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In American men, the incidence of prostate cancer (PC) is the highest among all types of cancer, making it the second leading cause of mortality associated with cancer. For advanced or metastatic PC, antiandrogen therapies are standard treatment options. The administration of these treatments unfortunately carries the potential risk of inducing neuroendocrine prostate cancer (NEPC). Neuroendocrine differentiation (NED) serves as a crucial indicator of prostate cancer development, encompassing various factors such as phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR), Yes-associated protein 1 (YAP1), AMP-activated protein kinase (AMPK), miRNA. The processes of autophagy and ferroptosis (an iron-dependent form of programmed cell death) play pivotal roles in the regulation of various types of cancers. Clinical trials and preclinical investigations have been conducted on many signaling pathways during the development of NEPC, with the deepening of research, autophagy and ferroptosis appear to be the potential target for regulating NEPC. Due to the dual nature of autophagy and ferroptosis in cancer, gaining a deeper understanding of the developmental programs associated with achieving autophagy and ferroptosis may enhance risk stratification and treatment efficacy for patients with NEPC.

Background: Magnetic resonance imaging of peripheral nerves in the wrist and palm is challenging due to the small size, tortuous course, complex surrounding tissues, and accompanying blood vessels. The occurrence of carpal palmar lesions leads to edema, swelling, and mass effect, which may further interfere with the display and identification of nerves. Objective: To evaluate whether contrast-enhanced magnetic resonance neurography (ceMRN) improves the visualization of the morphology and pathology of the median, ulnar nerves, and their small branches in the wrist and palm. Design: An observational study. Methods: In total 57 subjects, including 36 volunteers and 21 patients with carpal palmar lesions, were enrolled and underwent ceMRN and non-contrast MRN (ncMRN) examination at 3.0 Tesla. The degree of vascular suppression, nerve visualization, diagnostic confidence, and lesion conspicuity was qualitatively assessed by two radiologists. Kappa statistics were obtained for inter-reader agreement. The signal-to-noise ratio, contrast ratio (CR), and contrast-to-noise ratio (CNR) of the median nerve were measured. The subjective ratings and quantitative measurements were compared between ncMRN and ceMRN. Results: The inter-reader agreement was excellent ( k > 0.8) for all qualitative assessments and visualization assessment of each nerve segment. Compared with ncMRN, ceMRN significantly improved vascular suppression in volunteers and patients (both p

Abstract The association and underlying mechanisms between iron deposition and white matter hyperintensity (WMH) remain unclear. In this study, quantitative susceptibility mapping (QSM) was used to quantify deep gray matters iron deposition and to explore the association from both global and regional perspectives. A total of 84 patients with hypertension and 26 healthy controls underwent a strategically acquired gradient echo (STAGE) protocol, and the multi‐echo data were used to reconstruct QSM images. The susceptibilities were used to describe iron content. Global region (RI) susceptibilities were measured in regions of interest, and age‐related thresholds were used to determine high‐iron content region (RII) susceptibilities. Compared with healthy controls, hypertension had higher total WMH scores and regional scores (all p = .001) and higher susceptibilities using the RI or RII analysis (all p

Summary: The development of castration-resistant prostate cancer (CRPC) is driven by intricate genetic and epigenetic mechanisms. Traf2- and Nck-interacting kinase (TNIK) has been reported as a serine/threonine kinase associated with tumor cell proliferation or unfavorable cancer behavior. The microarray approach revealed a substantial upregulation of TNIK expression levels, enabling us to investigate the functional behaviors of the TNIK gene in CRPC. Specifically, we discovered that AR suppresses TNIK gene transcription in LNCaP and C4-2 cells by forming a complex with H3K27me3. Following the reduction of AR levels induced by androgen deprivation therapy (ADT), TNIK is recruited to activate EGFR signaling through phosphorylation in C4-2 cells, thereby promoting CRPC progression. Our findings unveil a regulatory role of AR as a repressor for TNIK while also highlighting how TNIK activates the EGFR pathway via phosphorylation to drive CRPC progression. Consequently, targeting TNIK may represent an appealing therapeutic strategy for CRPC.

The emergence of castration-resistant prostate cancer (CRPC) following androgen deprivation therapy (ADT) is associated with increased malignancy and limited treatment options. This study aims to investigate potential connections between immune cell infiltration and inflammatory cytokines with the YAP1/AR/PSA axis by exploring their interactions with autophagy. Our research reveals heightened levels of Yes-associated protein 1 (YAP1) expression in CRPC tissues compared with tissues from androgen-dependent prostate cancer (ADPC) and benign prostate hyperplasia (BPH). Additionally, a correlation was observed between YAP1 and PSA expressions in CRPC tissues, suggesting that YAP1 may exert a regulatory influence on PSA expression within CRPC. Enhanced YAP1 expression in C4-2 cells resulted in the upregulation of androgen receptor (AR) nuclear translocation and intracellular prostate-specific antigen (PSA) levels. Conversely, the suppression of YAP1 led to a decrease in PSA expression, suggesting that YAP1 may positively regulate the PSA in castration-resistant prostate cancer (CRPC) by facilitating AR nuclear import. The modulation of the autophagy activity exerts a significant impact on the expression levels of YAP1, the AR, and the PSA. Moreover, recent advancements in immunity and inflammation studies present promising avenues for potential therapies targeting prostate cancer (PC).

Abstract Prostate cancer is a major disease that threatens men’s health. Its rapid progression, easy metastasis, and late castration resistance have brought obstacles to treatment. It is necessary to find new effective anticancer methods. Ferroptosis is a novel iron-dependent programmed cell death that plays a role in various cancers. Understanding how ferroptosis is regulated in prostate cancer will help us to use it as a new way to kill cancer cells. In this review, we summarize the regulation and role of ferroptosis in prostate cancer and the relationship with AR from the perspective of metabolism and molecular pathways. We also discuss the feasibility of ferroptosis in prostate cancer treatment and describe current limitations and prospects, providing a reference for future research and clinical application of ferroptosis.

Abstract A common stage of advanced prostate cancer is castration-resistant prostate cancer (CRPC), greater understanding of which is required in order to address and solve the clinically difficult challenge. Cathepsin K (CTSK) is a cysteine protease that usually has a strong activity of degrading extracellular matrix and is related to osteoclast-mediated bone destruction. However, the mechanism of CTSK-regulation in CRPC is still unclear to us. The current study aimed to analyze the expression of differentially expressed genes (DEGs) in patient samples (from localized PC and CRPC). Interestingly, we found that CTSK to be significantly up-regulated in CRPC. Through further signal pathway enrichment analysis, we found that the IL-17 signaling pathway to be highly correlated with CTSK. The oncogenic functions of CTSK and IL-17 in CRPC were proven by a series of in vivo and in vitro experiments. Possible downstream molecules of CTSK were investigated, which could serve as control elements to regulate the expression of EMT, thereby facilitating the metastasis and excessive proliferation of PC cells. Expression of CTSK was related to high concentration of M2 tumor-associated macrophages (TAMs) M2 in CRPC. A CTSK-mediated feedback circuit between TAMs and CRPC tissues was indicated in the process of transfer, proving the possibility of CTSK could be use as an available therapeutic target for CRPC.

Thermal maturity of the shales from the Ziliujing Formation of the Jurassic age in the Sichuan Basin is in the hydrocarbon generation window, which makes it a candidate for shale oil and gas development. The meso- and macropore characteristics and heterogeneity of shales are important factors affecting the occurrence and development of oil and gas. However, the meso- and macropores of the Ziliujing shales have not been systematically studied. Thus, the mineral compositions and total organic carbon (TOC) of samples from this formation, as well as its pore structure, are analyzed by low-temperature N2 adsorption technique. Moreover, the heterogeneity of the pores was determined by multifractal analysis. The results show that the Ziliujing shales can be classified into three types according to the distributions of mineral compositions of carbonate and mixed and argillaceous shales. Results revealed that the smallest meso- and macropore volume (PV), the smallest specific surface area (SSA), and the largest average pore diameter (APD) occur in the carbonate shales. However, the largest PV and SSA and the smallest APD are observed in the argillaceous shales. The porosity of carbonate shales is mainly concentrated between 5 nm and 30 nm. Compared with carbonate shales, the porosity with pore sizes less than 30 nm of mixed and argillaceous shales shows a rapid increase. Furthermore, inorganic minerals are the main factors affecting the pore distributions, while TOC shows a weak effect. Herein, clay minerals significantly increase the mesopore volume and the pore number with a size of less than 30 nm. The Dq-q curves reveal that the meso- and macropore distributions of Ziliujing shales show multifractal behavior, but the multifractal characteristics of pores of various shales are distinctly different. The information dimension D1, the Hurst exponent H, and the width of the right side D0–D10 are key indicators to distinguish the local variations within the pore structure of different types of shales. The carbonate shales have the largest multifractal spectra width and the smallest D1 and H, while the opposite trend is found for the argillaceous shales. Clay minerals reduce the heterogeneity of the meso- and macropore distributions and increase the pore connectivity. Nevertheless, the carbonate minerals exhibit a reverse trend. Finally, it was found that TOC does not impact pore complexity as much. Collectively, this study supports our understanding of the occurrence of shale oil within various reservoir facies, thereby providing a guideline for future explorations in the Ziliujing Formation of the Jurassic age in the Sichuan Basin.

Abstract Background The incidence of bladder urothelial carcinoma (UC), a common malignancy of the urinary tract, is approximately three times higher in men than in women. High expression of the mitotic kinase BUB1 is associated with the occurrence and development of several cancers, although the relationship between BUB1 and bladder tumorigenesis remains unclear. Methods Using a microarray approach, we found increased BUB1 expression in human BCa. The association between BUB1 and STAT3 phosphorylation was determined through molecular and cell biological methods. We evaluated the impact of pharmacologic inhibition of BUB1 kinase activity on proliferation and BCa progression in vitro and in vivo. Results In this study, we found that BUB1 expression was increased in human bladder cancer (BCa). We further identified through a series of molecular and cell biological approaches that BUB1 interacted directly with STAT3 and mediated the phosphorylation of STAT3 at Ser727. In addition, the findings that pharmacologic inhibition of BUB1 kinase activity significantly suppressed BCa cell proliferation and the progression of bladder cancer in vitro and in vivo were further verified. Finally, we found that the BUB1/STAT3 complex promoted the transcription of STAT3 target genes and that depletion of BUB1 and mutation of the BUB1 kinase domain abrogated this transcriptional activity, further highlighting the critical role of kinase activity in the activation of STAT3 target genes. A pharmacological inhibitor of BUB1 (2OH-BNPP1) was able to significantly inhibit the growth of BCa cell xenografts. Conclusion This study showed that the BUB1 kinase drives the progression and proliferation of BCa by regulating the transcriptional activation of STAT3 signaling and may be an attractive candidate for therapeutic targeting in BCa.

Shale in the Jurassic Lianggaoshan Formation in central Sichuan exhibits strong heterogeneity. The study of the pore structure characteristics of different lithologies is crucial to the selection of the target interval. Shale samples of the Lianggaoshan Formation from well YS5 in the central part of the Sichuan Basin were analyzed using scanning electron microscopy, low-temperature nitrogen adsorption, high-pressure mercury injection (HPMI), and large -field splicing method -based scanning electron microscopy (LFS-SEM) to elucidate the pore structure characteristics of shale and their influencing factors. The mineral composition of the reservoir in the study area was diverse, primarily consisting of clay minerals, followed by quartz and calcite. The reservoir space comprised intergranular, granular, and organic matter pores, and oil was observed to fill the reservoir space. Reservoir characteristics varied with the lithological properties. In clayey shale, intergranular pores located in clay mineral particles and pores between pyrite and natural fractures were mainly observed, with a bimodal distribution of pore size and peak distribution of 10–50 nm and >100 nm. The storage space of ash-bearing shale mainly consisted of intragranular pores and intergranular (crystalline) micropores, with pore sizes primarily concentrated in the 10–50 nm range. The storage space in silty shale mainly developed in clastic mineral particles such as quartz, followed by clay mineral intergranular pores with a relatively wide distribution of sizes. Pores were mainly inkbottle-shaped and slit-type/plate-type pores, with an average specific surface area of approximately 6.9046 m2·g−1 and an average pore volume of approximately 0.0150 cm3·g−1. The full-pore capillary pressure curve was established using a combination of gas adsorption–desorption tests and HPMI. The fractal dimension of the sample pore structure was calculated, and a significant linear correlation was found between clay mineral content and the fractal dimension. Thus, the pore structure characteristics were mainly controlled by the content and distribution of clay minerals.

Natural fractures are of paramount importance in storing carbon in shale oil reservoirs, where ultra-low porosity and permeability necessitate their essentiality for enhanced oil recovery. Therefore, comprehensively clarifying the characteristics of natural fractures in shale oil reservoirs is imperative. This paper focuses on investigating the microscopic features of natural fractures in organic-rich continental shale oil reservoirs that are commonly found in the Lower Jurassic strata of the Sichuan Basin, employing them as a representative example. Multiple methods were utilized, including mechanical testing, Kaiser testing, multi-scale CT scanning (at 2 mm, 25 mm, and 100 mm scales), and a numerical simulation of fluid seepage in fracture models. The results revealed that the in situ stress of the target seam displays the characteristic of σH > σv > σh, with σv and σh being particularly similar. The relatively high lateral stress coefficient (ranging from 1.020 to 1.037) indicates that the horizontal stresses are higher than the average level. Although the 2 mm CT scan provides a more detailed view of fractures and connected pores, it primarily exhibited more pore information due to the high resolution, which may not fully unveil additional information about the fractures. Thus, the 25 mm shale core is a better option for studying natural fractures. The tortuosity of the different fractures indicated that the morphology of larger fractures is more likely to remain stable, while small-scale fractures tend to exhibit diverse shapes. The simulations demonstrated that the stress sensitivity of fracture permeability is approximately comparable across different fracture scales. Therefore, our research can enhance the understanding of the properties of natural fractures, facilitate predicting favorable areas for shale oil exploration, and aid in evaluating the carbon storage potential of shale oil reservoirs.

Abstract Prostate cancer is a common malignant tumor, which can spread to multiple organs in the body. Metastatic disease is the dominant reason of death for patients with prostate cancer. Prostate cancer usually transfers to bone. Bone metastases are related to pathologic fracture, pain, and reduced survival. There are many known targets for prostate cancer treatment, including androgen receptor (AR) axis, but drug resistance and metastasis eventually develop in advanced disease, suggesting the necessity to better understand the resistance mechanisms and consider multi-target medical treatment. Because of the limitations of approved treatments, further research into other potential targets is necessary. Metastasis is an important marker of cancer development, involving numerous factors, such as AKT, EMT, ECM, tumor angiogenesis, the development of inflammatory tumor microenvironment, and defect in programmed cell death. In tumor metastasis, programmed cell death (autophagy, apoptosis, and necroptosis) plays a key role. Malignant cancer cells have to overcome the different forms of cell death to transfer. The article sums up the recent studies on the mechanism of bone metastasis involving key regulatory factors such as macrophages and AKT and further discusses as to how regulating autophagy is crucial in relieving prostate cancer bone metastasis.

Objective: Neuroendocrine prostate cancer (NEPC) is an aggressive variant of prostate cancer (PC) that may arise de novo or in patients previously treated with hormonal therapies for prostate adenocarcinoma as a mechanism of resistance. In our investigation, there appeared to be a strong correlation between neuroendocrine differentiation prostate cancer (NEDPC) and NEPC. The objectives of this study included exploring whether NEDPC is an intermediate stage in the progression of high-risk prostate cancer (HRPC) to NEPC and identifying risk factors and new targets associated with survival in the treatment of NEPC.Methods: The selected prostate cancer patients were progressed to high-risk and characterized by neuroendocrine. We collected the clinical data and characteristics of patients with three types of cancer: the incidence of metastasis, site and time of metastasis, recurrence rate, related treatment methods, etc. The similarity and differences of the three groups were compared through experiment and database.Results: By analyzing the clinical data and immunohistochemical results, we found that there seems to be a clinical feature of neuroendocrine differentiation (NED) status in between when patients progress from PC to NEPC. Finding novel treatment targets would therefore be beneficial by taking into account NEDPC as the stage of PC progression prior to NEPC. The metastasis-free survival curve and the immunohistochemical results are informing us that NEDPC can be a pre-state for diagnosing NEPC.Conclusion: NEPC is a late PC symptom that is frequently disregarded and has a bad prognosis. Finding novel treatment targets would therefore be beneficial by taking into account NEDPC as the stage of PC progression prior to NEPC.

Abstract Background Allium sativum (garlic) is an economically important food source and medicinal plant rich in sulfides and other protective substances such as alliin, the precursor of allicin biosynthesis. Cysteine, serine and sulfur is the precursor of alliin biosynthesis. However, little is known about the alliin content under abiotic stress or the mechanism by which it is synthesized. Results The findings revealed that the content of alliin was lowest in the garlic roots, and highest in the buds. Furthermore, alliin levels decreased in mature leaves following wounding. Transcriptome data generated over time after wounding further revealed significant up-regulation of genes integral to the biosynthetic pathways of cysteine and serine in mature garlic leaves. Conclusions The findings suggest that differential expression of cysteine, serine and sulfide-related genes underlies the accumulation of alliin and its precursors in garlic, providing a basis for further analyses of alliin biosynthesis.

Background: Prostate cancer (PCa) is currently the most common cancer among males worldwide. It has been reported that OTUB1 plays a critical role in a variety of tumors and is strongly related to tumor proliferation, migration, and clinical prognosis. The aim of this research is to investigate the regulatory effect of OTUB1 on PCa proliferation and the underlying mechanism.Methods: Using the TCGA database, we identified that OTUB1 was up-regulated in PCa, and observed severe functional changes in PC3 and C4-2 cells through overexpression or knock down OTUB1. Heterotopic tumors were implanted subcutaneously in nude mice and IHC staining was performed on tumor tissues. The relationship between OTUB1 and cyclin E1 was identified via Western blotting and immunoprecipitations assays.Results: We found that the expression of OTUB1 in PCa was significantly higher than that in Benign Prostatic Hyperplasia (BPH). Overexpression OTUB1 obviously promoted the proliferation and migration of PC3 and C4-2 cells via mediating the deubiquitinated Cyclin E1, while OTUB1 knockout has the opposite effect. The nude mice experiment further explained the above conclusions. We finally determined that OTUB1 promotes the proliferation and progression of PCa via deubiquitinating and stabling Cyclin E1.Conclusions: Our findings reveal the critical role of OTUB1 in PCa, and OTUB1 promotes the proliferation and progression of PCa via deubiquitinating and stabilizing Cyclin E1. Blocking OTUB1/Cyclin E1 axis or applying RO-3306 could significantly repress the occurrence and development of PCa. OTUB1/Cyclin E1 axis might provide a new and potential therapeutic target for PCa.

Background: Renal carcinoma is a common urologic tumor, and there is no ideal tumor marker for clinical diagnosis except for imaging diagnosis. This study aims to screen the serum tumor markers closely related with the benign and malignant of renal carcinoma out and chart out the regulatory network that involves renal carcinoma-related genes. Methods: Based on 96 pathologically diagnosed renal cancer patients, factors strongly linked to renal carcinoma character were selected using Fisher discriminant analysis. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases were utilized to manipulate function annotation of erbB4 and the selected genes and pathway analysis. Results: Four essential tumor markers CYFRA21-1, CA125, VHL and HIF-1β were successfully screened out. Using GO and KEGG databases, the regulatory network of renal cancer cell escaping apoptosis was charted out on the basis of erbB4 signaling pathway. Conclusion: Serum tumor marker genes play a certain part in the genesis and development of renal carcinoma. We preliminarily illustrated the molecular mechanism of these markers to predict tumor, laying a foundation for further exploration in renal carcinoma.

The friction-type high-strength bolted (FHSB) T-stub connection has been widely used in steel structures, due to their good fatigue resistance and ease of installation. While the current studies on FHSB T-stub connections mainly focus on the structural behaviors under both shear and tensile force, no research has been reported on the mechanical responses of the connections under the combined effects of shear and compression. To make up for this gap, this paper presents a novel FHSB T-stub connection, which is simple in structure, definite in load condition, and easy to construct. Static load tests were carried out on 21 specimens under different shear–compression ratios, and the finite-element (FE) models were created for each specimen. The failure modes, initial friction loads and ultimate strengths of the specimens were compared in details. Then, 144 FE models were adopted to analyze the effects of the friction coefficient, shear–compression ratio, bolt diameter and clamping force on the initial friction load and ultimate strength. The results showed that the FHSB T-stub connection under shear and compression mainly suffers from bolt shearing failure. The load–displacement curve generally covers the elastic, yield, hardening and failure stage. If the shear–compression ratio is small and the friction coefficient is large, its curve only contains the elastic and failure stage. The friction coefficient and shear–compression ratio have great impacts on the initial friction load and ultimate strength. For every 1 mm increase in bolt diameter, the initial friction load increased by about 10%, while the ultimate strength increased by about 8.5%. For each 10% increase/decrease of the design clamping force, the initial friction load decreases/increases by 7.8%, while the ultimate load remains basically the same. The proposed formula of shear capacity and self-lock angles of FHSB T-stub connection can be applied to the design of CSS-enhanced prestressed concrete continuous box girder bridges (PSC-CBGBs) and diagonal bracing.

Features of porphyritic limestone matrix fracture-vug reservoirs in Tahe Oilfield, Tarim Basin, NW China was examined by core observation, thin section identification, cathodoluminescence, microscopic fluorescence, scanning electron microscope and energy spectrum analysis. Thick and widespread in the Lower-Middle Ordovician Yijianfang and Yingshan Formations, sand-clastic masses in the porphyritic limestone are rich in oil, quite a proportion of oil and gas produced currently is from their matrix rather than completely from the fracture cave system in the past understanding. In irregular spot or ribbon shape on cores, dolomitic sand-clastic masses usually account for about 40% of the total surface of core in many layers, arenite section has a surface porosity of around 39%. The arenite section is well-crystallized dolomite, the dolomite crystals are mainly 100−350 μm in diameter, equivalent to medium-fine sand; high-pressure mercury injection experiment results show that the reservoir physical property of sand-clastic masses is much better than that of micrite limestone, with a porosity of 12.57%−36.39%. There developed abundant stylolites and microcracks around the sand-clastic masses, which connect the oil bearing units of dolomitc sand-clastic masses, making micropores and microcracks communicate and become effective reservoir space. Key words: carbonate rock, matrix fractured-porous reservoir, porphyritic limestone, sand-clastic micrite, Tahe Oilfield, Ordovican

Polymethylmethacrylate-based (PMMA) bone cements containing functionalized carbon nanotubes (CNTs) were prepared, and the thermal properties of the resultant nanocomposite cements were characterized in accordance with the international standard for acrylic resin cements. The aim of this study was to determine the peak temperatures during the polymerization reaction in PMMA bone cement by thermocouple (temperature sensor). The CNTs were uniformly dispersed in the cement matrix. The setting time of the cement increased and the maximum temperature during exothermic polymerization reaction was effectively reduced by the incorporation of functionalized CNTs. This reduction decreased thermal necrosis of the respective nanocomposite cements, which probably could reduce the hyperthermia experienced in vivo.

In this work, an efficient procedure for the functionalization of multiwalled carbon nanotube (MWCNTs) based on nitric acid oxidation was presented. The morphologies of MWCNTs oxidized under various conditions were characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The FTIR provided clear evidence for the presence of carboxylic groups (–COOH) attached to the surface of MWCNTs resulting from the acid treatment. The unfunctionalised MWCNTs(p-MWCNTs) and carboxy1 functionalized MWCNTs (f-MWCNTs) were successfully applied into the Polymethyl methacrylate (PMMA) bone cement. The resultant mechanical experiment indicated that the f-MWCNTs were a promising additive to improve the compressive strength and bend strength of the PMMA bone cement. The morphology and degree of dispersion of the MWCNTs in the PMMA matrix at different scales were analyzed by SEM. Improvements in mechanical properties were attributed to the MWCNTs arresting or retarding crack propagation through the cement by providing a bridging effect into the crack, normal to the direction of crack growth.

Polymethylmethacrylate-based (PMMA) bone cements incorporating multiwalled carbon nanotubes (MWCNTs) as a means of reinforcement were prepared, and their structure and properties were investigated by displacement sensor and chevron-notched test method. The aim of this study was to determine the transverse-direction fracture toughness (KIv) in PMMA bone cement by using the displacement sensor. Three major advantages of the displacement sensor test method are: (1) It is easier to achieve the plane strain requirements; (2) Not required to make the fatigue-precracking; (3) It is considerable easy to produce stable crack propagation before completely fracture. The fracture toughness values of PMMA bone cement and PMMA/MWNCTs bone cement were measured to be 1.235±0.15 MPa m1/2 and 1.725±0.15 MPa m1/2, respectively. Based on the microstructures shown in SEM images, the improved fracture toughness of PMMA bone cement was contributed to the incorporation of surface functionalized MWCNTs.