High-fidelity synthesis of microhole templates with low-surface-energy-enabled self-releasing photolithography.

Material patterning through templates has provided an efficient way to meet the critical requirement for surface function in various fields. Here, we develop a self-releasing photolithographic process to make large-area freestanding templates with precise patterns. The low surface energy of substrates by hydrophobic treatment with proper silane modification ensures the template self-releasing. This method eliminates the need of mechanical separation or any sacrificial layers. Major steps including UV exposure and baking are optimized to realize high-quality structures and the final release of templates. The negative photoresists of SU-8 and polyimide are chosen to confirm the feasibility of this process. Wafer-scale freestanding templates with uniform microhole arrays are obtained with high structural fidelity, smooth surfaces and excellent flexibility. The hole size ranges from several to several tens of micrometers with an extremely low variation (<1%). These advantages could promote the application of precisely structured templates for surface patterning in material and surface science.

Freestanding Metal Nanomembranes and Nanowires by Template Transfer with a Soluble Adhesive.

The fabrication of nanostructures usually involves chemical processes that have in certain steps. Especially, it is necessary to use the chemical etching method to release the as-patterned structures from the substrate in most of the transfer techniques. Here, a novel scheme of template transfer as developed for the fabrication of freestanding Au nanomembranes and nanowires by using a soluble PVP adhesive. The nanomembranes feature the periodic nanohole arrays with high uniformity. Without the substrates, these plasmonic nanohole arrays show symmetric and antisymmetric resonance modes with bright and dark spectral features, respectively, in transmission. Through the spectral analysis for reflection, we have disclosed that the usual dark mode in transmission is not really dark, but it reveals a distinct feature in reflection. Two coupling modes present distinct spectral features in transmission and reflection due to their different loss channels. To show their versatility, the freestanding nanomembranes were also employed as secondary templates to form Si nanowire arrays by the metal-assisted chemical etching method.

Tunable Fluid-Type Metasurface for Wide-Angle and Multifrequency Water-Air Acoustic Transmission.

Efficient acoustic communication across the water-air interface remains a great challenge owing to the extreme acoustic impedance mismatch. Few present acoustic metamaterials can be constructed on the free air-water interface for enhancing the acoustic transmission because of the interface instability. Previous strategies overcoming this difficulty were limited in practical usage, as well as the wide-angle and multifrequency acoustic transmission. Here, we report a simple and practical way to obtain the wide-angle and multifrequency water-air acoustic transmission with a tunable fluid-type acoustic metasurface (FAM). The FAM has a transmission enhancement of acoustic energy over 200 times, with a thickness less than the wavelength in water by three orders of magnitude. The FAM can work at an almost arbitrary water-to-air incident angle, and the operating frequencies can be flexibly adjusted. Multifrequency transmissions can be obtained with multilayer FAMs. In experiments, the FAM is demonstrated to be stable enough for practical applications and has the transmission enhancement of over 20 dB for wide frequencies. The transmission enhancement of music signal across the water-air interface was performed to demonstrate the applications in acoustic communications. The FAM will benefit various applications in hydroacoustics and oceanography.

Lotus Metasurface for Wide-Angle Intermediate-Frequency Water-Air Acoustic Transmission.

Only 0.1% of the acoustic energy can transmit across the water-air interface because of the huge acoustic impedance mismatch. Enhancing acoustic transmission across the water-air interface is of great significance for sonar communications and sensing. However, due to the interface instability and subwavelength characteristics of acoustic metamaterials, wide-angle intermediate-frequency (10 kHz-100 kHz) water-air acoustic transmission remains a great challenge. Here, we demonstrate that the lotus leaf is a natural low-cost acoustic transmission metasurface, namely, the lotus acoustic metasurface (LAM). Experiments demonstrate the LAM can enhance the acoustic transmission across the water-air interface, with an energy transmission coefficient of about 40% at 28 kHz. Furthermore, by fabricating artificial LAMs, the operating frequencies can be flexibly adjusted. Also, the LAM allows a wide-angle water-to-air acoustic transmission. It will enable various promising applications, such as detecting and imaging underwater objects from the air, communicating between ocean and atmosphere, reducing ocean noises, etc.

Thiostrepton and miR-216b synergistically promote osteosarcoma cell cytotoxicity and apoptosis by targeting FoxM1.

Osteosarcoma is a common primary bone cancer that there are currently no effective treatment strategies for. Forkhead box M1 (FoxM1) is key in the development of osteosarcoma, and microRNA (miR)-216b serves an antitumor role by targeting FoxM1. Moreover, thiostrepton (TST), a natural thiazole antibiotic, induces antitumor effects and specifically targets FoxM1. Therefore, the present study investigated whether thiostrepton and miR-216b synergistically inhibited osteosarcoma cells by targeting FoxM1. The MTT assay, reverse transcription-quantitative PCR, a dual-luciferase reporter assay and flow cytometry were performed. Compared with the human osteoblast cell line hFOB1.19, miR-216b expression was significantly downregulated in the osteosarcoma cell lines U2OS, MG63 and Saos-2. By contrast, FoxM1 expression was significantly upregulated in osteosarcoma cell lines compared with the hFOB1.19 cell line. The results indicated that miR-216b targeted the 3'-untranslated region of FoxM1. Moreover, the results suggested that miR-216b cooperated with TST to decrease cell cytotoxicity and increase cell apoptosis. In addition, miR-216b cooperated with TST to increase Bax expression and decrease Bcl-2 expression. In conclusion, the combination of TST and miR-216b synergistically promoted osteosarcoma cell cytotoxicity and apoptosis by targeting FoxM1. Therefore, the present study suggested that the combination of TST and miR-216b may serve as a promising therapeutic strategy for osteosarcoma.

Sound absorption by acoustic microlattice with optimized pore configuration.

The great progress in material science and nano-micro fabrication enables the applications of metamaterials with well-defined and well-organized microstructures for noise reduction. However, what intrinsic morphology of the metamaterial would result in optimum sound absorbing efficiency remains uncertain. This work presents a microlattice metamaterial, comprising well-defined and organized material morphology in terms of pore size and porosity, for generating optimum sound dissipation. A compact governing equation is established and verified experimentally to show that the optimum sound absorption can only be reached when the pore size equals twice the thickness of a viscous boundary layer.

Macroporous Double-Network Hydrogel for High-Efficiency Solar Steam Generation Under 1 sun Illumination.

Solar steam generation is one of the most promising solar-energy-harvesting technologies to address the issue of water shortage. Despite intensive efforts to develop high-efficiency solar steam generation devices, challenges remain in terms of the relatively low solar thermal efficiency, complicated fabrications, high cost, and difficulty in scaling up. Herein, a double-network hydrogel with a porous structure (p-PEGDA-PANi) is demonstrated for the first time as a flexible, recyclable, and efficient photothermal platform for low-cost and scalable solar steam generation. As a novel photothermal platform, the p-PEGDA-PANi involves all necessary properties of efficient broadband solar absorption, exceptional hydrophilicity, low heat conductivity, and porous structure for high-efficiency solar steam generation. As a result, the hydrogel-based solar steam generator exhibits a maximum solar thermal efficiency of 91.5% with an evaporation rate of 1.40 kg m-2 h-1 under 1 sun illumination, which is comparable to state-of-the-art solar steam generation devices. Furthermore, the good durability and environmental stability of the p-PEGDA-PANi hydrogel enables a convenient recycling and reusing process toward real-life applications. The present research not only provides a novel photothermal platform for solar energy harvest but also opens a new avenue for the application of the hydrogel materials in solar steam generation.

A compact method for efficient evaluation of acoustic absorbers with submicron materials.

Materials with submicron or nano-scale features possess unique physical properties and are well-suited for application in noise reduction. To date, experimental characterization of the sound absorbing ability of the submicron/nano materials is still a challenging task, because the measuring of sound absorptivity usually requires bulky samples, while the preparation of large quantities of submicron/nano materials or structures is generally costly and laborious. In this work, an acoustic testing method is proposed to evaluate the acoustic absorptivity of submicron/nano materials using small samples. Based on the transfer-matrix algorithm, the method establishes correlations among acoustic-related parameters of a large sensor fixture and a small sample holder. A proof-of-principle experimental setup was developed to test absorbers with well-known acoustic behavior to verify accuracy of the method. Finally, the sound absorption properties of two submicron materials are characterized, with one comprising dispersed silver submicron fibers and the other comprising electrospinning submicron fibers. The results indicate that acoustic absorption coefficients can be effectively retrieved using only 1/200 of the amount of materials that are typically required in the standard test.

Effects of Sanguis Draconis on Perforator Flap Survival in Rats.

Sanguis draconis, a resin known to improve blood circulation, relieve pain, stimulate tissue regeneration, and heal wounds, is widely used in clinical practice. In this study, we prepared an ethanol extract of sanguis draconis (EESD) containing 75.08 mg/g of dracorhodin. The experiment was carried out on 20 rats that were divided into two groups, a control group (n = 10) and an EESD group (n = 10). All the rats underwent a perforator flap surgery, after which post-operative abdominal compressions of EESD were given to the EESD group for seven days, while the control group received saline. Flap survival percentages were determined after seven days, and were found to be significantly higher in the EESD group than in the control group. Results of laser Doppler flowmetry (LDF) showed that perforator flaps in the EESD group had higher perfusion values than those of the control group. The flap tissues were stained with hematoxylin and eosin, followed by immunohistochemical evaluation. Superoxide dismutase (SOD) expression and micro-vessel development markedly increased in the EESD group, while malondialdehyde (MDA) levels decreased. This is the first study to investigate the effect of sanguis draconis on perforator flap survival. Our results demonstrate that sanguis draconis can improve perforator flap survival in rats by promoting microvessel regeneration and blood perfusion.

A Novel Classification and Minimally Invasive Treatment of Degenerative Lumbar Spinal Stenosis.

AIM: We conducted a novel classification system of degenerative lumbar spinal stenosis (DLSS) based on clinical manifestations and imaging (computed tomography and magnetic resonance imaging) features. We chose different minimally invasive surgical procedures according to our system. Clinical parameters and radiological findings will be assessed in the article. MATERIAL AND METHODS: A retrospective study was conducted on 96 patients undergoing minimally invasive surgery for DLSS. We chose different surgical procedures according to our novel classification system based on clinical manifestations, imaging features, and concurrence with other spinal diseases. Clinical parameters and radiological findings were assessed pre- and postoperatively. RESULTS: The mean follow up period was 24 months (range, 15~36 months). There was a statistically significant improvement in the Visual Analogue Scale (VAS) score of low back pain and leg pain after surgery (p < 0.05). According to the Japanese Orthopaedic Association (JOA) scores, the operation efficacy was excellent in 57 cases, good in 36 cases, and fair in 3 cases. According to Bridwell's criterion, the fusion rate was 96% (48/50) in patients who underwent fusion surgery. There were no cages or pedicle screws related complications. CONCLUSION: Minimally invasive surgical treatment of DLSS has satisfactory outcomes according to the novel classification, but further long-term, prospective, randomized controlled studies involving a larger study group are needed to validate the long-term efficacy.

Biocompatibility of artificial bone based on vancomycin loaded mesoporous silica nanoparticles and calcium sulfate composites.

The aim of this study was to evaluate the in vitro and in vivo biocompatibility of artificial bone based on vancomycin loaded mesoporous silica nanoparticles and calcium sulfate composites. In vitro cytotoxicity tests by cholecystokinin octapeptide (CCK-8) assay showed that the 5%Van-MSN-CaSO4 and Van-CaSO4 bone cements were cytocompatible for mouse osteoblastic cell line MC3T3-E1. The microscopic observation confirmed that MC3T3-E1cells incubated with Van-CaSO4 group and 5%Van-MSN-CaSO4 group exhibited clear spindle-shaped changes, volume increase and maturation, showing that these cements supported adhesion of osteoblastic cells on their surfaces. In addition, the measurement of alkaline phosphatase activity revealed the osteoconductive property of these biomaterials. In order to assess in vivo biocompatibility, synthesized cements were implanted into the distal femur of twelve adult male and female New Zealand rabbits. After implantation in artificial defects of the distal femur, 5%Van-MSN-CaSO4 and Van-CaSO4 bone cements did not damage the function of main organs of rabbits. In addition, the Van-MSN-CaSO4 composite allowed complete repair of bone defects with new bone formation 3 months after implantation. These results show potential application of Van-MSN-CaSO4 composites as bone graft materials for the treatment of open fracture in human due to its mechanical, osteoconductive and potential sustained drug release characteristics and the absence of adverse effects on the body.

A feed-forward regulatory loop between androgen receptor and PlncRNA-1 promotes prostate cancer progression.

We previously reported that PlncRNA-1, a long non-coding RNA that is up-regulated in prostate cancer (PCa), affects the proliferation and apoptosis of PCa cells. However, the molecular mechanisms underlying these effects remain largely unknown. In this study, we demonstrated that long non-coding RNA PlncRNA-1, whose expression is promoted by Androgen Receptor (AR), protects AR from microRNA-mediated suppression in PCa cells. PlncRNA-1 knockdown resulted in the up-regulation of a series of AR-targeting microRNAs, among which miR-34c and miR-297 were found to regulate both AR and PlncRNA-1 expression at the post-transcriptional level. Functional analysis revealed that miR-34c and miR-297 overexpression down-regulated AR expression and inhibited the expression of downstream AR targets and that PlncRNA-1 overexpression rescued these effects. The association of PlncRNA-1 with tumor progression was also evaluated in mouse xenograft models, PCa tissues (16 paired samples), and blood samples (35 biopsy-negative and 37 biopsy-positive). Together, the data generated in this study indicate that PlncRNA-1 sponges AR-targeting microRNAs to protect AR from microRNA-mediated down-regulation and that these events form a regulatory feed-forward loop in the development of PCa. These findings suggest that PlncRNA-1 might potentially serve as a novel biomarker in PCa and that PlncRNA-1 might warrant further investigation to determine its potential role as a promising therapeutic target in PCa.

Direct Pen Writing of Adhesive Particle-Free Ultrahigh Silver Salt-Loaded Composite Ink for Stretchable Circuits.

In this article, we describe a writable particle-free ink for fast fabrication of highly conductive stretchable circuits. The composite ink mainly consists of soluble silver salt and adhesive rubber. Low toxic ketone was employed as the main solvent. Attributed to ultrahigh solubility of silver salt in short-chain ketone and salt-assisted dissolution of rubber, the ink can be prepared into particle-free transparent solution. As-prepared ink has a good chemical stability and can be directly filled into ballpoint pens and use to write on different substrates to form well adhesive silver salt-based composite written traces as needed. As a result of high silver salt loading, the trace can be converted into highly conductive silver nanoparticle-based composites after in situ reduction. Because of the introduction of adhesive elastomeric rubber, the as-formed conductive composite written trace can not only maintain good adhesion to various substrates but also show good conductivity under various deformations. The conductivity of written traces can be enhanced by repeated writing-reduction cycles. Different patterns can be fabricated by either direct handwriting or hand-copying. As proof-of-concept demonstrations, a typical handwriting heart-like circuit was fabricated to show its capability to work under different deformations, and a pressure-sensitive switch was also manufactured to present pressure-dependent change of resistance.

[Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation].

OBJECTIVE: To explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation. METHODS: From January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared. RESULTS: All patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis. CONCLUSION: Chosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain.

Age-Specific Cutoff Value for the Application of Percent Free Prostate-Specific Antigen (PSA) in Chinese Men with Serum PSA Levels of 4.0-10.0 ng/ml.

OBJECTIVE: The influence of age on the performance of percent free prostate-specific antigen (%fPSA) in diagnosing prostate cancer (PCa) in East Asians is controversial. We tested the diagnostic performance of %fPSA in a multi-center biopsy cohort in China and identified the proper age-specific cutoff values to avoid unnecessary biopsies. METHODS: Consecutive patients with a prostate-specific antigen (PSA) level of 4.0-10.0 ng/ml or 10.1-20.0 ng/ml who underwent transrectal ultrasound-guided or transperineal prostate biopsy were enrolled from 22 Chinese medical centers from Jan 1, 2010 to Dec 31, 2013. The diagnostic accuracy of PSA and %fPSA was determined using the area under the receiver operating characteristic (ROC) curve (AUC). Age-specific cutoff values were calculated using ROC curve analysis. RESULTS: The median %fPSA was much lower in younger patients compared with older patients with a PSA level of 4.0-10.0 ng/ml or 10.1-20.0 ng/ml. The AUC of %fPSA was higher than PSA only in older patients. In patients aged 50 to 59 years, %fPSA failed to improve the diagnosis compared with PSA in these two PSA ranges. Age-specific cutoff values were 24%, 27% and 32% for patients aged 60-69, 70-79 and ≥80 years, respectively, to reduce unnecessary biopsies in men with PSA levels of 4.0-10.0 ng/ml to detect 90% of all PCa. CONCLUSIONS: The effectiveness of %fPSA is correlated with age in the Chinese population. Age-specific cutoff values would help avoid unnecessary biopsies in the Chinese population.

Clinical utility of a novel urine-based gene fusion TTTY15-USP9Y in predicting prostate biopsy outcome.

OBJECTIVE: In recent years, great effort has been made to explore new biomarkers for early detection of prostate cancer. Our previous study has demonstrated the high prevalence of TTTY15-USP9Y in prostate cancer samples from a Chinese population. Our aim was to evaluate the clinical utility of TTTY15-USP9Y in predicting the prostate biopsy outcome. MATERIALS AND METHODS: We retrospectively examined the expression of TTTY15-USP9Y in 226 qualified urine sediment samples. Total RNA was extracted from the urine sediment by using TRIzol reagent, and complementary DNA was synthesized using TransPlex Complete Whole Transcriptome Amplification Kit (WTA2). Real-time quantitative polymerase chain reaction was performed to evaluate the expression of TTTY15-USP9Y and the prostate cancer-specific antigen (PSA) level. The TTTY15-USP9Y score was calculated as 2(Ct(PSA)-Ct(TTTY15-USP9Y))× 1,000. RESULTS: The TTTY15-USP9Y score was statistically significantly higher in men with positive biopsy outcome than in men with negative biopsy outcome (P<0.001). The area under the curve was 0.828 for the TTTY15-USP9Y score in the entire patient cohort. The TTTY15-USP9Y score׳s cutoff of 90.28 provided the optimal balance between sensitivity (84.0%) and specificity (77.5%). The combination of PSA level and the TTTY15-USP9Y score significantly improved the diagnostic performance of PSA level (P = 0.001). The TTTY15-USP9Y score alone was superior to PSA level, percent free PSA, and PSA density (serum PSA/prostate volume) in the subgroup of clinical interest (PSA level: 4-10ng/ml, gray zone). Univariable and multivariable logistic analyses indicated that TTTY15-USP9Y score, PSA level, age, and prostate volume were independent predictors of PCa. Adding the TTTY15-USP9Y score in the clinical base model (PSA level, age, and prostate volume) could bring a higher net benefit and reduce more unnecessary biopsies in the defined range of interest (10%-40% threshold probability). CONCLUSION: In conclusion, our study explored the potential utility of measuring the TTTY15-USP9Y score in post-digital rectal examination urine samples to predict biopsy outcome and provided the basis for the utility of this novel gene fusion in multicenter and large cohort studies.

Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ng ml(-1).

Percent free prostatic-specific antigen (%fPSA) has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml-1 , however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer (PCa) and high-grade PCa (HGPCa) was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA>4.0 ng ml-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA (%fPSA + PSA) was determined by the area under the receivers operating characteristic curve (AUC). %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml-1 and 10.1-20.0 ng ml-1 , respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml-1 and 10.1-20.0 ng ml-1 .

Optimization on microlattice materials for sound absorption by an integrated transfer matrix method.

Materials with well-defined microlattice structures are superlight, stable, and thus bear great potential in sound absorption. An integrated transfer matrix method (TMM) is proposed to evaluate the sound absorbing efficiency of these lattice materials, in which a massive number of micropores are densely placed. A comparison between integrated TMM and conventional TMM reveals that the proposed approach offers better predictions on sound absorption of microlattice. This approach is then employed to optimize the microlattice material to determine the best pore and porosity that lead to maximum absorbing efficiency capability and minimum required thickness to attain a target sound absorption.

Bone cement based on vancomycin loaded mesoporous silica nanoparticle and calcium sulfate composites.

A novel bone cement pellet, with sustained release of vancomycin (VAN), was prepared by mixing VAN loaded mesoporous silica nanoparticle (MSN) and calcium sulfate α-hemihydrate (CS) together. To improve the VAN loading ability, MSN was functionalized with aminopropyltriethoxysilane (APS) to give APS-MSN. The VAN loading content and entrapment efficiency of APS-MSN could reach up to 45.91±0.81% and 84.88±1.52%, respectively, much higher than those of MSN, which were only 3.91% and 4.07%, respectively. The nitrogen adsorption-desorption measurement results demonstrated that most of the VAN were in the pores of APS-MSN. The CS/VAN@APS-MSN composite pellet showed a strongly drug sustained release effect in comparison with CS control pellet. The in vitro cell assays demonstrated that CS/APS-MSN composite was highly biocompatible and suitable to use as bone cement. Furthermore, CS/VAN@APS-MSN pellet showed no pyrogenic effect and meet the clinical requirements on hemolytic reaction. These results imply that CS/VAN@APS-MSN was an ideal candidate to replace CS bone cement in the treatment of open fractures.

Unilateral or bilateral percutaneous vertebroplasty for acute osteoporotic vertebral fracture: a prospective study.

BACKGROUND: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, the matter of which surgical approach should be selected remains controversial. This research aims to compare the clinical results of unilateral and bilateral PVP for AOVF. METHODS: From January 2008 to December 2011, 68 patients with AOVF were randomly assigned to the unilateral puncture group (n=36) or the bilateral group (n=32). These patients underwent percutaneous injection of polymethyl methacrylate into posterior pedicle by the unilateral or bilateral puncture approach. Visual analogue scale (VAS) and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) were recorded on presentation, at 1 week, 3, 6, and 12 months after operation. The cement leakage was measured by x-ray and computed tomography scan. RESULTS: Follow-up data showed there were no significant differences in VAS and QUALEFFO between 2 groups at 1 week after PVP and only significant difference was observed between 2 groups at 3, 6, and 12 months after operation. The cement leakage was 52.7% in the unilateral puncture group and 28.1% in the bilateral group. CONCLUSIONS: Compared with unilateral puncture, use of bilateral approach during PVP may result in more superior long-term outcomes and less cement leakage for patients with AOVF.