Prevention and treatment of HPV-related cancer through a mRNA vaccine expressing APC-targeting antigen.

Persistent human papillomavirus (HPV) infection is associated with multiple malignancies. Developing therapeutic vaccines to eliminate HPV-infected and malignant cells holds significant value. In this study, we introduced a lipid nanoparticle encapsulated mRNA vaccine expressing tHA-mE7-mE6. Mutations were introduced into E6 and E7 of HPV to eliminate their tumourigenicity. A truncated influenza haemagglutinin protein (tHA), which binds to the CD209 receptor on the surface of dendritic cells (DCs), was fused with mE7-mE6 in order to allow efficient uptake of antigen by antigen presenting cells. The tHA-mE7-mE6 (mRNA) showed higher therapeutic efficacy than mE7-mE6 (mRNA) in an E6 and E7+ tumour model. The treatment resulted in complete tumour regression and prevented tumour formation. Strong CD8+ T-cell immune response was induced, contributing to preventing and curing of E6 and E7+ tumour. Antigen-specific CD8+ T were found in spleens, peripheral blood and in tumours. In addition, the tumour infiltration of DC and NK cells were increased post therapy. In conclusion, this study described a therapeutic mRNA vaccine inducing strong anti-tumour immunity in peripheral and in tumour microenvironment, holding promising potential to treat HPV-induced cancer and to prevent cancer recurrence.

Integrative mRNA-miRNA interaction analysis associated with the immune response of Strongylocentrotus intermedius to Vibrio harveyi infection.

Strongylocentrotus intermedius is one of the most economically valuable sea urchin species in China and has experienced mass mortality owing to outbreaks of bacterial diseases such as black mouth disease. This has caused serious economic losses to the sea urchin farming industry. To investigate the immune response mechanism of S. intermedius with different tube feet colors in response to Vibrio harveyi infection, we examined the different tube feet-colored S. intermedius under V. harveyi challenge and compared their transcriptome and microRNA (miRNA) profiles using RNA-Seq. We obtained 1813 differentially expressed genes (DEGs), 28 DE miRNAs, and 303 DE miRNA-DEG pairs in different tube feet-colored S. intermedius under V. harveyi challenge. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed that the most significant DEGs were associated with the Notch signaling and phagosome pathways. The target genes of immune-related miRNAs (miR-71, miR-184, miR-193) and genes (CALM1, SPSB4, DMBT, CSRP1) in S. intermedius were predicted and validated. This study provides insight into the molecular mechanisms that regulate genes involved in the immune response of S. intermedius infected with V. harveyi.

Comparison of Percutaneous Kyphoplasty and Bone Cement-Augmented Short-Segment Pedicle Screw Fixation for Management of Kümmell Disease.

BACKGROUND The purpose of this study was to compare the efficacy of percutaneous kyphoplasty (PKP) and bone cement-augmented short segmental fixation (BCA+SSF) for treating Kümmell disease. MATERIAL AND METHODS Between June 2013 and December 2015, 60 patients were treated with PKP or BCA+SSF. All patients were followed up for 12-36 months. We retrospectively reviewed outcomes, including Oswestry Disability Index (ODI), visual analogue scale (VAS), and kyphotic Cobb angle. RESULTS VAS, ODI, and Cobb angle, measured postoperatively and at the final follow-up, were lower than those measured preoperatively in both groups (P<0.05). VAS, ODI, and Cobb angle measured postoperatively demonstrated no significant differences when compared with those measured at the final follow-up in the PKP group (P>0.05). In the BCA+SSF group, VAS and ODI at the final follow-up were lower than those measured postoperatively (P<0.05), but no significant difference was found in the Cobb angle (P>0.05). The PKP group had better VAS and ODI than the BCA+SSF group, postoperatively (P<0.05). No significant difference was found in VAS and ODI at the final follow-up (P>0.05) or the Cobb angle measured postoperatively and at the final follow-up (P>0.05) between the 2 groups. Operative time, blood loss, and hospital stay in the PKP group were lower than those in the BCA+SSF group (P<0.05). No significant difference was found in complications (P>0.05). CONCLUSIONS PKP patients had better early clinical outcomes, shorter operation times and hospital admission times, and decreased blood loss, but had similar complications, radiographic results, and long-term clinical outcomes compared with BCA+SSF patients.

Bone Cement-Augmented Short-Segment Pedicle Screw Fixation for Kümmell Disease with Spinal Canal Stenosis.

BACKGROUND This study aimed to explore the feasibility and efficacy of bone cement-augmented short-segmental pedicle screw fixation in treating Kümmell disease. MATERIAL AND METHODS From June 2012 to June 2015, 18 patients with Kümmell disease with spinal canal stenosis were enrolled in this study. Each patient was treated with bone cement-augmented short-segment fixation and posterolateral bone grafting, and posterior decompression was performed when needed. All patients were followed up for 12-36 months. We retrospectively reviewed outcomes, including the Oswestry disability index (ODI), visual analog scale (VAS) score, anterior and posterior heights of fractured vertebrae, kyphotic Cobb angle, and neurological function by Frankel classification. RESULTS The VAS grades, ODI scores, anterior heights of affected vertebrae, and kyphotic Cobb angles showed statistically significant differences between pre- and postoperative and between preoperative and final follow-up values (P<0.05), whereas the differences between postoperative and final follow-up values were not statistically significant (P>0.05). The differences between posterior vertebral heights at each time point were not statistically significant (P>0.05). Improved neurological function was observed in 12 cases at final follow-up. Three cases had complications, including asymptomatic cement leakage in 2 patients and delayed wound infection in 1 patient. CONCLUSIONS Bone cement-augmented short-segment pedicle screw fixation is safe and effective for treating Kümmell disease, and can achieve satisfactory correction of kyphosis and vertebral height, with pain relief and improvement in neurological function, with few complications.

Black phosphorus-assisted laser desorption ionization mass spectrometry for the determination of low-molecular-weight compounds in biofluids.

Quantitative analysis of small molecules by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has been a challenging task due to matrix-derived interferences in low m/z region and poor reproducibility of MS signal response. In this study, we developed an approach by applying black phosphorus (BP) as a matrix-assisted laser desorption ionization (MALDI) matrix for the quantitative analysis of small molecules for the first time. Black phosphorus-assisted laser desorption/ionization mass spectrometry (BP/ALDI-MS) showed clear background and exhibited superior detection sensitivity toward quaternary ammonium compounds compared to carbon-based materials. By combining stable isotope labeling (SIL) strategy with BP/ALDI-MS (SIL-BP/ALDI-MS), a variety of analytes labeled with quaternary ammonium group were sensitively detected. Moreover, the isotope-labeled forms of analytes also served as internal standards, which broadened the analyte coverage of BP/ALDI-MS and improved the reproducibility of MS signals. Based on these advantages, a reliable method for quantitative analysis of aldehydes from complex biological samples (saliva, urine, and serum) was successfully established. Good linearities were obtained for five aldehydes in the range of 0.1-20.0 µM with correlation coefficients (R (2)) larger than 0.9928. The LODs were found to be 20 to 100 nM. Reproducibility of the method was obtained with intra-day and inter-day relative standard deviations (RSDs) less than 10.4 %, and the recoveries in saliva samples ranged from 91.4 to 117.1 %. Taken together, the proposed SIL-BP/ALDI-MS strategy has proved to be a reliable tool for quantitative analysis of aldehydes from complex samples. Graphical Abstract An approach for the determination of small molecules was developed by using black phosphorus (BP) as a matrix-assisted laser desorption ionization (MALDI) matrix.

Transoral anterior release, odontoid partial resection, and reduction with posterior fusion for the treatment of irreducible atlantoaxial dislocation caused by odontoid fracture malunion.

PURPOSE: Several techniques have been introduced to manage irreducible atlantoaxial dislocation (IAAD). However, no study has reported the surgical method for the management of IAAD caused by odontoid fracture malunion. This study aimed to introduce a surgical method of transoral anterior release, odontoid partial resection, and reduction with sequential posterior fusion for the treatment of IAAD caused by odontoid fracture malunion. We also evaluated the clinical efficacy of this surgery. METHODS: This study included seven cases of IAAD caused by odontoid fracture malunion, collected from January 2008 to January 2011. Anterior atlantoaxial release was performed through anterior transoral approach, followed by partial resection of the odontoid process. C1-C2 were then fixed through pedicle screws and rods, and then fused posteriorly by single stage. Neurologic status was evaluated using the Japanese Orthopaedic Association (JOA) scoring system. RESULTS: All seven patients had complete release, and satisfactory reduction. Bony fusion was seen in all patients postoperatively. The patients were followed up for an average of 19.6 months (ranged from 9 to 36 months). The average of patients JOA scores at the final follow-up was significantly higher than that of their preoperative scores. Furthermore, the average improvement in neurological function was 87.4 %. No screw loosening, implant migration or implant failures, atlantoaxial redislocation, or signs of instability were observed in any of the patients during the follow-up period. CONCLUSIONS: Transoral anterior release, odontoid partial resection, and reduction combined with posterior fusion are effective, reliable, and safe procedures for the treatment of IAAD caused by odontoid fracture malunion.

Comparison of Immune Indicators Related to Phagocytosis of Five Species of Sea Urchins under Artificial Infection with the Pathogenic Bacterium of Black Mouth Disease.

To screen for immune indicators closely related to disease resistance, two species of sea urchin susceptible to black mouth disease (Strongylocentrotus intermedius, S. intermedius ♀ × Heliocidaris crassispina ♂) and three species of sea urchin resistant to black mouth disease (H. crassispina, H. crassispina ♀ × S. intermedius ♂ and Mesocentrotus nudus) were artificially infected with the black mouth pathogen Vibrio echinoideorum. The phagocytosis-related immune indices of the five sea urchin species were compared at different time points post-infection. The results demonstrated that the parameters such as apoptotic rate of phagocytes, mean contribution value (MCV) of single effective phagocyte on Acid Phosphatase (ACP), Reactive Oxygen Species (ROS), and Total Antioxidant Capacity (T-AOC) of the five sea urchin species first increased and then decreased after infection. The key time points were 3 h to 6 h and 48 h post-infection when the black mouth disease-resistant and susceptible sea urchins demonstrated differences. At 3 h or 6 h post-infection, the up-regulation folds in MCV of ACP, ROS and T-AOC of black mouth disease-resistant sea urchins were considerably higher than that of the susceptible sea urchins. At 6 h post-infection, the apoptosis rate and the phagocytic index (PI) of the black mouth disease-resistant sea urchins were significantly higher than those of the susceptible sea urchins (p < 0.05). At 48 h post-infection, the necrosis rate of phagocytes, MCV of ACP and MCV of ROS of the black mouth disease-resistant sea urchins were significantly lower than those of the susceptible sea urchins (p < 0.05). The apoptosis and necrosis rate of phagocytes, PI, and MCV on ACP, ROS may be used as indicators of disease resistance in sea urchins. Disease resistance standards in immune indices can be summarized as phagocytosis increases greatly in the early infection stage and decreases timely to a normal level after killing the pathogen in a short period.

Computational study of the blood flow in three types of 3D hollow fiber membrane bundles.

The goal of this study is to develop a computational fluid dynamics (CFD) modeling approach to better estimate the blood flow dynamics in the bundles of the hollow fiber membrane based medical devices (i.e., blood oxygenators, artificial lungs, and hemodialyzers). Three representative types of arrays, square, diagonal, and random with the porosity value of 0.55, were studied. In addition, a 3D array with the same porosity was studied. The flow fields between the individual fibers in these arrays at selected Reynolds numbers (Re) were simulated with CFD modeling. Hemolysis is not significant in the fiber bundles but the platelet activation may be essential. For each type of array, the average wall shear stress is linearly proportional to the Re. For the same Re but different arrays, the average wall shear stress also exhibits a linear dependency on the pressure difference across arrays, while Darcy's law prescribes a power-law relationship, therefore, underestimating the shear stress level. For the same Re, the average wall shear stress of the diagonal array is approximately 3.1, 1.8, and 2.0 times larger than that of the square, random, and 3D arrays, respectively. A coefficient C is suggested to correlate the CFD predicted data with the analytical solution, and C is 1.16, 1.51, and 2.05 for the square, random, and diagonal arrays in this paper, respectively. It is worth noting that C is strongly dependent on the array geometrical properties, whereas it is weakly dependent on the flow field. Additionally, the 3D fiber bundle simulation results show that the three-dimensional effect is not negligible. Specifically, velocity and shear stress distribution can vary significantly along the fiber axial direction.

Nanoplastics affect the growth of sea urchins (Strongylocentrotus intermedius) and damage gut health.

Nanoplastics (NPs) are abundant and widespread throughout the ocean, not only causing severe environmental pollution, but also worsening the aquatic organisms. To elucidate the mechanism of biological toxic effects underlying the responses of marine invertebrates to NPs, Strongylocentrotus intermedius was stressed with three different NPs concentrations (0 particles/L, 102 particles/L and 104 particles/L). Specific growth rates, enzyme activity, gut tissue section observation and structural characteristics of the gut bacterial community were analyzed. After 28 days of exposure, the specific growth rate of S. intermedius decreased significantly with NPs groups. Further, both lysozyme, pepsin, lipase and amylase activities decreased, while the superoxide dismutase activity increased, indicating that NPs negatively affected digestive enzyme and immune enzyme activity. The analysis of gut tissue sections revealed that NPs caused atrophy and cytoplasmic reduction in the epithelial cells of the S. intermedius intestine. Moreover, the structural characterization of the gut bacterial community indicated significant changes in the abundances of members from Campylobacterota, Chlamydiae, and Firmicutes. Members from Arcobacteraceae, Christensenellaceae and Clostridia were endemic to the NPs treatment. The KEGG database analysis demonstrated that the metabolic pathways specific to the NPs treatment group were significantly associated with growth, energy metabolism, and immunity. In summary, NPs have negatively affected on physiological response and altered gut microecological environment.

Does the Choice of Operative Side Affect the Clinical Outcome of Unilateral Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fracture?

BACKGROUND: Studies have found that the rate of improvement in pain after percutaneous kyphoplasty (PKP) is 49% to 90%, and there are still some patients who may continue to sustain intractable back pain after surgery. OBJECTIVES: To compare the clinical efficacy and imaging results between unilateral PKP performed from the symptom-dominating side and the non-dominating side in OVCF treatment. STUDY DESIGN: Prospective study. SETTING: All data were from Honghui Hospital in Xi'an. METHODS: One hundred forty-two patients of osteoporotic vertebral compression fracture (OVCF) treated with unilateral PKP were eventually recruited and randomly assigned to either the A or B group. Patients in group A received PKP from the symptom-dominating side; patients in group B received PKP from the symptom non-dominating side. The demographic characteristics, related surgical information, and complications observed within both groups were recorded. The clinical outcomes evaluation included the visual analog scale (VAS) score for low back pain and the Oswestry Disability Index (ODI). Evaluation of imaging results included anterior height (AH), kyphosis angulation (KA), and contralateral distribution rate of bone cement. RESULTS: One hundred eighteen patients (48 men and 70 women; age range: 60-83 years), including 59 patients in the A group and 59 patients in the B group, were available for the complete assessment. There were 5 cases and 7 cases of bone cement leakage in groups A and B, respectively, which were asymptomatic para-vertebral or inter-vertebral leakage without intra-spinal leakage. Compared with the preoperative data, significant improvements in the VAS scores and ODI were observed at each follow-up interval. The VAS score and ODI in the A group were significantly lower than in the B group only within 2 months (P < 0.05). Compared with the preoperative data, the AH and KA in the 2 groups were improved (P < 0.05). There was no significant difference in AH and KA between the 2 groups at each follow-up interval (P > 0.05). LIMITATIONS: A single-center study. CONCLUSIONS: The unilateral PKP performed via the symptom-dominating side can effectively relieve back pain and improve the patient's quality of life at the early stage.

Synthesis of manganese ferrite/graphene oxide nanocomposites for biomedical applications.

In this study, MnFe(2)O(4) nanoparticle (MFNP)-decorated graphene oxide nanocomposites (MGONCs) are prepared through a simple mini-emulsion and solvent evaporation process. It is demonstrated that the loading of magnetic nanocrystals can be tuned by varying the ratio of graphene oxide/magnetic nanoparticles. On top of that, the hydrodynamic size range of the obtained nanocomposites can be optimized by varying the sonication time during the emulsion process. By fine-tuning the sonication time, MGONCs as small as 56.8 ± 1.1 nm, 55.0 ± 0.6 nm and 56.2 ± 0.4 nm loaded with 6 nm, 11 nm, and 14 nm MFNPs, respectively, are successfully fabricated. In order to improve the colloidal stability of MGONCs in physiological solutions (e.g., phosphate buffered saline or PBS solution), MGONCs are further conjugated with polyethylene glycol (PEG). Heating by exposing MGONCs samples to an alternating magnetic field (AMF) show that the obtained nanocomposites are efficient hyperthermia agents. At concentrations as low as 0.1 mg Fe mL(-1) and under an 59.99 kA m(-1) field, the highest specific absorption rate (SAR) recorded is 1588.83 W g(-1) for MGONCs loaded with 14 nm MFNPs. It is also demonstrated that MGONCs are promising as magnetic resonance imaging (MRI) T(2) contrast agents. A T(2) relaxivity value (r(2) ) as high as 256.2 (mM Fe)(-1) s(-1) could be achieved with MGONCs loaded with 14 nm MFNPs. The cytotoxicity results show that PEGylated MGONCs exhibit an excellent biocompatibility that is suitable for biomedical applications.

Influence of the Aspect Ratio of Iron Oxide Nanorods on Hysteresis-Loss-Mediated Magnetic Hyperthermia.

Owing to the problems associated with conventional cancer treatment methods, magnetic hyperthermia-based cancer therapy has gained importance recently. Achieving the desired heating effect at the site of the tumor with a minimal concentration of iron oxide nanoparticles (IONPs) and a safer field is necessary to explore the advantages of hyperthermia. For one to address this challenge, biocompatible IONPs with a desirable magnetic response at a tolerable field are necessary. In this work, magnetic shape anisotropy of iron oxide nanorods (NR) of different lengths (70, 115, 170, and 210 nm) with different aspect ratios ranging from 1.55 to 3.2 was explored to achieve higher hysteresis loss, in turn leading to better hyperthermia efficiency. The magnetic properties of the NRs with respect to the applied field were studied using micromagnetic simulation. Even though the nanorods with high aspect ratio showed a higher hysteresis loss of 69485 J/m3 at 2000 Oe, the field required to attain it was high and well beyond the safety limit. From nanorods of various aspect ratios, the nanorod with a lower aspect ratio of 1.55 and a length of 70 nm exhibited a better hysteresis loss and specific absorption rate (SAR) value of 4214 W g-1 was achieved at a frequency and alternating magnetic field of 400 kHz and 800 Oe, respectively. The PEGylated GO-Nanorod of 70 nm exhibited excellent antitumor efficacy in 4T1 tumor model mice by obstructing the tumor progression within a safer dosage and field.

Risk Factors for New Vertebral Fracture After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures.

PURPOSE: To analyze the risk factors for new vertebral fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs). PATIENTS AND METHODS: We retrospectively reviewed the records of patients with symptomatic OVCFs who underwent PVP in our hospital, from January 2014 to January 2019. Demographic and lifestyle data on the presence of underlying chronic disease, preoperative bone mineral density, details of vertebral fractures, postoperative osteoporosis treatment, and new fracture development were collected. Patients were divided into postoperative fracture and non-fracture groups. To identify the independent risk factors for new vertebral fracture development, variables significant on univariate analysis were included in a multivariate regression model. RESULTS: Of the 2202 patients treated with PVP, 362 (16.43%) had a new postoperative vertebral fracture. All patients were followed up for >12 months (mean 14.7 months). Univariate analysis revealed no significant difference in height; body weight; preoperative bone mineral density; number of fractured vertebrae; injection volume of bone cement in a single vertebra; leakage rate of bone cement; or presence of hypertension, coronary heart disease, and chronic obstructive pulmonary disease between the fracture and non-fracture groups (P>0.05). Age, sex, smoking, alcohol consumption, diabetes mellitus, postoperative exercise, and postoperative osteoporosis treatment were associated with new vertebral fractures (all P<0.05). A multivariate analysis showed that age (odds ratio [OR]=1.212, P<0.0001), female sex (OR=1.917, P<0.0001), smoking (OR=1.538, P=0.026), and diabetes (OR=1.915, P<0.0001) were positively correlated with new vertebral fracture development, whereas postoperative exercise (OR=0.220, P<0.0001) and osteoporosis treatment (OR=0.413, P<0.0001) were negatively correlated. CONCLUSION: Elderly patients, females, and those with a history of smoking and diabetes are at high risk of new vertebral fracture after PVP. Patients should be encouraged to stop smoking and consuming alcohol, control blood glucose level, participate in sufficient physical activity, and adhere to osteoporosis treatment to prevent new vertebral fractures.

Can Additional Facet Joint Block Improve the Clinical Outcome of Kyphoplasty for Acute Osteoporotic Vertebral Compression Fractures?

BACKGROUND: Percutaneous kyphoplasty (PKP) has been reported to provide a favorable analgesic effect for pain caused by osteoporotic vertebral compression fractures (OVCFs). However, a systematic review demonstrated that pain relief was only reported for approximately 86% of kyphoplasty treatments. OBJECTIVES: To explore whether an additional facet joint block (FJB) can minimize pain and improve the clinical outcome of PKP in patients with acute OVCFs. STUDY DESIGN: Prospective study. SETTING: All data were from Honghui Hospital in Xi'an. METHODS: According to the inclusion and exclusion criteria, 194 patients were eventually included in our study; they were randomly divided into 2 groups of 97 patients each and treated with either PKP + FJB or PKP alone. Follow-up consultations were scheduled 1 day, 3 days, 1 week, 1 month, 3 months, and 1 year postoperatively; the demographic characteristics, related surgical information, and complications observed within both groups were recorded. The clinical evaluation parameters included the intraoperative satisfaction score, the Visual Analog Scale (VAS) score, and the Oswestry Disability Index (ODI). RESULTS: A total of 171 patients (61 men and 110 women; age range: 62-85 years) completed the full postoperative follow-up schedule, with 83 patients in the PKP + FJB group and 88 in the PKP group. No significant differences were observed in the genders, ages, preoperative bone mineral density, surgical levels, or volume of cement injected between the 2 groups (P > 0.05, respectively). The average duration of the surgeries in the PKP + FJB group was slightly longer than that in the PKP group (35.5 ± 4.8 min vs. 31.8 ± 4.3 min; P = 0.038), and in terms of the clinical outcomes, the average intraoperative satisfaction score was significantly higher in the PKP + FJB group (8.6 ± 1.1 vs. 6.3 ± 1.3; P < 0.001). Compared with the preoperative data, significant improvements in the VAS scores of back pain and ODI were observed at each follow-up interval (P < 0.05, respectively). These scores were significantly higher in the PKP + FJB group than in the PKP group; however, this was only observed within the first month after the procedure. LIMITATIONS: A single-center noncontrol study. CONCLUSIONS: The addition of an FJB (which in our study involved a unique combination of ropivacaine, prednisolone, and vitamin B12) improved the short-term clinical outcome of PKP for acute OVCFs. The local anti-inflammatory and analgesic effects on the facet joints resulted in higher intraoperative satisfaction and lower VAS and ODI scores for the first postoperative month when compared with the PKP group.

Hydrogen Peroxide-Activatable Nanoparticles for Luminescence Imaging and In Situ Triggerable Photodynamic Therapy of Cancer.

Abnormally increased reactive oxygen species (ROS) are intimately related to the development and metastasis of cancer. Since hydrogen peroxide (H2O2) is a major component of ROS, molecular imaging and selective treatment in response to high H2O2 are intriguing for the management of cancers. Herein, we report novel self-assembly luminescent nanoparticles, which can be activated by H2O2, thereby serving as an effective nanotheranostics for luminescence imaging and in situ photodynamic therapy (PDT) of tumors with high H2O2. This functional nanomedicine was assembled from an amphiphilic conjugate (defined as CLP) based on chlorin e6 (Ce6) simultaneously conjugated with luminol and poly(ethylene glycol), exhibiting a well-defined core-shell nanostructure. Upon triggering by pathologically relevant levels of H2O2, CLP nanoparticles produced luminescence due to the luminol unit and simultaneous excitation of Ce6 by chemiluminescence resonance energy transfer, enabling in vitro and in vivo imaging of tumors with highly expressed H2O2. In addition, excited Ce6 can produce singlet oxygen (1O2) for in situ PDT of H2O2-high tumors and inhibiting lung metastasis, which was demonstrated by in vitro and in vivo experiments. Furthermore, preliminary studies revealed the biosafety of CLP nanoparticles. Consequently, the self-illuminating nanoparticles are promising for noninvasive imaging and therapy of tumors with high expression of H2O2.

The Healing Rate of Type II Odontoid Fractures Treated With Posterior Atlantoaxial Screw-rod Fixation: A Retrospective Review of 77 Patients.

BACKGROUND: In theory, temporary posterior atlantoaxial screw-rod fixation for type II odontoid fractures is a way to preserve rotatory motion. However, the healing rate of type II odontoid fractures treated in this way is unknown; that is, the risk associated with conducting a temporary screw-rod fixation for type II odontoid fractures is unknown. This study investigates the healing rate of type II odontoid fractures treated with posterior atlantoaxial screw-rod fixation by CT imaging and evaluates the feasibility of conducting a temporary screw-rod fixation for type II odontoid fractures. METHODS: Patients with type II odontoid fracture who underwent posterior atlantoaxial screw-rod fixation in our spine center from January 2011 to December 2014 were identified. Patients older than 65 years or younger than 18 years were excluded. Those who were confirmed to have healing odontoid fractures on CT imaging were included. Those in whom fracture healing was not confirmed were asked to undergo a CT examination. Fracture healing was confirmed on the basis of the presence of bridging bone across the odontoid fracture site on CT imaging. RESULTS: Seventy-seven patients (56 men and 21 women) were included in the study. The average age of the patients was 40.7 ± 11.6 years (range, 18 to 64 years). The mean duration of follow-up was 26.4 ± 4.6 months (range, 24 to 40 months). Fracture healing was observed in 73 patients (94.8%). DISCUSSION: The healing rate of type II odontoid fractures (with an age range of 18 to 64 years) treated with modern posterior atlantoaxial fixation is relatively high. For patients at that age range, posterior atlantoaxial temporary screw-rod fixation for type II odontoid fractures can be conducted with a low risk of nonunion. LEVEL OF EVIDENCE: Level IV, therapeutic.

Dual pitch titanium-coated pedicle screws improve initial and early fixation in a polyetheretherketone rod semi-rigid fixation system in sheep.

BACKGROUND: Reports on the efficacy of modifications to the thread design of pedicle screws are scarce. The aim of the study was to investigate initial and early fixation of pedicle screws with a plasma-sprayed titanium coating and dual pitch in the pedicle region (dual pitch titanium-coated pedicle screw [DPTCPS]) in a polyetheretherketone (PEEK) rod semi-rigid fixation system. METHODS: Fifty-four sheep spine specimens and 64 sheep were used to investigate initial ("0-week" controls) and early (post-operative 6 months) fixation, respectively. Sheep were divided into dual pitch pedicle screw (DPPS), standard pitch pedicle screw (SPPS), DPTCPS, and standard pitch titanium-coated pedicle screw (SPTCPS) groups. Specimens/sheep were instrumented with four screws and two rods. Biomechanical evaluations were performed, and histology at the implant-bone interface was investigated. RESULTS: At 0-week, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (557.0 ±â€Š25.2 vs. 459.1 ±â€Š19.1 N, t = 3.61, P < 0.05; 622.6 ±â€Š25.2 vs. 459.1 ±â€Š19.1 N, t = 3.43, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (343.4 ±â€Š16.5 vs. 237.5 ±â€Š12.9 N, t = 3.52, P < 0.05; 343.4 ±â€Š16.5 vs. 289.9 ±â€Š12.8 N, t = 3.12, P < 0.05; 124.7 ±â€Š13.5 vs. 41.9 ±â€Š4.3 cycles, t = 2.18, P < 0.05; 124.7 ±â€Š13.5 vs.79.5 ±â€Š11.8 cycles, t = 2.76, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (1.8 ±â€Š0.13 vs. 3.76 ±â€Š0.19 mm, t = 2.29, P < 0.05; 1.8 ±â€Š0.13 vs. 2.46 ±â€Š10.20 mm, t = 2.69, P < 0.05). At post-operative 6 months, mean axial pull-out strength was significantly higher for the DPTCPS and SPTCPS than the SPPS (908.4 ±â€Š33.6 vs. 646.5 ±â€Š59.4 N, t = 3.34, P < 0.05; 925.9 ±â€Š53.9 vs. 646.5 ±â€Š59.4 N, t = 3.37, P < 0.05). On toggle-testing, the DPTCPS was significantly more resistant than the SPPS and SPTCPS (496.9 ±â€Š17.9 vs. 370.3 ±â€Š16.4 N, t = 2.86, P < 0.05; 496.9 ±â€Š17.9 vs. 414.1 ±â€Š12.8 N, t = 2.74, P < 0.05; 249.1 ±â€Š11.0 vs.149.9 ±â€Š11.1 cycles, t = 2.54, P < 0.05; 249.1 ±â€Š11.0 vs.199.8 ±â€Š7.2 cycles, t = 2.61, P < 0.05). On cyclic loading, maximum displacement was significantly lower for the DPTCPS than the SPPS and SPTCPS (0.96 ±â€Š0.11 vs. 2.39 ±â€Š0.14 mm, t = 2.57, P < 0.05; 0.96 ±â€Š0.11 vs. 1.82 ±â€Š0.12 mm, t = 2.73, P < 0.05). Resistance to toggle testing (370.3 ±â€Š16.4 vs. 414.1 ±â€Š12.8 N, t = 3.29, P < 0.05; 149.9 ±â€Š11.1 vs.199.8 ±â€Š7.2 cycles, t = 2.97, P < 0.05) was significantly lower and maximum displacement in cyclic loading (2.39 ±â€Š0.14 vs.1.82 ±â€Š0.12 mm; t = 3.06, P < 0.05) was significantly higher for the SPTCPS than the DPTCPS. Bone-to-implant contact was significantly increased for the DPTCPS compared to the SPPS (58.3% ±â€Š7.0% vs. 36.5% ±â€Š4.4%, t = 2.74, P < 0.05); there was no inflammatory reaction or degradation of coated particles. CONCLUSION: DPTCPSs might have stronger initial and early fixation in a PEEK rod semi-rigid fixation system.

Causes of Residual Back Pain at Early Stage After Percutaneous Vertebroplasty: A Retrospective Analysis of 1,316 Cases.

BACKGROUND: Percutaneous vertebroplasty (PVP) is now well accepted in the treatment of painful osteopathic vertebral compression fractures (OVCF), providing early pain relief and strengthening of the bone of the vertebrae. However, some patients still experienced severe back pain after PVP. OBJECTIVES: To analyze the possible reason for unsatisfactory back pain relief (UBPR) after PVP at early stage. STUDY DESIGN: Retrospective analysis. SETTING: Hong-Hui Hospital in Xi'an. METHODS: Between March 2013 and January 2015, a total of 1,316 patients with OVCF were treated by PVP at our Hospital. Demographics, clinical data, and surgical data were collected to analyze the factors associated with UBPR after PVP. RESULTS: Sixty cases complained of UBPR, and the prevalence was 4.6%. Univariate analyses showed that preoperative bone mineral density (BMD), number of fractures, cement distribution and volume injected per level, lumbodorsal fascia contusion, and depression were associated with UBPR after PVP (P < 0.001). Multivariate analysis revealed that preoperative BMD (odds ratio [OR], 3.577; P = 0.029), lumbodorsal fascia contusion (OR, 3.805; P = 0.002), number of fractures (OR, 3.440; P < 0.001), cement volume injected per level (OR, 0.079; P < 0.001), cement distribution (OR, 3.009; P = 0.013), and depression (OR, 3.426; P = 0.028) were independently associated with UBPR after PVP at the early postoperative stage. LIMITATIONS: A further prospective controlled study is needed to explore the association between the different degrees of the aforementioned factors and UBPR after PVP. CONCLUSIONS: Preoperative low BMD, lumbodorsal fascial injury, multiple segment PVP, insufficient cement injected volume, unsatisfactory cement distribution, and depression were strong risk factors associated with UBPR after PVP in patients with OVCF. KEY WORDS: Unsatisfactory back pain relief, residual back pain, percutaneous vertebroplasty.

Le Fort I osteotomy for extensive juvenile nasopharyngeal angiofibroma: a retrospective study.

INTRODUCTION: Juvenile nasopharyngeal angiofibroma (JNA) is a rare, nonencapsulated, benign neoplasm typically diagnosed in adolescent boys. Surgery is the usual treatment modality for JNA. The optimal surgical procedure should allow maximal exposure of the tumor for complete excision with minimum morbidity. One possible surgical approach is Le Fort I maxillary osteotomy. The aim of this study was to review our experience with the Le Fort I osteotomy and to investigate the feasibility of this approach for extensive JNA invaded into pterygopalatine and infratemporal fossae. METHODS: We retrospectively studied patients who had undergone JNA resection via the Le Fort I osteotomy approach from July 2000 to September 2007, considering tumor location and size, complications, and tumor recurrence associated with the surgical approach. RESULTS: Six patients of JNA (all boys; mean age, 15.5 years) were identified through the chart review. All the angiofibromas had extended into the pterygomaxillary space and infratemporal fossa. The mean follow-up for this cohort was 50.1 months. No intraoperative and postoperative complications were noted, except for slight diplopia in one patient due to injury of the left medial rectus muscle. There were no cases of tumor recurrence that could be attributed to the procedure. CONCLUSION: Our experience suggests that the Le Fort I osteotomy approach is a useful technique for the removal of extensive JNA invaded into pterygopalatine and infratemporal fossae. It has distinct advantages over traditional anterior or lateral approaches, providing a more direct vision, improved exposure, and cosmesis.