Effect of Capecitabine Maintenance Therapy Using Lower Dosage and Higher Frequency vs Observation on Disease-Free Survival Among Patients With Early-Stage Triple-Negative Breast Cancer Who Had Received Standard Treatment: The SYSUCC-001 Randomized Clinical Trial.

Importance: Among all subtypes of breast cancer, triple-negative breast cancer has a relatively high relapse rate and poor outcome after standard treatment. Effective strategies to reduce the risk of relapse and death are needed. Objective: To evaluate the efficacy and adverse effects of low-dose capecitabine maintenance after standard adjuvant chemotherapy in early-stage triple-negative breast cancer. Design, Setting, and Participants: Randomized clinical trial conducted at 13 academic centers and clinical sites in China from April 2010 to December 2016 and final date of follow-up was April 30, 2020. Patients (n = 443) had early-stage triple-negative breast cancer and had completed standard adjuvant chemotherapy. Interventions: Eligible patients were randomized 1:1 to receive capecitabine (n = 222) at a dose of 650 mg/m2 twice a day by mouth for 1 year without interruption or to observation (n = 221) after completion of standard adjuvant chemotherapy. Main Outcomes and Measures: The primary end point was disease-free survival. Secondary end points included distant disease-free survival, overall survival, locoregional recurrence-free survival, and adverse events. Results: Among 443 women who were randomized, 434 were included in the full analysis set (mean [SD] age, 46 [9.9] years; T1/T2 stage, 93.1%; node-negative, 61.8%) (98.0% completed the trial). After a median follow-up of 61 months (interquartile range, 44-82), 94 events were observed, including 38 events (37 recurrences and 32 deaths) in the capecitabine group and 56 events (56 recurrences and 40 deaths) in the observation group. The estimated 5-year disease-free survival was 82.8% in the capecitabine group and 73.0% in the observation group (hazard ratio [HR] for risk of recurrence or death, 0.64 [95% CI, 0.42-0.95]; P = .03). In the capecitabine group vs the observation group, the estimated 5-year distant disease-free survival was 85.8% vs 75.8% (HR for risk of distant metastasis or death, 0.60 [95% CI, 0.38-0.92]; P = .02), the estimated 5-year overall survival was 85.5% vs 81.3% (HR for risk of death, 0.75 [95% CI, 0.47-1.19]; P = .22), and the estimated 5-year locoregional recurrence-free survival was 85.0% vs 80.8% (HR for risk of locoregional recurrence or death, 0.72 [95% CI, 0.46-1.13]; P = .15). The most common capecitabine-related adverse event was hand-foot syndrome (45.2%), with 7.7% of patients experiencing a grade 3 event. Conclusions and Relevance: Among women with early-stage triple-negative breast cancer who received standard adjuvant treatment, low-dose capecitabine maintenance therapy for 1 year, compared with observation, resulted in significantly improved 5-year disease-free survival. Trial Registration: ClinicalTrials.gov Identifier: NCT01112826.

Effective and Sustained Control of Soil-Borne Plant Diseases by Biodegradable Polyhydroxybutyrate Mulch Films Embedded with Fungicide of Prothioconazole.

Soil-borne diseases and plant rhizosphere nematode have caused many crop yield losses. Increased environmental awareness is leading to more restrictions on the use of certain fumigants and root irrigation methods due to their impact on human health and soil system. Therefore, it is necessary to find alternative treatments to maintain crop economic yields and environmental sustainability. In the present work, biodegradable antifungal mulches were prepared by blending poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (PHB) with fungicide of prothioconazole (PRO), which were used for effective and sustained control of soil-borne plant diseases. To reveal the application prospect of the PHB/PRO composite films in the management of soilborne plant diseases, some physical and biological properties were evaluated. The proper mulch film of PHB/PRO was assessed based on its mechanical and optical properties, while water solubility and the film micromorphology was further characterized. The release patterns of composite films under different pH levels were investigated. Moreover, the in vitro antifungal bioassay and pot experiment showed satisfactory bioactivity of the PHB/PRO films against Sclerotium rolfsii Sacc., a soil-borne disease in peanut fields. This study demonstrated that the biodegradable mulch films containing PRO fungicide are capable of inhibiting soil-borne plant pathogenic fungi effectively, and this facile but powerful strategy may find wide applicability in sustainable plant and horticulture protection.

A Novel Self-Assembly Nanocrystal as Lymph Node-Targeting Delivery System: Higher Activity of Lymph Node Targeting and Longer Efficacy Against Lymphatic Metastasis.

Mitoxantrone (MTO) is used to treat certain types of cancer, mostly metastatic cancer. While the drug has poor aqueous solubility and high side effects. Self-assembly nanocrystal is a novel lymphatic targeting delivery system. In our study, MTO self-assembly nanocrystal (MTO NC) was successfully prepared to improve lymphatic targeting ability and reduce its toxicity. MTO NCs had small size, stable potential, and uniform distribution. The average particle size of MTO NCs was less than 100 nm with the 0.218 PDI and - 6.6 mV the Zeta potential value. TEM images showed that MTO NCs had a sphere-like morphology with smooth surface and uniform distribution; Atomic force microscopy (AFM) images gave a 3D surface of MTO NCs. Polarizing microscope micrograph (PLM) of MTO NCs in lymph nodes demonstrated the crystal structure of MTO NCs when it was exposed to physiological condition. Transmission electron microscopy showed the presence of MTO NCs in mice lymph nodes. Pharmacokinetic parameters of MTO strongly demonstrated that MTO NCs could target the lymph nodes after subcutaneous injection. Moreover, tissue distribution results indicated that MTO NCs were mainly absorbed by the lymphatics and reduced system toxicity. Finally, a lymphatic metastasis mice model was established to precede the pharmacodynamics of MTO NCs, and using MTO liposomes as a reference preparation, the inhibitory effect of MTO NCs on lymphatic metastasis was markedly higher. Briefly, MTO NCs, as a novel self-assembled lymphatic targeting system, can accumulate in the metastatic lymph nodes and lead anticancer drug to kill cancer cells and control lymphatic metastasis with extremely low systemic toxicity.

A sensitive chemiluminescence enzyme immunoassay based on molecularly imprinted polymers solid-phase extraction of parathion.

The chemiluminescence enzyme immunoassay (CLEIA) method responds differently to various sample matrices because of the matrix effect. In this work, the CLEIA method was coupled with molecularly imprinted polymers (MIPs) synthesized by precipitation polymerization to study the matrix effect. The sample recoveries ranged from 72.62% to 121.89%, with a relative standard deviation (RSD) of 3.74-18.14%.The ratio of the sample matrix-matched standard curve slope rate to the solvent standard curve slope was 1.21, 1.12, 1.17, and 0.85 for apple, rice, orange and cabbage in samples pretreated with the mixture of PSA and C18. However, the ratio of sample (apple, rice, orange, and cabbage) matrix-matched standard-MIPs curve slope rate to the solvent standard curve was 1.05, 0.92, 1.09, and 1.05 in samples pretreated with MIPs, respectively. The results demonstrated that the matrices of the samples greatly interfered with the detection of parathion residues by CLEIA. The MIPs bound specifically to the parathion in the samples and eliminated the matrix interference effect. Therefore, the CLEIA method have successfully applied MIPs in sample pretreatment to eliminate matrix interference effects and provided a new sensitive assay for agro-products.

Polysaccharide-based biopolymer hydrogels for heavy metal detection and adsorption.

BACKGROUND: With rapid development in agriculture and industry, water polluted with heavy metallic ions has come to be a serious problem. Adsorption-based methods are simple, efficient, and broadly used to eliminate heavy metals. Conventional adsorption materials have the problems of secondary environmental contamination. Hydrogels are considered effective adsorbents, and those prepared from biopolymers are biocompatible, biodegradable, non-toxic, safe to handle, and increasingly used to adsorb heavy metal ions. AIM OF REVIEW: The natural origin and easy degradability of biopolymer hydrogels make them potential for development in environmental remediation. Its water absorption capacity enables it to efficiently adsorb various pollutants in the aqueous environment, and its internal pore channels increase the specific surface area for adsorption, which can provide abundant active binding sites for heavy metal ions through chemical modification. KEY SCIENTIFIC CONCEPT OF REVIEW: As the most representative of biopolymer hydrogels, polysaccharide-based hydrogels are diverse, physically and chemically stable, and can undergo complex chemical modifications to enhance their performance, thus exhibiting superior ability to remove contaminants. This review summarizes the preparation methods of hydrogels, followed by a discussion of the main categories and applications of polysaccharide-based biopolymer hydrogels.

Personalized three-dimensional printed polyether-ether-ketone prosthesis for reconstruction after subtotal removal of chronic clavicle osteomyelitis: A case report.

RATIONALE: Three-dimensional (3D) printing has attracted wide attention for its potential and abilities in the assistance of surgical planning and the development of personalized prostheses. We herewith report a unique case of chronic clavicle osteomyelitis treated with a two-stage subtotal clavicle reconstruction using a 3D printed polyether-ether-ketone (PEEK) prosthesis. PATIENT CONCERNS: A 23-year-old Chinese female presented to our clinic complaining about a progressive pain of her right clavicle for about 1 year. DIAGNOSES: Chronic clavicle osteomyelitis confirmed by percutaneous biopsy and lesion biopsy. INTERVENTIONS: This patient accepted a long-term conservative treatment, which did not gain satisfactory outcomes. Thus, a subtotal removal and two-stage reconstruction of the right clavicle with a 3D-printed polyether-ether-ketone prosthesis stabilized by screw fixation system was performed. OUTCOMES: At 2-year follow-up, complete pain relief and satisfactory functional recovery of her right shoulder were observed. LESSONS: Personalized 3D printed prosthesis is an effective and feasible method for reconstruction of complex bone defects.

Mussel-inspired triple bionic adsorbent: Facile preparation of layered double hydroxide@polydopamine@metal-polyphenol networks and their selective adsorption of dyes in single and binary systems.

To effectively address the serious human health challenges and ecological damage caused by organic dyes in wastewater, we developed a novel bionic adsorbent (LDH@PDA@MPNs) for the selective adsorption and removal of malachite green (MG) and crystalline violet (CV). The adsorbent was prepared using a facile two-step method based on mussel-inspired chemistry and metal complexation. The physicochemical structure, surface morphology, and composition of the LDH@PDA@MPNs were characterized by scanning electron microscopy, Fourier-transform infrared spectrometry, X-ray photoelectron spectroscopy, and thermogravimetric analysis. Adsorption of MG and CV with the LDH@PDA@MPNs was evaluated. Under optimal conditions, the maximum adsorption of MG and CV by the adsorbent was 89.608 and 40.481 mg/g, respectively. The adsorption kinetics showed that the experimental data were in good agreement with the pseudo-second-order kinetic model, and the equilibrium adsorption isotherm data fitted well with the Freundlich model. The thermodynamic results indicated that the adsorption of the dyes on LDH@PDA@MPNs was a spontaneous endothermic process. Importantly, the bionic adsorbent not only shows high removal efficiency by easy regeneration with low-cost reagents but also exhibits high selectivity for dyes in both single and binary systems. Therefore, LDH@PDA@MPNs have the potential to adsorb and remove dyes from complex wastewater solutions.

Technique Nuances for Functional Preservation of Lower Cranial Nerves during Surgical Management of Ventral Foramen Magnum Meningiomas Via a Dorsal Lateral Approach.

BACKGROUND: This study established novel technique nuances in surgery for ventral foramen magnum meningiomas (vFMMs) via a dorsal lateral approach. METHODS: From July 2012 to July 2019, 37 patients with vFMMs underwent tumor resection surgery and were operated on with a dorsal lateral approach. Two safe zones were selected as the entrance of the surgical corridor. Safe zone I was located between the dural attachment of the first dental ligament (FDL) and the branches of C1; safe zone II lay between the dural attachment of the FDL and the jugular foramen. The tumor was debulked first through safe zone I and then through safe zone II. The tumor was removed through a trajectory from the caudal to cephalad to allow tumor debulking from below and downward delivery, away from the brainstem and lower cranial nerves. RESULTS: Thirty-three patients underwent gross total resection, and 4 patients underwent subtotal resection. Four patients transiently required a nasogastric feeding tube. All patients recovered within 3 months postoperatively. Three patients (8.1%) developed permanent mild hoarseness and dysphagia as a result of postoperative damage of cranial nerves IX and X. One patient underwent tracheotomy. No patient experienced tumor recurrence during the follow-up period. CONCLUSIONS: We established a minimal retraction principle, in which the selection of 2 safe zones as the entrance of the surgical corridor, tumor removal from the inferior to superior direction, and debulking followed by devascularization were the key elements to implement the minimal retraction principle in vFMM surgery.

Pursuing for the better lung cancer therapy effect: Comparison of two different kinds of hyaluronic acid and nitroimidazole co-decorated nanomedicines.

Lung cancer remains the leading cause of cancer associated deaths worldwide. Compared with traditional chemotherapy for non-small cell lung cancer (NSCLC), specific targeted therapies are better choices for advanced patients to improve their survival. In this study, we attempted to fabricate Nitroimidazoles (NI) and Hyaluronic acid (HA) co-decorated, cisplatin (DDP) loaded polymeric nanoparticles (PNPs) (NI/HA-DDP-PNPs) and lipid-polymer hybrid nanoparticles (LPNs) (NI/HA-DDP-LPNs) for the facilitated drug delivery at lung tumor regions (hypoxic regions). In vitro cytotoxicity and cellular uptake; In vivo anti-tumor activity and in vivo tissue biodistribution of PNPs and LPNs were evaluated and compared in lung carcinoma cells and xenograft. Hydrodynamic size of NI/HA-DDP-LPNs was 185.6 ± 4.7 nm, which is larger than that of NI/HA-DDP-PNPs (136.7 ± 3.5 nm). The zeta potential of NI/HA-DDP-PNPs (-31.2 ± 2.7 mV) was more negative than NI/HA-DDP-LPNs (-22.3 ± 2.1 mV). The peak plasma concentration (Cmax) achieved from NI/HA-DDP-PNPs and NI/HA-DDP-LPNs was 35.2 ± 1.6 and 37.3 ± 1.7 µg/mL. The half-life (T1/2) of NI/HA-DDP-PNPs and NI/HA-DDP-LPNs was 12.03 ± 0.75 and 11.78 ± 0.89 h. Area Under Curve (AUC) of NI/HA-DDP-PNPs and NI/HA-DDP-LPNs showed no significant difference while greater than other groups. NI/HA-DDP-LPNs exhibited excellent antitumor effect against drug-resistant human lung cancer A549/DDP cells in vitro and in vivo, better than that of NI/HA-DDP-PNPs. Considering that the low toxicity of NI/HA-DDP-LPNs and NI/HA-DDP-PNPs, NI/HA-DDP-LPNs could be a more promising system for lung cancer targeted therapy.

Combination Chemotherapy of Lung Cancer - Co-Delivery of Docetaxel Prodrug and Cisplatin Using Aptamer-Decorated Lipid-Polymer Hybrid Nanoparticles.

PURPOSE: Lung cancer is the leading cause of cancer mortality worldwide. Drug resistance is the major barrier for the treatment of non-small cell lung cancer (NSCLC). The aim of this research is to develop an aptamer-decorated hybrid nanoparticle for the co-delivery of docetaxel prodrug (DTXp) and cisplatin (DDP) and to treat lung cancer. MATERIALS AND METHODS: Aptamer-conjugated lipid-polymer ligands and redox-sensitive docetaxel prodrug were synthesized. DTXp and DDP were loaded into the lipid-polymer hybrid nanoparticles (LPHNs). The targeted efficiency of aptamer-decorated, DTXp and DDP co-encapsulated LPHNs (APT-DTXp/DDP-LPHNs) was determined by performing a cell uptake assay by flow cytometry-based analysis. In vivo biodistribution and anticancer efficiency of APT-DTXp/DDP-LPHNs were evaluated on NSCLC-bearing mice xenograft. RESULTS: APT-DTXp/DDP-LPHNs had a particle size of 213.5 ± 5.3 nm, with a zeta potential of 15.9 ± 1.9 mV. APT-DTXp/DDP-LPHNs exhibited a significantly enhanced cytotoxicity (drug concentration causing 50% inhibition was 0.71 ± 0.09 µg/mL), synergy antitumor effect (combination index was 0.62), and profound tumor inhibition ability (tumor inhibition ratio of 81.4%) compared with the non-aptamer-decorated LPHNs and single drug-loaded LPHNs. CONCLUSION: Since the synergistic effect of the drugs was found in this system, it would have great potential to inhibit lung tumor cells and in vivo tumor growth.

Preparation and biocompatibility evaluation of polypropylene mesh coated with electrospinning membrane for pelvic defects repair.

Composite mesh with different materials composition could compensate for the drawbacks brought by single component mesh. Coating a membrane layer on the surface of macroporous mesh is a common method for preparing composite medical mesh. Electrospinning and dipping methods were introduced to form the two kinds of membrane-coated PP meshes (electro-mesh and dip-mesh); several properties were measured based on subcutaneous implantation model in rat. The results revealed that continuous tissue ingrowth could be observed for electro-mesh only with evidences of strength increase (electro-mesh: 0 week - 13.1 ±â€¯0.88 N, 2 week - 16.87 ±â€¯1.39 N, 4 week - 22.04 ±â€¯2.05 N) and thickness increase (electro-mesh: 0 week - 0.437 ±â€¯0.023 mm, 2 week - 0.488 ±â€¯0.025 mm, 4 week - 0.576 ±â€¯0.028 mm). However, no tissues were observed for dip-mesh in the first 2 weeks, both on macroscopic level and microscopic level, proved by strength data (dip-mesh: 0 week - 13.36 ±â€¯1.06 N, 2 week - 13.4 ±â€¯1.33 N, 4 week - 18.61 ±â€¯1.89 N) and thickness data (dip-mesh: 0 week - 0.439 ±â€¯0.018 mm, 2 week - 0.439 ±â€¯0.019 mm, 4 week - 0.502 ±â€¯0.032 mm). Electro-mesh had larger surface area decrease (10.74 ±â€¯1.22%) than that of dip-mesh (2.78 ±â€¯0.52%). The adhesion level of electro-mesh (medium adhesion) was also higher than that of dip-mesh (mild adhesion). Even if showing differences in several properties, both meshes were similar under histological observation, with the ability to support fresh tissues ingrowth. Considering operation environment, electro-mesh seems more suitable than dip-mesh with a rapid tissue growing, medium adhesion rate for repairing pelvic floor defects.

Thermosensitive Hydrogel System With Paclitaxel Liposomes Used in Localized Drug Delivery System for In Situ Treatment of Tumor: Better Antitumor Efficacy and Lower Toxicity.

Intratumoral delivery of chemotherapeutic agents may provide drug localization within the tumor and divert the drug from nontarget organs to improve toxicity and increase efficacy. Thermosensitive injectable hydrogel system may be suitable for the treatment of pancreatic cancer. A study was carried out to examine the efficacy and toxicity of paclitaxel (PTX) liposome gel as a local chemotherapy system against pancreatic cancer in tumor-bearing mice model. The thermosensitive hydrogel we prepared had an appropriate sol-to-gel transition temperature and particle size and morphology study showed this new dosage form possessed physical stability of drug without precipitation and particle size growth of liposome. PTX-lip-gel release in vitro showed a much more slowly release than PTX-lip. The PTX-lip-gel system was proven to have a good retention inside of tumor tissue by intratumoral retention experiments. The in vivo trials showed a better balance between antitumor efficacy and systemic safety in PTX-lip-gel group than in other groups at the equal drug dose. In conclusion, the PTX-lip-gel we prepared in this study provided a high local PTX concentration, sustained and stable drug release, extend drug retention inside of tumor, and low toxicity to normal tissues.

Fluorescent molecular imaging of metastatic lymph node using near-infrared emitting low molecular weight heparin modified nanoliposome based on enzyme-substrate interaction.

Tumor metastatic lymph node mapping has been widely used to predict the metastatic spread of primary tumor and guide the lymph node dissection in clinical practice. In this research, a new near-infrared (NIR)-emitting low molecular weight heparin (LMWHEP)-modified Cy7-loaded nanoliposome (LMWHEP-NLips/Cy7) was developed and had the particle size of about 80 nm and the fluorescence intensity of about 2300, which is optimal for metastatic lymph node uptake and imaging. The NIR-emitting nanoliposomes were designed by LMWHEP coating on the surface of Cy7-loaded nanoliposome (NLips/Cy7) according to electrostatic attraction. The LMWHEP-NLips/Cy7 with negligible cytotoxicity for Hela and RAW264.7 cells and was found to be fluorescent stability compared with the Cy7-free dye at room temperature. The BALB/c nude mice bearing tumor lymphatic metastasis was established at eighth week post-injection by subcutaneously injecting Hela cells suspension. Heparanase (HPA) expression concentrations quantitatively measured by ELISA kit respectively were 237.42U/mL, 214.82U/mL and 128.45U/mL in the extracellular Hela cells, metastatic popliteal and iliac lymph node. LMWHEP-NLips/Cy7 successfully increased fluorescence signal in the metastatic lymph node compared with normal lymph node and achieve in vivo and ex vivo high fluorescence signal within 10 min and retention time up to 4 h post-injection. Maximum mean fluorescence intensity of the LMWHEP-NLips/Cy7 group was significantly more than NLips/Cy7 group (increase 2-fold in the metastatic popliteal lymph node and 4.8-fold in the metastatic iliac lymph node, p < 0.05). The experimental results demonstrating LMWHEP-NLips/Cy7 have the potential utility as specific, biosafe and stable near-infrared imaging contrast agents for HPA-expression tumor metastatic lymph node mapping. Copyright © 2016 John Wiley & Sons, Ltd.

A Near Infrared Light Triggered Hydrogenated Black TiO2 for Cancer Photothermal Therapy.

White TiO2 nanoparticles (NPs) have been widely used for cancer photodynamic therapy based on their ultraviolet light-triggered properties. To date, biomedical applications using white TiO2 NPs have been limited, since ultraviolet light is a well-known mutagen and shallow penetration. This work is the first report about hydrogenated black TiO2 (H-TiO2 ) NPs with near infrared absorption explored as photothermal agent for cancer photothermal therapy to circumvent the obstacle of ultraviolet light excitation. Here, it is shown that photothermal effect of H-TiO2 NPs can be attributed to their dramatically enhanced nonradiative recombination. After polyethylene glycol (PEG) coating, H-TiO2 -PEG NPs exhibit high photothermal conversion efficiency of 40.8%, and stable size distribution in serum solution. The toxicity and cancer therapy effect of H-TiO2 -PEG NPs are relative systemically evaluated in vitro and in vivo. The findings herein demonstrate that infrared-irradiated H-TiO2 -PEG NPs exhibit low toxicity, high efficiency as a photothermal agent for cancer therapy, and are promising for further biomedical applications.

Analysis of Mtwo rotary instrument separation during endodontic therapy: a retrospective clinical study.

To analyze the incidence of instrument separation (IS) and the factors influencing it, when associated with Mtwo rotary system (VDW, Munich, Germany) during endodontic therapy. A retrospective study involving a total of 24,108 root canals (11,036 endodontic treated teeth) was conducted at Nanjing Stomatology Hospital between January 2011 and March 2013. The information included were tooth type, root canal curvature, number of fractured instruments, length of the separated fragments, and the distance from broken tip to apex. The incidence of IS was observed to be 2.2 % according to the number of teeth and 1.0 % according to the number of root canals. Many of the separated fragments were 2-4 mm in length and the mean length was 3.07 ± 1.46 mm, and 78.4 % of fractures occurred in the apex. The mean length of separated fragments in severely curved canals was maximum, while ultra-severe curved canals was observed to be minimum. Mtwo instruments demonstrated an extremely low fracture rate during endodontic therapy. Molar teeth (especially lower molars) and the degree of canal curvature had a significant effect on the incidence of IS.

Bio-inspired synthesis of titania with polyamine induced morphology and phase transformation at room-temperature: insight into the role of the protonated amino group.

Poly(allylamine hydrochloride) (PAAH), a mimic of biopolyamines, was used to induce the mineralization of titania at room-temperature, hollow spheres with a mixed phase (anatase and rutile) were obtained, and the fine anatase and rutile nanocrystals were observed mixing at the sub-10 nm scale on the hollow spheres. The structural information about the precipitated titania gained by transmission electron microscopy, X-ray diffraction, and X-ray photoelectron spectroscopy revealed a distinct dependence of the polymorph and morphology of the titania precipitates on the molecular structure of the polyamines and titanium precursors. Moreover, we have observed the phase transformation from anatase to rutile in the formation process of hollow spheres, and it was suggested that the protonated amino groups on PAAH played key roles in the transformation of both polymorphs and morphologies of titania. Additionally, poly(diallyldimethylammonium chloride) (PDDA), a long chain quaternary ammonium polymer, was used as another catalytic template for the synthesis of titania, which also led to a hollow structure with a mixture of anatase and TiO2-B.

Biomimetic layer-by-layer Co-mineralization approach towards TiO2/Au nanosheets with high rate performance for lithium ion batteries.

We fabricated a sandwich-like branched-polyethyleneimine (b-PEI)/TiO2/Au/graphene oxide (GO) nanocomposite through a biomimetic layer-by-layer co-mineralization approach, and the polymer b-PEI was believed to act as both an inducing agent for the hydrolysis of titanium bis(ammonium lactato)-dihydroxide (Ti-BALDH) and a reducing agent for the reduction of HAuCl4 in the synthetic procedure. Upon organic pyrolysis in air at 500 °C, a TiO2/Au nanosheet was formed; and gold nanocrystals were observed uniformly dispersed on TiO2 nanosheet. Moreover, the obtained TiO2/Au nanosheets demonstrated an enhanced lithium storage performance when they are used as anode materials for lithium ion batteries (LIBs), particularly, a high capacity of 205 mA h g(-1) and 189 mA h g(-1) was obtained at 5 C and 10 C rate, respectively, indicating the high rate capability of the material. The greatly improved rate performance might be attributed from both the sheet-like nanostructure and the existence of uniformly dispersed gold nanocrystals, which facilitate electron transfer and lithium ions diffusion in the material. The result suggests that the TiO2 electrode performance can be improved through a design of sheet-like nanocomposites using a bio-inspired route, which is desirable for both "green synthesis" and application for high power LIBs, moreover, such a benign bio-inspired route can be developed into a general pathway to synthesize many other TiO2 based nanocomposites for broad applications in the fields of batteries, photoelectrochemistry, photocatalysis and dye-sensitized solar cells.

A new plastic model of endoscopic technique training for endonasal transsphenoidal pituitary surgery.

BACKGROUND: Endoscopic transsphenoidal approach is a minimally invasive surgical technique for the removal of sellar and parasellar lesions, which has been progressively accepted by neurosurgeons. However, frustration is often expressed by neurosurgeons when first attempting endoscopic endonasal pituitary surgery. To overcome the learning curve from microscope to endoscope in a smooth way, a new human nasal model has been developed. The present study assessed this new model of the human paranasal sinuses for endonasal surgery training, particularly for endonasal pituitary surgery training. METHODS: The procedure for endonasal transsphenoidal endoscopy was performed using this model. Three approaches were used to observe the endonasal structures and sphenoidal sinus: paraseptal; middle turbinectomy; and middle meatal. Attempts were made to identify anatomical landmarks in the nasal cavity and sphenoidal sinus. Model landmarks were compared with those in a cadaver and a real patient. RESULTS: This model precisely reproduced nasal bone structure. Compared with cadavers and living bodies, intranasal structures displayed very good color and texture, providing a close facsimile of the operative environment, and good morphology, with similar hardness and tactile feel on resection. All intranasal anatomical landmarks were easily identified, including choanae, inferior, middle and superior turbinates, and even the natural ostium of the sphenoidal sinus. CONCLUSION: This human nasal model is very useful for training neurosurgeons in endoscopic endonasal transsphenoidal pituitary surgery, but typical anatomical landmarks in the posterior wall of the sphenoidal sinus in this model should be improved.