[en] This study aimed to evaluate whether placing dose constraints on the brachial plexus (BP) could provide dosimetric benefits in patients with nasopharyngeal carcinoma (NPC) undergoing intensity-modulated radiation therapy (IMRT). Planning CT images for 30 patients with NPC treated with definitive IMRT were retrospectively reviewed. Target volumes, the BP and other critical structures were delineated; two separate IMRT plans were designed for each patient: one set no restrictions for the BP; the other considered the BP as a critical structure for which a maximum dose limit of ≤66 Gy was set. No significant differences between the two plans were observed in the conformity index, homogeneity index, maximum dose to the planning target volumes (PTVs), minimum dose to the PTVs, percentages of the volume of the PTVnx and PTVnd receiving more than 110% of the prescribed dose, or percentages of the volume of the PTVs receiving 95% and > 93% of the prescribed dose. Dose constraints significantly reduced the maximum dose, mean dose, V45, V50, V54, V60, V66 and V70 to the BP. Dose constraints significantly reduced the maximum dose to the BP, V45, V60 and V66 in both N0–1 and N2–3 disease; however, the magnitude of the dosimetric gain for each parameter between N0–1 and N2–3 disease was not significantly different, except for the V60 and V66. In conclusion, placing dose constraints on the BP can significantly decrease the irradiated volume and dose, without compromising adequate dose delivery to the target volume. (author)

[en] The interfacial pH value has a marked effect on cell viability because the pro-mineralization activity of osteoblasts increases at alkaline extracellular pH, whereas the pro-resorptive activity of osteoclasts increases under more acidic conditions. To obtain the more favorable alkaline interface, we developed a novel nanotube layer that was incorporated with magnesium oxide on a titanium implant substrate (MgO/NT/Ti) via ethylenediamine tetraacetic acid (EDTA) chelation. This facile immersion-annealing process successfully created a homogeneous magnesium oxide layer with sustained release kinetics and superior hydrophilicity according to the surface characterization and microenvironment measurement. The titania nanotubes on the substrate with an anatase phase exhibited a lower passivation current and a more positive corrosion potential compared with pure titanium, which guaranteed a reasonable corrosion resistance, even when it was wrapped with a magnesium oxide layer. In vitro cell cultures showed that MgO/NT/Ti significantly increased cell proliferation and alkaline phosphatase (ALP) activity. The resulting alkalescent microenvironment created by the MgO layer encouraged the cells to spread into polygonal shapes, accelerated the differentiation stage to osteoblast and induced a higher expression of vinculin. In summary, the incorporated alkalescent microenvironment of MgO/NT/Ti provided a viable approach to stimulate cell proliferation, adhesion, and differentiation and to improve the implant osseointegration. - Highlights: • We developed a novel nanotube layer incorporated with magnesium oxide to obtain a favorable alkaline interface. • The homogeneous magnesium oxide layer exhibited sustained release kinetics. • The resulting alkalescent microenvironment provided a viable approach to improve the implant osseointegration.

[en] Zwitterionic materials as a new class of emerging materials have recently been developed and applied to a broad range of biomedical and engineering applications. Zwitterionic materials possess a unique molecular structure combining both cationic and anionic groups with overall charge neutrality and high hydrophilicity. In this review, we first provide the structure-property relationship of the zwitterionic materials at molecular level, from a molecular simulation viewpoint. Then, we discuss the recent experimental developments in the preparation, properties, and applications of zwitterionic materials, with a particular focus on their antifouling properties on coating surfaces and with additional functionality and applications. Finally, we offer our personal viewpoint of current challenges and future directions in this emerging area. Our goal is to introduce the current status of this type of new zwitterionic materials to researchers from different areas and motivate them to explore all the potentials. (topical review)