Photochemical conversion of CO to C1 and C2 products mediated by porphyrin rhodium(II) metallo-radical complexes.

Unimolecular reduction and bimolecular reductive coupling of carbon monoxide (CO) represent important ways to synthesize organic feedstocks. Reductive activation of CO through open-shell pathways, though rare, can help overcome the barriers of many traditional organometallic elementary reactions that are hard to achieve. Herein we successfully achieve the unimolecular reduction of CO to (TPP)RhCH2OSiR1R2R3 (TPP = 5,10,15,20-tetraphenylporphyrin), and the release of products CH3OSiR1R2R3, TEMPO-CH2OSiR1R2R3 and BrCH2OSiR1R2R3 in near-quantitative yield under visible light (420-780 nm), which involves radical formation from Rh-C bond homolysis. Bimolecular CO reductive coupling products, (TPP)RhCOCH2OSiR1R2R3, are then obtained via a radical mechanism. Subsequent treatment with n-propylamine, BrCCl3 or TEMPO under thermal or photochemical conditions afford small-molecule bimolecular reductive coupling products. To the best of our knowledge, homogeneous systems which reductively couple CO under photochemical conditions have not been reported before. Here, the use of an open-shell transition metal complex, that delivers more than one kind of small-molecule CO reductive coupling products bearing different functional groups, provides opportunities for useful CO reductive transformations.

Longitudinal Associations Between Negative Body Image, Self-Disgust, and Nonsuicidal Self-Injury Among Chinese Adolescents: Disentangling Between- and Within-Person Effects.

Nonsuicidal self-injury (NSSI) and negative body image are both highly prevalent among adolescents, and there are theoretically proposed reciprocal associations between them. However, previous research has not differentiated between stable personal traits and time-varying state levels when examining these associations, and the underlying mechanisms remain unclear. To address these gaps, this study investigated the longitudinal associations between negative body image, self-disgust, and NSSI among Chinese adolescents, disentangling the between- and within-person effects by employing random intercept cross-lagged panel models (RI-CLPMs). A total of 515 Chinese adolescents (50.7% boys; baseline Mage = 12.34 years, SD = 0.47) participated in a four-wave longitudinal study with 6-month intervals. The results indicated that, at the between-person level, higher levels of self-disgust were associated with more NSSI and more concerns about general appearance, facial appearance, shortness, and fatness, but were not associated with concerns about thinness. At the within-person level, general appearance concern and NSSI positively predicted each other over time through self-disgust. Concerns about facial appearance, shortness, and fatness all positively predicted self-disgust, which in turn positively predicted NSSI over time, but not vice versa. These findings highlight the stable and trait-like associations between self-disgust, NSSI, and most negative body image dimensions. Self-disgust is worth considering as a target for intervention, as it plays a mediating role in the long-term associations between negative body image and NSSI.

Early salvage therapy with anti-PD-1 antibody Camrelizumab in patients with advanced cervical cancer: a retrospective study.

OBJECTIVE: To observe the clinical efficacy of Camrelizumab in patients with advanced cervical cancer who presented with resistance to initial therapy. METHODS: We retrieved data from 25 patients with advanced (stage IIA2-IV) cervical cancer who were administered a combination salvage therapy with Camrelizumab due to the poor response to initial chemotherapy. The primary outcome was objective response rate (ORR) and disease control rate (DCR), the secondary endpoints included progression-free survival (PFS) and the occurrence of adverse events. To evaluate its long-term effect on PFS, we included 64 patients diagnosed with stage IIA2-IV during the study period, who were responsive to initial radiotherapy or chemotherapy and received conventional therapy as control. RESULTS: Camrelizumab exhibits a high salvage treatment efficacy, with ORR of 80.0% (20/25) and DCR of 88.0% (22/25) in Camrelizumab salvage group (CS group). The PFS in CS group was significantly longer than that in control group. The median follow-up time were 18.1 and 18.3 months in the CS group and the control group, respectively, and neither achieved median PFS. The adverse event (AEs) rates in the CS and control groups were 52.0% (13/25) and 51.6% (33/64), in which the most common adverse events were myelosuppression, cutaneous capillary endothelial proliferation (CCEP), and elevated liver enzymes, and the grade of AEs was less than grade 3 in all patients. CONCLUSION: Camrelizumab demonstrated promising efficacy and safety as the early salvage treatment for patients with advanced cervical cancer.

Novel hydrogel pillar array based ratiometric multicolor fluorescence biosensor for visual detection of alkaline phosphatase activity.

Enzyme-induced in-situ fluorescence is crucial for the development of biosensing mechanisms and correlative spectroscopic analysis. Inspired by simple p-aminophenol (AP)-controlled synthesis and the specific catalytic reaction of 4-aminophenyl phosphate (APP) triggered by alkaline phosphatase (ALP), our research proposed a strategy to prepare carbon dots (CDs) as fluorescent signals for ALP detection using AP and 3-aminopropyltrimethoxysilane (APTMS) as the precursors. The further constructed ratiometric fluorescence sensor reduced the detection limit of ALP to 0.075 µU/mL by a significant margin. Considering the need for point-of-care testing (POCT), we chose agarose for the preparation of portable hydrogel sensors so that even untrained personnel can quickly achieve semi-quantitative visual detection of ALP using colorimetric cards. These results demonstrate the practical applicability of ratiometric fluorescence sensing hydrogel pillar arrays, which are important for high-sensitivity, visualization, and portable rapid enzyme activity assays.

The bidirectional longitudinal associations between fear of negative evaluation and suicidal ideation among Chinese adolescents: The mediating role of interpersonal needs factors.

Based on previous theories and studies, fear of negative evaluation (FNE) may be a key predictor of suicidal ideation in adolescents. However, few studies examined the longitudinal relationships between FNE and suicidal ideation. This study aimed to explore the bidirectional longitudinal relationships between FNE and suicidal ideation. Meanwhile, based on the Interpersonal Theory of Suicide, this study would examine the longitudinal mediating role of interpersonal needs factors (thwarted belongingness and perceived burdensomeness) on the relationship between FNE and suicidal ideation. A sample of 515 adolescents (Mage = 12.309, SD = 0.807; 49.3 % girls) completed questionnaires on 4 waves, 6 months apart. The Random Intercept Cross-Lagged Panel Models (RI-CLPMs) were utilized to estimate the associations among study variables. The results showed that: (1) there was a significant bidirectional longitudinal relationship between FNE and suicidal ideation; (2) thwarted belongingness and perceived burdensomeness independently and serially mediated the relationship between FNE and suicidal ideation. This study contributed to understanding the complex relationship between FNE and suicidal ideation, emphasizing the critical roles of thwarted belongingness and perceived burdensomeness. The findings underscore the bidirectional nature of these associations and provide insights into the potential pathways involved in the development of suicidal ideation among adolescents.

Suvemcitug plus chemotherapy for platinum-resistant epithelial ovarian, fallopian tube and primary peritoneal cancer: A phase 1b dose-escalation trial.

OBJECTIVE: The use of bevacizumab has been hampered by safety concerns despite demonstrable progression-free survival (PFS) benefit in subjects with platinum-resistant ovarian cancer, highlighting the need for novel effective and safe antiangiogenic agents. This study aimed to characterize the tolerability, safety, and antitumor activities of escalating doses of anti-VEGF antibody suvemcitug plus chemotherapy in platinum-resistant ovarian cancer patients. METHODS: This open-label, dose-escalation trial enrolled adult patients (≥18 years) with platinum-resistant histologically or cytologically-confirmed epithelial ovarian, fallopian tube and primary peritoneal cancer. Eligible patients received paclitaxel or topotecan plus escalating doses of suvemcitug 0.5, 1, 1.5, or 2 mg/kg once every two weeks. The primary endpoints were safety and tolerability, and antitumor activities of suvemcitug. RESULTS: Twenty-nine subjects received paclitaxel (n = 11) or topotecan (n = 18). No dose-limiting toxicities occurred. The most common adverse events of special interest were proteinuria (41.4%), hypertension (20.7%) and epistaxis (10.3%). No gastrointestinal perforations occurred. Nine subjects (31.0%, 95% CI 15.3-50.8) demonstrated investigators-confirmed objective response, including complete response in 1 and partial response in 8. The median PFS was 5.4 months (95% CI 2.2-7.4). CONCLUSIONS: Suvemcitug demonstrated an acceptable safety profile and promising antitumor activities in platinum-resistant ovarian cancer patients, supporting its further clinical development.

Low PDE4A expression promoted the progression of ovarian cancer by inducing Snail nuclear translocation.

Widespread metastasis is the primary reason for the high mortality associated with ovarian cancer (OC), and effective targeted therapy for tumor aggressiveness is still insufficient in clinical practice. Therefore, it is urgent to find new targets to improve prognosis of patients. PDE4A is a cyclic nucleotide phosphodiesterase that plays a crucial role in the occurrence and development in various malignancies. Our study firstly reported the function of PDE4A in OC. Expression of PDE4A was validated through bioinformatics analysis, RT-qPCR, Western blot, and immunohistochemistry. Additionally, its impact on cell growth and motility was assessed via in vitro and in vivo experiments. PDE4A was downregulated in OC tissues compared with normal tissues and low PDE4A expression was correlated with poor clinical outcomes in OC patients. The knockdown of PDE4A significantly promoted the proliferation, migration and invasion of OC cells while overexpression of PDE4A resulted in the opposite effect. Furthermore, smaller and fewer tumor metastatic foci were observed in mice bearing PDE4A-overexpressing OVCAR3 cells. Mechanistically, downregulation of PDE4A expression can induce epithelial-mesenchymal transition (EMT) and nuclear translocation of Snail, which suggests that PDE4A plays a pivotal role in suppressing OC progression. Notably, Rolipram, the PDE4 inhibitor, mirrored the effects observed with PDE4A deletion. In summary, the downregulation of PDE4A appears to facilitate OC progression by modulating the Snail/EMT pathway, underscoring the potential of PDE4A as a therapeutic target against ovarian cancer metastasis.

Inhibition of 14-3-3 proteins increases the intrinsic excitability of mouse hippocampal CA1 pyramidal neurons.

14-3-3 proteins are a family of regulatory proteins that are abundantly expressed in the brain and enriched at the synapse. Dysfunctions of these proteins have been linked to neurodevelopmental and neuropsychiatric disorders. Our group has previously shown that functional inhibition of these proteins by a peptide inhibitor, difopein, in the mouse brain causes behavioural alterations and synaptic plasticity impairment in the hippocampus. Recently, we found an increased cFOS expression in difopein-expressing dorsal CA1 pyramidal neurons, indicating enhanced neuronal activity by 14-3-3 inhibition in these cells. In this study, we used slice electrophysiology to determine the effects of 14-3-3 inhibition on the intrinsic excitability of CA1 pyramidal neurons from a transgenic 14-3-3 functional knockout (FKO) mouse line. Our data demonstrate an increase in intrinsic excitability associated with 14-3-3 inhibition, as well as reveal action potential firing pattern shifts after novelty-induced hyperlocomotion in the 14-3-3 FKO mice. These results provide novel information on the role 14-3-3 proteins play in regulating intrinsic and activity-dependent neuronal excitability in the hippocampus.

Correction: Clodronate-nintedanib-loaded exosome-liposome hybridization enhances the liver fibrosis therapy by inhibiting Kupffer cell activity.

Correction for 'Clodronate-nintedanib-loaded exosome-liposome hybridization enhances the liver fibrosis therapy by inhibiting Kupffer cell activity' by Keqin Ji et al., Biomater. Sci., 2022, 10, 702-713, https://doi.org/10.1039/D1BM01663F.

Co-developmental trajectories of suicidal ideation and non-suicidal self-injury among Chinese adolescents: Transdiagnostic predictors and association with suicide attempts.

INTRODUCTION: Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories. METHODS: Four hundred fifty-three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4. RESULTS: Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency. CONCLUSION: These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.

Combining photodynamic therapy and cascade chemotherapy for enhanced tumor cytotoxicity: the role of CTT2P@B nanoparticles.

The mitochondria act as the main producers of reactive oxygen species (ROS) within cells. Elevated levels of ROS can activate the mitochondrial apoptotic pathway, leading to cell apoptosis. In this study, we devised a molecular prodrug named CTT2P, demonstrating notable efficacy in facilitating mitochondrial apoptosis. To develop nanomedicine, we enveloped CTT2P within bovine serum albumin (BSA), resulting in the formulation known as CTT2P@B. The molecular prodrug CTT2P is achieved by covalently conjugating mitochondrial targeting triphenylphosphine (PPh3), photosensitizer TPPOH2, ROS-sensitive thioketal (TK), and chemotherapeutic drug camptothecin (CPT). The prodrug, which is chemically bonded, prevents the escape of drugs while they circulate throughout the body, guaranteeing the coordinated dispersion of both medications inside the organism. Additionally, the concurrent integration of targeted photodynamic therapy and cascade chemotherapy synergistically enhances the therapeutic efficacy of pharmaceutical agents. Experimental results indicated that the covalently attached prodrug significantly mitigated CPT cytotoxicity under dark conditions. In contrast, TPPOH2, CTT2, CTT2P, and CTT2P@B nanoparticles exhibited increasing tumor cell-killing effects and suppressed tumor growth when exposed to light at 660 nm with an intensity of 280 mW cm-2. Consequently, this laser-triggered, mitochondria-targeted, combined photodynamic therapy and chemotherapy nano drug delivery system, adept at efficiently promoting mitochondrial apoptosis, presents a promising and innovative approach to cancer treatment.

Novel porphyrin derivative containing cations as new photodynamic antimicrobial agent with high efficiency.

Bacterial infections from chronic wounds affect about 175 million people each year and are a significant clinical problem. Through the integration of photodynamic therapy (PDT) and chemotherapy, a new photosensitizer consisting of ammonium salt N,N-bis-(2-hydroxyethyl)-N-(6-(4-(10,15,20-trimesitylporphyrin-5-yl) phenoxy) hexane)-N-methanaminium bromide, TMP(+) was successfully synthesized with a total reaction yield of 10%. The novel photosensitizer consists of two parts, a porphyrin photosensitizer part and a quaternary ammonium salt part, to achieve the synergistic effect of photodynamic and chemical antibacterial activity. With the increase of TMP(+) concentration, the diameter of the PCT fiber membranes (POL/COL/TMP(+); POL, polycaprolactone; COL, collagen) gradually increased, which was caused by the charge of the quaternary ammonium salt. At the same time, the antibacterial properties were gradually improved. We finally selected the PCT 0.5% group for the antibacterial experiment, with excellent performance in fiber uniformity, hydrophobicity and biosafety. The antibacterial experiment showed that the modified porphyrin TMP(+) had a better antibacterial effect than others. In vivo chronic wound healing experiments proved that the antibacterial and anti-inflammatory effect of the PCTL group was the best, further confirmed by H&E histological analysis, immunofluorescence and immunohistochemistry mechanism experiments. This research lays the foundation for the manufacture of novel molecules that combine chemical and photodynamic strategies.

2D Atomic Layers for CO2 Photoreduction.

Artificial photosynthesis can convert carbon dioxide into high value-added chemicals. However, due to the poor charge separation efficiency and CO2 activation ability, the conversion efficiency of photocatalytic CO2 reduction is greatly restricted. Ultrathin 2D photocatalyst emerges as an alternative to realize the higher CO2 reduction performance. In this review, the basic principle of CO2 photoreduction is introduced, and the types, advantages, and advances of 2D photocatalysts are reviewed in detail including metal oxides, metal chalcogenides, bismuth-based materials, MXene, metal-organic framework, and metal-free materials. Subsequently, the tactics for improving the performance of 2D photocatalysts are introduced in detail via the surface atomic configuration and electronic state tuning such as component tuning, crystal facet control, defect engineering, element doping, cocatalyst modification, polarization, and strain engineering. Finally, the concluding remarks and future development of 2D photocatalysts in CO2 reduction are prospected.

Covalent Coupling Assisted Hydrophilic Perovskite Spheres for Ratiometric Fluorescent Visual Multichannel Immunoassay.

Quantitative fluorescence immunoassay is essential for the construction of biosensing mechanisms and the quantification of trace markers. But the interference problems caused by low fluorescence efficiency and broad fluorescence spectrum of fluorescent probes have hindered the continued development of ratiometric fluorescence sensing in biosensing. Perovskite materials, with ultra-high color purity (FWHM < 30 nm) and photoluminescence quantum yield (PLQY) (close to 100%), are expected to be next-generation fluorescent probes. However, poor water stability and biocompatibility are still non-negligible in biosensor applications. In this work, hyperstatic perovskite fluorescent microspheres prepared by swelling-shrinking method can be used as ratiometric fluorescence signals and biological immunoassay platforms. Meanwhile, inspired by p-aminophenol (AP) controlled synthesis and the catalytic reaction of 4-aminophenol phosphate (APP) triggered by alkaline phosphatase (ALP), a strategy to prepare fluorescent nanoparticles as fluorescence signals for ALP detection is proposed. Most importantly, it is proposed for the first time to combine this enzymatic fluorescence with perovskite materials using covalent linkage to create a novel cascade immunoassay and use it for quantitative and visualization determination of hepatitis B surface antigen (HBsAg) for application verification. These results indicate the biosensing potential of perovskite materials and provide a pathway for high sensitivity enzyme detection and enzyme triggered immune detection.

Chalcopyrite functionalized ceramic membrane for micropollutants removal and membrane fouling control via peroxymonosulfate activation: The synergy of nanoconfinement effect and interface interaction.

This work developed a novel chalcopyrite (CuFeS2) incorporated catalytic ceramic membrane (CFSCM), and comprehensively evaluated the oxidation-filtration efficiency and mechanism of CFSCM/peroxymonosulfate (PMS) for organics removal and membrane fouling mitigation. Results showed that PMS activation was more efficient in the confined membrane pore structure. The CFSCM50/PMS filtration achieved almost complete removal of 4-Hydroxybenzoic acid (4-HBA) under the following conditions: pH = 6.0, CPMS = 0.5 mM, and C4-HBA = 10 mg/L. Meanwhile, the membrane showed good stability after multiple uses. During the reaction, SO4•- and •OH were generated in the CFSCM50/PMS system, and SO4•- was considered to be the dominant reactive species for pollutant removal. The roles of copper, iron, and sulfur species, as well as the possible catalytic mechanism were also clarified. Besides, the CFSCM50/PMS catalytic filtration exhibited excellent antifouling properties against NOM with reduced reversible and irreversible fouling resistances. The Extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory analysis showed an increased in repulsive energy at the membrane-foulant interface in the CFSCM50/PMS system. Membrane fouling model analysis indicated that standard blocking was the dominant fouling pattern for CFSCM50/PMS filtration. Overall, this work demonstrates an efficient catalytic filtration process for foulants removal and outlines the synergy of catalytic oxidation and interface interaction.

Self-calibrating dual-sensing electrochemical sensors for accurate detection of carbon dioxide in blood.

A paper-based electrochemical dual-function biosensor capable of determining pH and TCO2 was synthesized for the first time using an iridium oxide pH electrode and an all-solid-state ion electrode (ASIE). In the study, to obtain highly reliable results, the biosensor was equipped with a real-time pH correction function before TCO2 measurements. Compared to traditional liquid-filling carbon dioxide detection sensors, the utilization of ferrocene endows our novel sensor with abundant positive sites, and thus greatly improves its performance. Conversely, the introduction of MXene with conductivity close to that of metals reduces electrode resistance, which is beneficial for accelerating the electrochemical reaction of the sensor and reducing LOD. After optimization, the detection range of TCO2 is 0.095 nM-0.66 M, with a detection limit of as low as 0.023 nM. In addition, the sensor was used in real serum sample-spiked recovery experiments and comparison experiments with existing clinical blood gas analyzers, which confirmed the effectiveness of its clinical application. This study provides a method for the rational design of paper-based electrochemical biosensors and a new approach for the clinical detection of blood carbon dioxide.

Functional brain region-specific neural spheroids for modeling neurological diseases and therapeutics screening.

3D spheroids have emerged as powerful drug discovery tools given their high-throughput screening (HTS) compatibility. Here, we describe a method for generating functional neural spheroids by cell-aggregation of differentiated human induced pluripotent stem cell (hiPSC)-derived neurons and astrocytes at cell type compositions mimicking specific regions of the human brain. Recordings of intracellular calcium oscillations were used as functional assays, and the utility of this spheroids system was shown through disease modeling, drug testing, and formation of assembloids to model neurocircuitry. As a proof of concept, we generated spheroids incorporating neurons with Alzheimer's disease-associated alleles, as well as opioid use disorder modeling spheroids induced by chronic treatment of a mu-opioid receptor agonist. We reversed baseline functional deficits in each pilot disease model with clinically approved treatments and showed that assembloid activity can be chemogenetically manipulated. Here, we lay the groundwork for brain region-specific neural spheroids as a robust functional assay platform for HTS studies.

Synergistic defect and doping engineering building strong bonded S-scheme heterojunction for photocatalysis.

Photocatalytic degradation of pollutants is considered a promising approach for wastewater treatment, but is hampered by low efficiency and limited understanding of degradation pathways. A novel oxygen-doped porous g-C3N4/oxygen vacancies-rich BiOCl (OCN/OVBOC) heterostructure was prepared for photocatalytic degradation of bisphenol A (BPA). The synergistic defect and doping engineering favor the formation of strong bonded interface for S-scheme mechanism. Among them, 0.3 OCN/OVBOC showed the most excellent degradation rate, which was 8 times and 4 times higher than that of pure g-C3N4 and BiOCl, respectively. This excellent performance is mainly attributed to the significantly enhanced charge separation via strong bonded interface and redox capability of the S-scheme heterojunction structure, by tuning the coordination excitation and electron localization of the catalyst via O doping and vacancies. This work provides important insights into the role of synergistic defect and doping engineering in facilitating the formation of strong bonded S-scheme heterojunction and ultimately sheds new light on the design of efficient photocatalysts.

Boron Nitride/Polyurethane Composites with Good Thermal Conductivity and Flexibility.

Thermal insulating composites are indispensable in electronic applications; however, their poor thermal conductivity and flexibility have become bottlenecks for improving device operations. Hexagonal boron nitride (BN) has excellent thermal conductivity and insulating properties and is an ideal filler for preparing thermally insulating polymer composites. In this study, we report a method to fabricate BN/polyurethane (PU) composites using an improved nonsolvent-induced phase separation method with binary solvents to improve the thermal performance and flexibility of PU. The stress and strain of BN60/PU are 7.52 ± 0.87 MPa and 707.34 ± 38.34%, respectively. As prepared, BN60/PU composites with unordered BN exhibited high thermal conductivity and a volume resistivity of 0.653 W/(m·K) and 23.9 × 1012 Ω·cm, which are 218.71 and 39.77% higher than that of pure PU, respectively. Moreover, these composite films demonstrated a thermal diffusion ability and maintained good integrity after 1000 bending cycles, demonstrating good mechanical and thermal reliability for practical use. Our findings provide a practical route for the production of flexible materials for efficient thermal management.

Endoscopic Posterior Cervical Decompression for Ossified Posterior Longitudinal Ligament: A Technical Note.

BACKGROUND: Ossification of the posterior longitudinal ligament (OPLL) may cause cervical myelopathy. In its multilevel form, it may not be easy to manage. Minimally invasive endoscopic posterior cervical decompression may be an alternative to traditional laminectomy surgery. METHODS: Thirteen patients with multilevel OPLL and symptomatic cervical myelopathy were treated with endoscopic spine surgery from January 2019 to June 2020. In this consecutive observational cohort study, pre- and postoperative Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI) were analyzed at a final follow-up of 2 years postoperatively. RESULTS: There were 13 patients consisting of 3 women and 10 men. The patient's average age was 51.15 years. At the final 2-year follow-up, the JOA score improved from a preoperative value of 10.85 ± 2.91 to 14.77 ± 2.13 postoperatively (P < 0.001). The corresponding NDI scores decreased from 26.61 ± 12.88 to 11.12 ± 10.85 (P < 0.001). There were no infections, wound complications, or reoperations. CONCLUSION: Direct posterior endoscopic decompression for multilevel OPLL is feasible in symptomatic patients when executed at a high skill level. While 2-year outcomes were encouraging and on par with historic data obtained with traditional laminectomy, future studies will need to show whether any long-term shortcomings exist.