitaxel; and then, western blot was applied to investigate the expression of phosphorylated STAT3 (pSTAT3). RESULTS: The PSPCs cell viability was reduced after treated with BBI608 at a lower concentration. Western blot results showed a reduction trend of pSTAT3 after PSPCs treated with BBI608. Our results demonstrated that BBI608 at the certain concentrations worked well in reducing the cell viability of PSPC from the patients who suffered from cervical cancer and endometrial cancer. CONCLUSIONS: In this study, the patient-specific primary cell (PSPC) was used as the pre-clinical model for investigating the efficiency of BBI608 in reducing cancer cells viability. BBI608, at a clinical-relevant concentration, had valid efficiency in PSPCs from the patients. The dose of drugs treatment and the measured results were more valuable for further guiding clinical trials.

Effectiveness of varicella vaccination during an outbreak in a large one-dose-vaccinated population in Shanghai.

Emergency vaccination (EV) is used as effective postexposure prophylaxis (PEP) to control varicella outbreaks within 3-5 days. However, the advantages of a second dose of varicella vaccine (VarV) in students who had received one dose before an outbreak and the potential benefits of EV at more than 5 days after exposure have not been fully evaluated. This study evaluated the vaccine effectiveness (VE) of EV in preventing disease development during a varicella outbreak in Shanghai, China, in 2020. Questionnaires were used to obtain student demographic information, clinical manifestations, varicella history, vaccination status, and willingness to receive EV. The VE of EV was calculated as [1-relative risk (RR)] ×100%. Among the 1455 students included in this study, 31 cases were identified, resulting in an overall attack rate of 2.13%. There were 6 cases in unvaccinated students and 25 cases in one-dose-vaccinated students. A total of 788 students received one EV dose. The attack rates were 6.38% (6/94), 4.26% (19/446), 2.82% (2/71), and 0.56% (4/717) among unvaccinated students, students who received 1 dose of VarV, and students who received EV with the 1st and 2nd dose of VarV, respectively. Compared to that in unvaccinated students, the VE of EV with the 2nd dose of VarV was 88% (95% CI 49% to 97%). EV should be performed as soon as possible after exposure. Nevertheless, vaccination is still recommended at more than 5 days post exposure to control varicella outbreaks.

GALNT14 regulates ferroptosis and apoptosis of ovarian cancer through the EGFR/mTOR pathway.

Background: Chemoresistance usually occurs in ovarian cancer. We aimed to explore the mechanisms of chemoresistance. Methods: Western blotting assay was used to detect the expression of GALNT14. Further cell function experiments were performed to investigate the effect of GALNT14 in ovarian cancer. Results: GALNT14 is significantly upregulated in ovarian cancer. Downregulation of GALNT14 significantly inhibits both apoptosis and ferroptosis of ovarian cancer cells. A further mechanism assay illustrated that downregulation of GALNT14 suppresses the activity of the mTOR pathway through modifying O-glycosylation of EGFR. Finally, an additive effect promoting cell death occurs with a combination of an mTOR inhibitor and cisplatin. Conclusion: Our study might provide a promising method to overcome cisplatin resistance for patients with ovarian cancer.

Prospective clinical trial of hepatitis B vaccination for children with hematological malignancies: a study on the safety and immunogenicity efficacy.

Children with hematological malignancies are at increased risk of hepatitis B virus infection. This study assessed the immunogenicity and safety profile of HBV vaccination in pediatric hemato-oncological children. A nonrandomized interventional study was conducted from January 2017 to February 2020 in Shanghai, China. Seventy-three pediatric hemato-oncological children with hepatitis B surface antibody (anti-HBs) titers <10 mIU/ml were recruited. The participants received three doses of recombinant HBV vaccine according to the 0-, 1-, and 6- month immunization schedule. Adverse events following immunization and anti-HBs titers (at baseline, 1 month, and 6 months after inoculation) were recorded. Forty-three males and thirty females with median ages of 9.12 and 9.60 years, respectively, were included. The mean anti-HBs titer was 4.88 ± 2.61 mIU/ml, 893.12 ± 274.12 mIU/ml, and 711.45 ± 337.88 mIU/ml at baseline, one month, and six months after inoculation, respectively (P< .001). A total of fourteen adverse events following immunization were reported, and among them, 5 (6.85%), 5 (6.85%), and 4 (5.48%) events were reported after the first, second, and third inoculation, respectively (P= .927). In conclusions, the HBV vaccine is immunogenic and safe in children with hematological malignancies. It is worth noting that the anti-HBs titer was decreased at the 6-month follow-up, and periodic monitoring of the anti-HBs titer accompanied by timely booster vaccination should be carefully considered.Abbreviations: AEFI: Adverse events following immunization; HBV: Hepatitis B virus; Anti-HBs: Antibody against hepatitis B surface antigen; HBsAg: Hepatitis B surface antigen; APC: Antigen-presenting cell; HSCT: Hemopoietic stem cell transplantation; COVID-19: Corona Virus Disease 2019.

Bile Acids Impair Vaccine Response in Children With Biliary Atresia.

Background: Vaccination is the best way to protect children under 5 years from death or disability. Children with biliary atresia (BA), which is the most common pediatric cholestatic end-stage liver disease (PELD), are more vulnerable to infectious diseases. However, the vaccination coverage and factors modulating vaccine responses in children with BA are largely unknown. Methods: In this study, 288 children (median age: 7 months) diagnosed with BA before liver transplantation were enrolled for the evaluation of vaccination status and the factors affecting the immune response to the hepatitis B (HBV) vaccine. Moreover, 49 BA children (median age: 4 months) were enrolled for flow cytometric analysis of CD4+ T cells and CD19+ B cell subsets and correlations with serum bile acid levels. Results: Generally, these children had very low routine vaccination rates for the meningococcal serogroup AC (Men AC) (41.2%), measles-mumps-rubella (MMR) (31.3%), poliomyelitis (Polio) (25.3%), hepatitis A (HAV) (25.0%), Japanese encephalitis (JE) (15.0%), diphtheria-tetanus-pertussis (DTP) (14.2%), meningococcal serogroup A (Men A) (13.5%) and varicella (VAR) (10.8%) vaccines, but not for the HBV (96.2%) and bacillus Calmette-Guérin (BCG) (84.7%) vaccines. Remarkably, 19.8% (57/288) of the patients had HBV infection. Out of 220 patients vaccinated for HBV, 113 (51.4%), 85 (38.6%) and 22 (10%) had one, two or three doses of the HBV vaccine, respectively. Furthermore, logistic regression analysis revealed that the bile acid level was an independent factor associated with poor HBV vaccine response (p = 0.03; OR = 0.394; 95% CI = 0.170-0.969). Immunophenotyping showed that bile acids were only negatively correlated with the CD19+CD27+IgG+ post-class-switched memory B cell ratio (p = 0.01). Conclusion: This study reveals the overall vaccination rates of routine vaccines in Chinese BA children are very low and the poor HBV vaccine responses are associated with bile acids, possibly via the inhibition of CD19+CD27+IgG+ post-class-switched memory B cell response. Clinical Trial Registration: http://www.chictr.org.cn, identifier ChiCTR1800019165.

Electrically compensated, tattoo-like electrodes for epidermal electrophysiology at scale.

Epidermal electrophysiology is widely carried out for disease diagnosis, performance monitoring, human-machine interaction, etc. Compared with thick, stiff, and irritating gel electrodes, emerging tattoo-like epidermal electrodes offer much better wearability and versatility. However, state-of-the-art tattoo-like electrodes are limited in size (e.g., centimeters) to perform electrophysiology at scale due to challenges including large-area fabrication, skin lamination, and electrical interference from long interconnects. Therefore, we report large-area, soft, breathable, substrate- and encapsulation-free electrodes designed into transformable filamentary serpentines that can be rapidly fabricated by cut-and-paste method. We propose a Cartan curve-inspired transfer process to minimize strain in the electrodes when laminated on nondevelopable skin surfaces. Unwanted signals picked up by the unencapsulated interconnects can be eliminated through a previously unexplored electrical compensation strategy. These tattoo-like electrodes can comfortably cover the whole chest, forearm, or neck for applications such as multichannel electrocardiography, sign language recognition, prosthetic control or mapping of neck activities.

Knockdown of NRSF inhibits cell proliferation of ovarian cancer via activating Hippo pathway.

AIMS: Ovarian cancer is the most leading cause of deaths among gynecologic malignancies, and Neuron-restrictive silencer factor (NRSF) can be upregulated or downregulated according to the type of tumor. However, the expression and function of NRSF in ovarian cancer is still unknown. MAIN METHODS: Expression of NRSF in normal ovary and ovarian cancer cells were evaluated by quantitative PCR (qPCR). NRSF expression in normal ovary and ovarian cancer tissue samples were examined by qPCR, western blotting and immunohistochemistry (IHC). MTT, colony formation, anchorage-independent growth assay were applied to examine the effect of NRSF on ovarian cancer cell proliferation. Bromodeoxyuridine (BrdUrd) labeling and flow cytometry assay were carried out to investigate the role of NRSF on cell cycle of ovarian cancer cells. Luciferase reporter assay and western blotting, immunofluorescence labeling were devoted to explore the mechanism by which NRSF contributes to proliferation of ovarian cancer cells. KEY FINDINGS: The results demonstrated that NRSF is significantly upregulated in ovarian cancer cells and tissues and negatively related with the survival of patients with ovarian cancer, and knockout of NRSF inhibit proliferation of ovarian cancer cells. Further analysis showed that NRSF can influence G1/S transition of cell cycle via regulating the transcription of Hippo pathway. SIGNIFICANCE: Herein, our study suggest that NRSF is associated with the progression of ovarian cancer, and NRSF may be a valuable early detection marker of ovarian cancer and inhibiting NRSF expression may be an effective method to treat ovarian cancer.

[Characteristics of distribution and changes of telomere length in human].

OBJECTIVE: To explore the relationship between telomere length changes and age, and to provide data and reference for further study of geriatric medical problems.
 Methods: The healthy people over 20 years old were chosen as subject from several hospitals by random sampling method, and their peripheral blood samples were collected. The relative length of telomere was detected by quantitative real-time PCR, and the relationship between age and telomere length was analyzed by statistical software.
 Results: A total of 1 022 samples were obtained. There were significant differences in the relative telomere length among different age groups (F=21.492, P<0.001). Telomere length and age showed negative correlation (r=-0.325, P<0.001), the regression equation was y=-0.008x+1.772 (x for age, y for the average telomere length, P<0.001).
 Conclusion: The telomere length for peripheral blood leukocytes in healthy people varies between different age groups, suggesting that telomere length gradually decreases with age.

A core/shell stabilized polysaccharide-based nanoparticle with intracellular environment-sensitive drug delivery for breast cancer therapy.

In this work, we developed a novel core/shell chitosan (Cs)/hyaluronan (HA)-based hybrid nanoparticle, i.e. SNX@Cs-SNX/cHA, with good stability in the bloodstream and intracellular environment-sensitive drug delivery for breast cancer therapy. The core was a drug-loaded self-assembled micelle (SNX@Cs-SNX), and the shell was crosslinked to cysteine-conjugated hyaluronan (cHA) by disulfide bonds. Thanks to the combination of chemical bonding and physical encapsulation, the drug loading capacity of SNX@Cs-SNX/cHA nanoparticles was up to (14.6 ± 0.3)% in mass percentage. These stabilized core/shell nanoparticles were little affected by ionic strength (0.05-1.0 M sodium chloride solution), pH (6.8 and 7.4) and human plasma mimicking the bloodstream, but promptly disassembled by the multi-stimuli of glutathione (GSH), hyaluronidases (Hyals) and acidity (pH 5.0) mimicking the intracellular environment of breast cancer cells. In vitro 84% of the loaded drugs was released by GSH/Hyals/pH multi-stimuli within 72 h, as opposed to 28% at pH 7.4. SNX@Cs-SNX/cHA nanoparticles were highly endocytosed by both MCF-7 and MDA-MB-453 breast cancer cells and escaped from the endosomes/lysosomes as revealed by confocal laser scanning microscopy, showing a close IC50 value of 24.5 ng mL-1 and 41.0 ng mL-1 respectively to pure SNX. Thus, the SNX@Cs-SNX/cHA nanoparticle, which can not only increase the drug loading ability and stability in the blood circulation, but also control the fast intracellular drug delivery by GSH/Hyals/pH multi-stimuli in breast cancer cells, is a potential drug carrier for breast cancer therapy.

[Based on empirical research: a preliminary study on application of the social aging scale for healthy people].

OBJECTIVE: To build a social aging scale for healthy people, and get the accuracy and feasibility of the scale to judge the aging of healthy people on the basis of the empirical research.
 Methods: Stratified random sampling was conducted according to the nine different age groups, and the age-related social function information was collected for healthy people by using the scale, which was made in our own plant; the distribution of the score, the correlations between the score and age or telomere length were analyzed by statistical software.
 Results: A total of 2 297 subjects were collected for the analysis. The ratio of male to female was 0.8:1. Social function of aging score was in the range of 3.00-12.90; aging score of personal ability was in the range of 1.00-4.45; aging score of social participation was in the range of 1.00-4.52; and aging score of organizational communication was in the range of 1.00-5.00. The correlation coefficient of aging scores with age was 0.696 (P<0.001). The result of telomere length showed that the relative telomere length was 1.056±0.261. The telomere length in different groups were significantly different (F=35.803, P<0.001). The telomere length was negatively correlated with aging (r=-0.964, P<0.001) and social function of aging (r=-0.857, P<0.001), respectively.
 Conclusion: The scores of age-related social function, personal ability, social participation, and organizational communication are increased with age. The telomere length is negatively correlated to aging score. The scale is applicable to measure social function of aging, which can provide reference for evaluation of the comprehensive of aging.

Association of ischemic and hemorrhagic strokes hospital admission with extreme temperature in Nanchang, China-A case-crossover study.

Despite consistent evidence of a higher short-term risk of stroke mortality associated with ambient temperature, there are no findings on the association between extreme temperature and stroke. A total of 16,264 stroke hospital admissions were observed in three hospitals of Nanchang between 2008 and 2015. The case-crossover design was utilized for our study. Conditional logistic regression models were used to calculate the odds ratios. Extreme high temperature exposure during the 3days before the stroke was associated with both ischemic (OR=1.18; 95% CI: 1.07-1.36) and hemorrhagic stroke admissions (OR=1.34; 95% CI: 1.26-1.42) as compared to 3-day control periods (1-3days last week before the onset of stroke). Extreme low temperature was associated with hemorrhagic stroke admission (OR=1.42; 95% CI: 1.28-1.58) but not ischemic stroke (OR=1.06; 95% CI: 0.93-1.13). This study suggests that extreme high temperature might be a risk factor for both hemorrhagic and ischemic strokes, and that extreme low temperature might be a risk factor of hemorrhagic stroke. Further studies are necessary in order to clarify this relationship and provide evidence for stroke prevention.

Paris saponin-induced autophagy promotes breast cancer cell apoptosis via the Akt/mTOR signaling pathway.

Paris saponins possess anticancer, anti-inflammatory, and antiviral effects. However, the anticancer effect of Paris saponins has not been well elucidated and the mechanisms underlying the potential function of Paris saponins in cancer therapy are needed to be further identify. In this study, we report that saponin compounds isolated from Paris polyphylla exhibited antitumor activity against breast cancer cell lines, MCF-7 and MDA-MB-231. Paris saponin XA-2 induced apoptosis in both cell lines, as evidenced by the activation of caspases and cleavage of Poly (ADP-ribose) polymerase. The ability of XA-2 to induce autophagy was confirmed by acridine orange staining, accumulation of autophagosome-bound Long chain 3 (LC3)-II, and measurement of autophagic flux. XA-2-induced autophagy was observed to promote apoptosis by the combined treatment of breast cancer cell lines with XA-2 and autophagy inhibitors 3-methyladenine and bafilomycin A1, respectively. Moreover, we report a decrease in the levels of Akt/mTOR signaling pathway proteins, such as the phosphorylated forms of Akt, mTOR, P70S6K, and eukaryotic translation initiation factor 4E-binding protein 1 (4EBP1). Taken together, these results provide important insights explaining the anticancer activity of Paris saponins and the potential development of XA-2 as a new therapeutic agent.

Shock wave-induced ATP release from osteosarcoma U2OS cells promotes cellular uptake and cytotoxicity of methotrexate.

BACKGROUND: Osteosarcoma is the most prevalent primary malignant bone tumor, but treatment is difficult and prognosis remains poor. Recently, large-dose chemotherapy has been shown to improve outcome but this approach can cause many side effects. Minimizing the dose of chemotherapeutic drugs and optimizing their curative effects is a current goal in the management of osteosarcoma patients. METHODS: In our study, trypan blue dye exclusion assay was performed to investigate the optimal conditions for the sensitization of osteosarcoma U2OS cells. Cellular uptake of the fluorophores Lucifer Yellow CH dilithium salt and Calcein was measured by qualitative and quantitative methods. Human MTX ELISA Kit and MTT assay were used to assess the outcome for osteosarcoma U2OS cells in the present of shock wave and methotrexate. To explore the mechanism, P2X7 receptor in U2OS cells was detected by immunofluorescence and the extracellular ATP levels was detected by ATP assay kit. All data were analyzed using SPSS17.0 statistical software. Comparisons were made with t test between two groups. RESULTS: Treatment of human osteosarcoma U2OS cells with up to 450 shock wave pulses at 7 kV or up to 200 shock wave pulses at 14 kV had little effect on cell viability. However, this shock wave treatment significantly promoted the uptake of Calcein and Lucifer Yellow CH by osteosarcoma U2OS cells. Importantly, shock wave treatment also significantly enhanced the uptake of the chemotherapy drug methotrexate and increased the rate of methotrexate-induced apoptosis. We found that shock wave treatment increased the extracellular concentration of ATP and that KN62, an inhibitor of P2X7 receptor reduced the capacity methotrexate-induced apoptosis. CONCLUSIONS: Our results suggest that shock wave treatment promotes methotrexate-induced apoptosis by altering cell membrane permeability in a P2X7 receptor-dependent manner. Shock wave treatment may thus represent a possible adjuvant therapy for osteosarcoma.