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Titanium dioxide nanomaterials are applied in numerous fields due to their splendid physicochemical characteristics, which in turn poses a potential threat to human health. Recently, numerous in vivo studies have revealed that titanium dioxide nanoparticles (TNPs) can be transported into animal brains after exposure through various routes. Absorbed TNPs can accumulate in the brain and may disturb neuronal cells, leading to brain dysfunction. In vitro studies verified the neurotoxicity of TNPs. The mechanisms underlying the neurotoxicity of TNPs remains unclear. Whether necroptosis is involved in the neurotoxicity of TNPs is unknown. Therefore, we performed an in vitro study and found that TNPs induced inflammatory injury in SH-SY5Y cells in a dose-dependent way, which was mitigated by necrostatin-1 (Nec-1) pretreatment. Since receptor-interacting protein kinase 1 (RIP1) is reported to be the target of Nec-1, we silenced it by siRNA. We exposed mutant and wild-type cells to TNPs and assessed inflammatory injury. Silencing RIP1 expression inhibited inflammatory injury induced by TNPs exposure. Taken together, Nec-1 ameliorates the neurotoxicity of TNPs through RIP1. However, more studies should be performed to comprehensively assess the correlation between the neurotoxicity of TNPs and RIP1.BACKGROUND Gastrointestinal stromal tumors (GIST) are rare mesenchymal tumors, most commonly arising in the stomach. Surgical resection remains the mainstay of cure, and can often be accomplished laparoscopically. Tumor size and location guide selection of appropriate resection technique. METHODS A retrospective review of all patients undergoing surgery at a single academic center between 2000 and 2018. Comparisons and descriptive statistics performed using student's t test and χ2 test. RESULTS 77 patients underwent resection for gastric GIST, 53 (68%) laparoscopic. Patients undergoing open operations had significantly larger tumors (4&nbsp;cm vs 7&nbsp;cm, p  less then  0.001). Operative time was not significantly different between the two groups (117&nbsp;min vs 104&nbsp;min, p = 0.26). Median length of stay was significantly shorter for laparoscopic resection, and postoperative complication rate was lower. A review of the operative notes revealed four types of resection non-anatomic stapled wedge resection, resection of a full-thickness "disk" of stomach around the tumor with primary closure, formal partial gastrectomy with reconstruction, and laparoscopic transgastric (endoluminal) resection. CONCLUSION Non-anatomic resection (wedge or disk) is most feasible for tumors on the greater curve or gastric body, far enough from the pylorus and gastroesophageal junction to avoid narrowing inflow or outflow. A partial gastrectomy may be required for large tumors or those encroaching on the esophagus or pylorus. For small intraluminal tumors, a laparoscopic transgastric approach is ideal. This review of the technical details of each type of resection can aid in selecting the ideal approach for difficult tumors.BACKGROUND Operating room (OR) efficiency requires coordinated teamwork between the staff surgeon, anesthesia team, circulating nurse, surgical technician, and surgical trainee or assistant. Bariatric cases present unique challenges including difficult airways, challenging intravenous access, use of specialized surgical equipment, and synchronized exchange of orogastric tubes. The high contribution margin of these complex bariatric procedures rests on OR efficiency. OBJECTIVE To compare the efficiency of bariatric surgeries performed by a single surgeon at a tertiary academic medical center with its inherent variability of OR staff to that of a private hospital with a standardized surgical team. METHODS All laparoscopic Roux-en-Y gastric bypasses (LRYGB) performed by a single surgeon at University Hospitals Cleveland Medical Center (UHCMC) and a Community Affiliate (CA) from 2013 to 2015 were retrospectively reviewed.&nbsp;Patient demographics and preoperative comorbidities were compared. The variability of OR stat-case times were longer at UHCMC compared to the CA (38 ± 9&nbsp;min vs. 33 ± 6&nbsp;min; p  less then  0.0001; 13 ± 6&nbsp;min vs. 10 ± 3&nbsp;min; p = 0.01). CONCLUSION The academic center has much greater variability in staff for these complex bariatric procedures. There was a trend toward longer OR times at the tertiary center as demonstrated by the difference in pre- and post-case times, but the consistent surgeon and assistant allowed for consistent surgical case time regardless of the setting. The implication of variability in OR staff can be overcome by the surgeon directing the procedure itself. The opportunity for improving the efficiency of bariatric surgery should focus on the perioperative care of the patient in OR that requires everyone to be familiar with the procedure.BACKGROUND It is technical challenging to perform laparoscopic duodenum-preserving pancreatic head resection (LDPPHR). Only a few case reports and case series of LDPPHR are available in the literature. MATERIALS AND METHODS From February 2019 to November 2019, 24 cases of LDPPHR were carried out in the Department of Pancreas Surgery, West China Hospital, Sichuan University. Data were prospectively collected in terms of demographic characteristics (age, gender, BMI, and pathological diagnosis), intraoperative variables (operative time, estimated blood loss, transfusion, pancreatic texture, and diameter of main pancreatic duct), and post-operative variables (time for oral intake, post-operative hospital stay, and complications). RESULTS Nine male patients and fifteen female patients were included in this study. The median age of these patients was 43&nbsp;years. All patients underwent duodenum-preserving total pancreatic head resection laparoscopically. [https://www.selleckchem.com/products/Pyroxamide(NSC-696085).html selleck kinase inhibitor] The median operative time was 255&nbsp;min. The median estimated blood loss was 200&nbsp;ml. One patient required blood transfusion. The median post-operative hospital stay was 10&nbsp;days. Three patients suffered from biliary fistula. Eleven patients (45.8%) suffered from pancreatic fistula; however, only one patient (4.2%) suffered from grade B pancreatic fistula. No patient suffered from grade C pancreatic fistula. One patient with chronic pancreatitis required re-operation for jejunal anastomotic bleeding on the first post-operative day. No patient suffered from gastroparesis, duodenal necrosis, or abdominal bleeding. The 30-day mortality was 0. CONCLUSION LDPPHR is safe and feasible. Real-time indocyanine green fluorescence imaging may help prevent bile duct injury and bile leakage.