Thoracolumbar fractures patients undergoing posterior pedicle screw fixation can benefit from drainage.

PURPOSE: To explore whether it is necessary to put drain tubes after posterior pedicle screw fixation of thoracolumbar fractures. METHODS: From April 2020 to January 2023, a total of 291 patients with recent thoracolumbar fractures (AO type-A or type-B) who received the pedicle screw fixation operation were enrolled retrospectively. In 77 patients, drain tubes were used in the pedicle screw fixation surgery, while no drain tubes were placed in the other group. After gleaning demographic information and results of lab examination and imageology examination, all data were put into a database. Independent-sample t-tests, Pearson Chi-Square tests, Linear regression analysis, and correlation analysis were then performed. RESULTS: Compared to the control group, the drainage group had significantly lower postoperative CRP levels (P = 0.047), less use of antipyretics (P = 0.035), higher ADL scores (P = 0.001), and lower NRS scores (P < 0.001) on the 6th day after surgery. Other investigation items, such as demographic information, operation time, intraoperative blood loss, body temperature, and other preoperative and postoperative lab results, showed no significant differences. CONCLUSIONS: The use of a drain tube in the pedicle screw fixation of thoracolumbar fractures is correlated with the improvement of patients' living and activity ability and the reduction of inflammation, postoperative fever and pain.

Molecular Surgery at Microporous MOF for Mesopore Generation and Renovation.

Hierarchically porous MOFs (HP-MOFs) present advantageous synergism of micro- and mesopore but challenging in synthetic control at molecular scale. Herein, we present the first example of reversible and controllable mesopore generation and renovation in a microporous MOF of HKUST-1 via synthetic manipulation at molecular scale. An ammonia-gas etching strategy is proposed to create mesopores in carboxylate-based microporous MOFs and thus produce HP-MOFs. Gas-phase etching ensures uniform mesopore formation inside the MOF crystals via plane-oriented cutting the carboxylate-metal bonds off without affecting the crystal size and morphology. The mesopore size is controlled by the etching temperature, while the mesopore volume could be tuned by adjusting etchant pressure. The generated mesopores could be renovated using MOF precursors solutions so that to achieve controllable mesopore generation/closure, and encapsulation of the adsorbed molecules. This work demonstrates a powerful protocol for precisely tailoring and tuning the properties of MOF materials at molecular scale.

Dual-Function HKUST-1: Templating and Catalyzing Formation of Graphitic Carbon Nitride Quantum Dots Under Mild Conditions.

Graphitic carbon nitride quantum dots (g-CNQDs) are highly promising photoresponsive materials. However, synthesis of monodispersed g-CNQDs remains challenging. Here we report the dual function of MOF [Cu3 BTC2 ] (HKUST-1) as a catalyst and template simultaneously to prepare g-CNQDs under mild conditions. Cyanamide (CA), a graphitic carbon nitride precursor, catalytically dimerized inside the larger MOF cavities at 90 °C and condensed into g-CNQDs at 120 °C in a controlled fashion. The HKUST-1 template was stable under the reaction conditions, leading to uniform g-CNQDs with a particle size of 2.22±0.68 nm. The as prepared g-CNQDs showed photoluminescence emission with a quantum yield of 3.1 %. This concept (MOF dual functionality) for catalyzing CA polycondensation (open metal sites (OMSs) effect) and controlling the produced particle size (pore-templating effect), together with the tunable MOF porosity, is expected to produce unique g-CNQDs with controllable size, morphology, and surface functionality.

Genetic characteristics of vancomycin resistance gene cluster in Enterococcus spp.

Vancomycin resistant enterococci has become an important nosocomial pathogen since it is discovered in late 1980s. The products, encoded by vancomycin resistant gene cluster in enterococci, catalyze the synthesis of peptidoglycan precursors with low affinity with glycopeptide antibiotics including vancomycin and teicoplanin and lead to resistance. These vancomycin resistant gene clusters are classified into nine types according to their gene sequences and organization, or D-Ala:D-Lac (VanA, VanB, VanD and VanM) and D-Ala:D-Ser (VanC, VanE, VanG, VanL and VanN) ligase gene clusters based on the differences of their encoded ligases. Moreover, these gene clusters are characterized by their different resistance levels and infection models. In this review, we summarize the classification, gene organization and infection model of vancomycin resistant gene cluster in Enterococcus spp.

Publication times, impact factors, and advance online publication in ophthalmology journals.

OBJECTIVE: Publication speed of peer-reviewed journals may play a major role in early dissemination of knowledge and may raise the citation index. In this study, we evaluated the publication speed of ophthalmology journals. DESIGN: Observational study. PARTICIPANTS: Observational study of bibliometric data in published ophthalmology journals. METHODS: A list of ophthalmic journals featured in the 2010 Journal Citation Report was obtained on September 1, 2011. A total of 12 articles were chosen randomly from each of these journals published between January and December 2010. Median publication time and interquartile range (IQR) were obtained from the full texts of the published articles. MAIN OUTCOME MEASURES: Time lag between submission and revision, acceptance, and publication of the manuscripts was calculated. Correlation between publication time lag and journal impact factor as well as advance online publication was analyzed. RESULTS: A total of 51 ophthalmic journals were included. There was no statistically significant difference in the impact factors of journals based on their reporting of submission, revision, or acceptance times of the manuscripts (both P>0.05, Wilcoxon test). The median peer review and publication time of all ophthalmology journals was 133 days (IQR, 100.5-171.5) and 100 days (IQR, 62.9-166.3), respectively. There was no correlation between the journal impact factors and publication time lag (Spearman correlation). Approximately half of the ophthalmology journals (n = 26; 50.98%) published online in advance. Journals with advance online publication had higher impact factors compared with those without this feature (median, 1.692 [IQR, 1.05-2.80] vs. 1.02 [0.39-1.53]; P = 0.015, Mann-Whitney U test). For journals with advance online publication, the median time from acceptance to advance online publication (74.3 days [IQR, 48.3-115 days]) was significantly shorter than the median time between acceptance and print publication (170.75 days [IQR, 101.4-217 days]; P<0.001, Wilcoxon test). CONCLUSIONS: Publication time lag in ophthalmology journals was not correlated with journal impact factors. Advance online publication facility was provided by only half of the ophthalmology journals published in 2010. Journals with advance online publication had a higher impact factor compared with those without this feature. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Artificial Total Disc Replacement Versus Fusion for Lumbar Degenerative Disc Disease: An Update Systematic Review and Meta-Analysis.

AIM: To conduct an updated systematic review and meta-analysis to compare the efficacy and safety between total disc replacement (TDR) and fusion surgery for lumbar degenerative disc disease (LDDD). MATERIAL AND METHODS: We comprehensively searched meta-analyses comparing TDR with fusion through the PubMed, Embase, and Cochrane Library databases. Only randomized controlled trials (RCTs) were selected and collected. The end of the retrieval time was June 2017. Two authors independently extracted the data from the studies after assessing their quality. The statistical software STATA version 12.0 was used to analyze the data. RESULTS: A total of seven RCTs (1706 patients) were included in our analysis. The patients in the TDR group had significantly improved. A greater percentage of these patients were satisfied with the surgery concerning Oswestry disability index, visual analog scale score, and complication rate. In addition, the clinical success in the TDR group was greater than that in the fusion group. Meanwhile, the TDR group had shorter operative time and hospital stay. However, there was no clinical significance regarding blood loss, work status, and reoperation rate between the two groups. CONCLUSION: Our current updated meta-analysis suggests that TDR could be an alternative treatment for LDDD, since it yielded better clinical success and patient satisfaction, shorter hospital stay and operative time, less pain, and lower complication rates than lumbar fusion.

Migration-Prevention Strategy to Fabricate Single-Atom Fe Implanted N-Doped Porous Carbons for Efficient Oxygen Reduction.

It is highly desired but challenging to achieve highly active single-atom Fe sites from iron-based metal-organic frameworks (MOFs) for efficient oxygen reduction reaction (ORR) due to the easy aggregation of iron species and formation of the inactive Fe-based particles during pyrolysis. Herein, a facile migration-prevention strategy is developed involving the incorporation of polyaniline (PANI) into the pores of iron porphyrinic-based MOF PCN-224(Fe) and followed by pyrolysis to obtain the single-atom Fe implanted N-doped porous carbons material PANI@PCN-224(Fe)-900. The introduced PANI inside the pores of PCN-224(Fe) not only served as protective fences to prevent the aggregation of the iron species during thermal annealing, but also acted as nitrogen sources to increase the nitrogen content and form Fe-Nx-C active sites. Compared with the pristine PCN-224(Fe) derived carbonization sample containing Fe-based particles, the carbonaceous material PANI@PCN-224(Fe)-900 without inactive Fe-based particles exhibited superb ORR electrocatalytic activity with a more positive half-wave potential, significantly improved stability in both alkaline media, and more challenging acidic condition. The migration-prevention strategy provides a new way to fabricate atomically dispersed metal active sites via pyrolysis approach for promoting catalysis.

Highly selective sensing of Fe3+ by an anionic metal-organic framework containing uncoordinated nitrogen and carboxylate oxygen sites.

Fast and highly selective detection of trace amounts of metal ions has become one of the most urgent issues concerning public security and living systems. However, developing a highly efficient fluorescent sensor for metal ions still remains a great challenge. Metal-organic frameworks (MOFs) are a promising class of porous fluorescent sensors towards ion detection. Herein, the anionic MOF FJI-C8 based on the π-conjugated aromatic ligand H6TDPAT (2,4,6-tris(3,5-dicarboxylphenylamino)-1,3,5-triazine) containing uncoordinated nitrogen and carboxylate oxygen atoms was chosen as highly efficient sensor for selective detection of Fe3+. Due to the strong interaction between Fe3+ and Lewis base sites (uncoordinated nitrogen and carboxylate oxygen atoms), the high overlap between the emission spectrum of the anionic FJI-C8 and the absorption spectrum of Fe3+, and the good overlap of the excitation spectrum of the host material FJI-C8 with the absorption spectrum of Fe3+, FJI-C8 exhibited a high sensitivity (0.0233 mM of Fe3+) and extra selectivity (Ksv = 8245 M-1) for the rapid detection (less than 30 s) of Fe3+ with low usage (0.04 mg mL-1 of FJI-C8 suspension). To the best of our knowledge, this is the first example of a luminescent MOF chemosensor based on a trefoil ligand with the highest density of uncoordinated N and carboxylate O atoms for the highly selective detection of Fe3+. It is also crucial to note that this is a first time detection of Fe3+ using both FJI-C8 suspension and solid after filtration, and the results indicate that the detection of Fe3+ using the FJI-C8 suspension is better. This study will pave the way for designing luminescent MOF chemosensors for the detection of Fe3+ ion.

Defective Pt nanoparticles encapsulated in mesoporous metal-organic frameworks for enhanced catalysis.

Highly dispersed ultrafine defective Pt nanoparticles (NPs) encapsulated in the mesopores of MIL-101 were successfully achieved for the first time through a facile chemical dealloying approach. PtCo alloy NPs inside the mesoporous MIL-101 were firstly formed via a double-solvent method and the Co species were subsequently selectively etched by diluted nitric acid to achieve the defective Pt NPs. Compared with PtCo alloy NPs, the as-prepared defective Pt NPs showed an improved catalytic activity towards the hydrogenation of nitroarenes under mild conditions.

The addition of 3D printed models to enhance the teaching and learning of bone spatial anatomy and fractures for undergraduate students: a randomized controlled study.

BACKGROUND: Whether or not the addition of 3D (three-dimension) printed models can enhance the teaching and learning environment for undergraduate students in regard to bone spatial anatomy is still unknown. In this study, we investigated the use of 3D printed models versus radiographic images as a technique for the education of medical students about bone spatial anatomy and fractures. METHODS: The computed tomography (CT) data from four patients, each with a different fracture type (one spinal fracture, one pelvic fracture, one upper limb fracture, and one lower limb fracture), were obtained, and 3D models of the fractures were printed. A total of 90 medical students were enrolled in the study and randomly divided into two groups as follows: a traditional radiographic image group (presented by PowerPoint) and a 3D printed model group (combined PowerPoint and 3D models). Each student answered 5 questions about one type of fracture and completed a visual analog scale of satisfaction (0-10 points). RESULTS: No significant differences were found in the upper limb or lower limb test scores between the 3D printed model group and the traditional radiographic image group; however, the scores on the pelvis and spine test for the traditional radiographic image group were significantly lower than the scores for the 3D printed model group (P=0.000). No significant differences were found in the test-taking times for the upper limb or lower limb (P=0.603 and P=0.746, respectively) between the two groups; however, the test-taking times for the pelvis and spine in the traditional radiographic image group were significantly longer than those of the 3D printed model group (P=0.000 and P=0.002, respectively). CONCLUSIONS: The 3D printed model may improve medical students' understanding of bone spatial anatomy and fractures in some anatomically complex sites.

Chondrosarcoma of the Osseous Spine Treated by Surgery With or Without Radiotherapy: A Propensity Score Matched and Grade/Stage-stratified Study.

STUDY DESIGN: This was a longitudinal cohort study. OBJECTIVE: The main objective of this study was to investigate the outcomes of surgery with or without radiotherapy during treatment of patients with chondrosarcoma of the osseous spine. SUMMARY OF BACKGROUND DATA: Chondrosarcoma is a primary spinal malignant tumor; chemotherapy and radiotherapy (RT) are generally unsuccessful, and thus, the main treatment of choice is complete en bloc resection. However, even with complete resection, these patients still have a significant rate of recurrence, morbidity, and mortality. Although there have been reports that the addition of RT to surgery may lead to increased survival and better cancer control, the evidence of the efficacy of RT remains controversial. MATERIALS AND METHODS: Patients diagnosed with chondrosarcoma who are then treated by surgery alone or surgery+RT were identified and extracted from the SEER (Surveillance, Epidemiology, and End Results) database (1973-2013). Propensity score matched (PSM) analysis was performed to balance patient characteristics between surgery alone and surgery+RT groups. Patients with a different grade and stage were stratified and analyzed. RESULTS: A total of 778 patients with chondrosarcoma of the osseous spine treated by surgery alone or surgery+RT were extracted from the SEER database. Before PSM, the unadjusted Kaplan-Meier curve and bivariable Cox proportional hazard regression models showed that the surgery alone group had higher chondrosarcoma cancer-specific survival and overall survival than the surgery+RT group (both P<0.001), while the difference was attenuated after PSM. Stratified analysis found that RT was worse for low-grade chondrosarcoma patients and had a better trend for high-grade chondrosarcoma patients. CONCLUSIONS: The results of our present study suggest that low-grade chondrosarcoma of the osseous spine is resistant to RT, while high-grade chondrosarcoma patients had a better trend with RT. LEVEL OF EVIDENCE: Level III.

Three-dimensional reconstructions in spine and screw trajectory simulation on 3D digital images: a step by step approach by using Mimics software.

There is a rapidly increasing amount of literature outlining the use of three-dimensional (3D) reconstruction and printing technologies in recent years. However, precise instructive articles which describe step-by-step methods of reconstructing 3D images from computed tomography (CT) or magnetic resonance imaging (MRI) remain limited. To address these issues, this article describes a detailed protocol which will allow the reader to easily perform the 3D reconstruction in their future research, to allow investigation of the appropriate surgical anatomy and allow innovative designs of novel screw fixation techniques or pre-operative surgical planning.

The Outcomes of Minimally Invasive versus Open Posterior Approach Spinal Fusion in Treatment of Lumbar Spondylolisthesis: The Current Evidence from Prospective Comparative Studies.

Purpose. To investigate the evidence of minimally invasive (MI) versus open (OP) posterior lumbar fusion in treatment of lumbar spondylolisthesis from current prospective literatures. Methods. The electronic literature database of Pubmed, Embase, and Cochrane library was searched at April 2016. The data of operative time, estimated blood loss and length of hospital stay, visual analog scale (VAS) of both lower back pain and leg pain, Oswestry disability index (ODI), SF-36 PCS (physical component scores) and SF-36 MCS (mental component scores), complications, fusion rate, and secondary surgery were extracted and analyzed by STATA 12.0 software. Results. Five nonrandom prospective comparative studies were included in this meta-analysis. The meta-analysis showed that the MI group had a significantly longer operative time than OP group, less blood loss, and shorter hospital stay. No significant difference was found in back pain, leg pain, ODI, SF-36 PCS, SF-36 MCS, complications, fusion rate, and secondary surgery between MI and OP groups. Conclusion. The prospective evidence suggested that MI posterior fusion for spondylolisthesis had less EBL and hospital stay than OP fusion; however it took more operative time. Both MI and OP fusion had similar results in pain and functional outcomes, complication, fusion rate, and secondary surgery.

Comparison of the more than 5-year clinical outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion: A protocol for a systematic review and meta-analysis of prospective randomized controlled trials.

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) was almost the "golden standard" technique in treatment of symptomatic cervical degenerative disc disease, however, it cause motion loss of the indexed level, increase the intradiscal pressure and motion of the adjacent levels, and may accelerate the degeneration of adjacent level. Cervical disc arthroplasty (CDA) was designed to preserve the motion of index level, avoid the over-activity of adjacent levels and reduce the degeneration of adjacent disc levels, the process of degeneration of adjacent level is very slowly, long term follow up studies should be conducted, this study aim to compare the more than 5 years' long-term clinical outcomes and safety between CDA and ACDF. METHODS: A systematic review and meta-analysis that will be performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The electric database of Medline, Embase, and Cochrane library will be systematic search. A standard data form will be used to extract the data of included studies. We will assess the studies according to the Cochrane Handbook for Systematic Reviews of Interventions, and perform analysis in software STATA 12.0. Fixed-effects models will be used for homogeneity data, while random-effects will be used for heterogeneity data. The overall effect sizes will be determined as weighted mean difference (WMD) for continuous outcomes and Relative risk (RR) for dichotomous outcomes. RESULTS: The results of study will be disseminated via both international conference and peer-review journal. CONCLUSION: The conclusion of our study will provide the long-term and updated evidence of clinical outcomes and safety between CDA and ACDF, and help surgeon to change better surgical technique for patients.

Estimating Finite Rate of Population Increase for Sharks Based on Vital Parameters.

The vital parameter data for 62 stocks, covering 38 species, collected from the literature, including parameters of age, growth, and reproduction, were log-transformed and analyzed using multivariate analyses. Three groups were identified and empirical equations were developed for each to describe the relationships between the predicted finite rates of population increase (λ') and the vital parameters, maximum age (Tmax), age at maturity (Tm), annual fecundity (f/Rc)), size at birth (Lb), size at maturity (Lm), and asymptotic length (L∞). Group (1) included species with slow growth rates (0.034 yr(-1) < k < 0.103 yr(-1)) and extended longevity (26 yr < Tmax < 81 yr), e.g., shortfin mako Isurus oxyrinchus, dusky shark Carcharhinus obscurus, etc.; Group (2) included species with fast growth rates (0.103 yr(-1) < k < 0.358 yr(-1)) and short longevity (9 yr < Tmax < 26 yr), e.g., starspotted smoothhound Mustelus manazo, gray smoothhound M. californicus, etc.; Group (3) included late maturing species (Lm/L∞ ≧ 0.75) with moderate longevity (Tmax < 29 yr), e.g., pelagic thresher Alopias pelagicus, sevengill shark Notorynchus cepedianus. The empirical equation for all data pooled was also developed. The λ' values estimated by these empirical equations showed good agreement with those calculated using conventional demographic analysis. The predictability was further validated by an independent data set of three species. The empirical equations developed in this study not only reduce the uncertainties in estimation but also account for the difference in life history among groups. This method therefore provides an efficient and effective approach to the implementation of precautionary shark management measures.

Association among polymorphisms at MYH9, environmental factors, and nonsyndromic orofacial clefts in western China.

Myosin heavy chain 9, nonmuscle (MYH9) and environmental factors have been shown to be associated with nonsyndromic cleft lip with or without cleft palate in several populations. Our study aimed to confirm the contribution of MYH9 and environmental factors to nonsyndromic orofacial cleft risk in western Han Chinese. Four single-nucleotide polymorphisms were investigated in 180 case trios and 224 normal peers in western China using transmission disequilibrium test, family-based association test analysis, and logistic regression models. Strong evidence of linkage disequilibrium was found between these markers and the disease by both single-nucleotide polymorphism analysis (G allele at rs2269529 and T allele at rs16996652) and haplotype analysis (G-T [for rs2269529 and rs16996652] and G-A-T [for rs2269529, rs3752462, and rs16996652] among others). Mothers' illness, medication, and passive smoking during the first trimester may increase the risk of nonsyndromic orofacial clefts, but mothers' vitamin (including folic acid) supplementation during the first trimester is a protective factor. Interactions between mothers' passive smoking during the first trimester and T/T genotype of rs16996652 had statistical significance. Risk factors identified in our study may provide a better understanding of the etiological role of MYH9 and influence of environmental factors in nonsyndromic orofacial cleft incidence.

Association among IRF6 polymorphism, environmental factors, and nonsyndromic orofacial clefts in western china.

The interferon regulatory factor 6 (IRF6) gene and environmental factors have been shown to be associated with nonsyndromic cleft lip with or without cleft palate (NSCL/P) in several populations. This study aimed to confirm the contribution of IRF6 and environmental factors to NSCL/P risk in western Han Chinese. Five single nucleotide polymorphisms (SNPs) were investigated in 107 case trios (child and parents) and 100 normal peers in western China using transmission disequilibrium test, case-control analysis, and logistic regression models. Strong evidence of linkage disequilibrium was found between these markers and the disease in both SNP analysis (A allele at rs4844880, G allele at rs2073485, and C allele at rs599021) and haplotype analysis (A-A for rs861019 and rs4844880, A-C for rs4844880 and rs599021, among others). Both mothers' medication and passive smoking during the first trimester of pregnancy may increase the risk of NSCL/P, but mothers' vitamins (including folic acid) supplementation during the first trimester was a protective factor. Interactions between mothers' abortion history and TT genotype of rs2235373 were statistically significant (odds ratio = 6.70, 95% confidence interval =1.69-26.52). Risk factors identified in this study may provide a better understanding of the etiological role IRF6 and environmental factors play in NSCL/P incidence.