Impact electrochemistry for biosensing: advances and future directions.

Impact electrochemistry allows for the investigation of the properties of single entities, ranging from nanoparticles (NPs) to soft bio-particles. It has introduced a novel dimension in the field of biological analysis, enhancing researchers' ability to comprehend biological heterogeneity and offering a new avenue for developing novel diagnostic devices for quantifying biological analytes. This review aims to summarize the recent advancements in impact electrochemistry-based biosensing over the past two to three years and provide insights into the future directions of this field.

Size- and Voltage-Dependent Electron Transport of C2N-Rings-Based Molecular Chains.

C2N-ring-based molecular chains were designed at the molecular level and theoretically demonstrated to show distinctive and valuable electron transport properties that were superior to the parent carbonaceous system and other similar nanoribbon-based molecular chains. This new -type molecular chain presented an exponential attenuation of the conductance and electron transmission with the length. Essentially, the molecular chain retained the electron-resonant tunneling within 7 nm and the dominant transport orbital was the LUMO. Shorter molecular chains with stronger conductance anomalously possessed a larger tunnel barrier energy, attributing to the compensation of a much smaller HOMO-LUMO gap, and these two internal factors codetermined the transport capacity. Some influencing factors were also studied. In contrast to the common O impurity with a tiny effect on electron transmission of the C2N rings chain, the common H impurity clearly improved it. When the temperature was less than 400 K, the electron transmission varied with temperature within a narrow range, and the structural disorder deriving from proper heating did not greatly modify the transmission possibility and the exponentially decreasing tendency with the length. In a non-equilibrium condition, the current increased overall with the bias but the growth rate varied with size. A valuable negative differential resistance (NDR) effect appeared in longer molecular chains with an even number of big carbon-nitrogen rings and strengthened with size. The emergence of such an effect originated from the reduction in transmission peaks. The conductance of longer molecular chains was enhanced with the voltage but the two shortest ones presented completely different trends. Applying the bias was demonstrated to be an effective way for C2N-ring-based molecular chains to slow down the conductance decay constant and affect the transport regime. C2N-ring-based molecular chains show a perfect application in tunneling diodes and controllable molecular devices.

Fabrication of a three-dimensional micro/nanocarbon structure with sub-10 nm carbon fiber arrays based on the nanoforming and pyrolysis of polyacrylonitrile-based jet fibers.

To produce a three-dimensional micro/nanocarbon structure, a manufacturing design technique for sub-10 nm carbon fiber arrays on three-dimensional carbon micropillars has been developed; the method involves initiating electrostatic jetting, forming submicron-to-nanoscale PAN-based fibers, and maximizing the shrinkage from polyacrylonitrile (PAN)-based fibers to carbon fibers. Nanoforming and nanodepositing methods for polyacrylonitrile-based jet fibers as precursors of carbon fibers are proposed for the processing design of electrostatic jet initiation and for the forming design of submicron-to-nanoscale PAN-based fibers by establishing and analyzing mathematical models that include the diameter and tensile stress values of jet fibers and the electric field intensity values on the surfaces of carbon micropillars. In accordance with these methods, an array of jet fibers with diameters of ~80 nm is experimentally formed based on the thinning of the electrospinning fluid on top of a dispensing needle, the poking of drum into an electrospinning droplet, and the controlling of the needle-drum distance. When converting thin PAN-based jet fibers to carbon fibers, a pyrolysis method consisting of the suspension of jet nanofibers between carbon micropillars, the bond between the fibers and the surface of the carbon micropillar, and the control of micropillar spacing, stabilization temperature, and carbonation rate is presented to maximize the shrinkage from PAN-based fibers to carbon fibers and to form sub-10 nm carbon fiber arrays between three-dimensional carbon micropillars. The manufacturing design of a three-dimensional micro/nanocarbon structure can produce thin PAN-based jet nanofibers and nanofiber arrays aligned on micropillar surfaces, obtain shrinkage levels reaching 96% and incorporate sub-10 nm carbon fibers into three-dimensional carbon micropillars; these actions provide new research opportunities for correlated three-dimensional micro/nanocarbon structures that have not previously been technically possible.

Iron-catalyzed regioselective synthesis of (E)-vinyl sulfones mediated by unprotected hydroxylamines.

An Fe-catalyzed unprotected hydroxylamine mediated Heck-type coupling between sulfinic acids and alkenes for the regioselective synthesis of (E)-vinyl sulfones has been developed. Mechanism studies indicated for the first time that a radical process may be involved and that hydroxylamines play multiple roles, including those of a mild oxidant and an in situ base. It was found for the first time that this transformation not only realizes C-S bond construction promoted by unprotected hydroxylamines, but also provides a practical and complementary method for the preparation of structurally important (E)-vinyl sulfones.

How the Establishment of the National Civilized City Promotes Urban Green Development: From the Perspective of Administrative Competing Theory-A Quasi Experiment Study in China.

Green development is the core goal for contemporary urban areas. It has become essential to explore new types of urban green development, and the concept of the "national civilized city" which is the most influential city brand in China, has emerged. Drawing upon the administrative competing theory, based on the panel data of 281 cities in China from 2000 to 2018, this paper employs a propensity scores matching (PSM) design and a difference-in-difference (DID) approach to examine the influence of the establishment of the national civilized city policy on the green development of prefecture-level cities in China. First, the result shows that the establishment of the national civilized city policy can significantly improve the urban green total factor productivity (GTFP). Second, the mediation mechanism analyses show that the establishment of national civilized city policy can promote cities to increase their investment in R&D, increase the financial investment in environmental governance, and optimize the industrial structure, which further lays a solid foundation for urban green development. Third, the heterogeneity analysis shows that the impact of civilized city construction on urban GTFP is different in terms of population and economic scales. The results show that the weight of environmental management and R&D investment should be increased in the evaluation index of the national civilized city, and the promotion of urban green development should be maximized.

Enhanced Antibacterial and Osteogenic Properties of Graphene Oxide Loaded with Berberine on Biomedical Titanium.

Internal implants are widely used in most orthopedic surgeries, of which titanium and its alloys are most widely used owing to the excellent corrosiveness resistance, low elastic modulus and good biocompatibility. However, implant failure still occurs for that titanium and its alloys themselves do not own antibacterial and osteogenic properties. In this work, we successfully fabricated berberine-loaded graphene oxide (GO) on the surface of biomedical titanium and systematically investigated its capabilities of antibacteria and osteogenesis. In vitro results showed that berberine had low antibacterial activity, but GO loaded with berberine on titanium (Ber&GO@Ti) exhibited superior antibacterial activity against Staphylococcus aureus (S. aureus) with the synergistic effect of GO and berberine. Meanwhile, Ber&GO@Ti performed satisfactory cytocompatibility and was capable of promoting osteogenic differentiation of MC3T3-E1 cells. In the vivo experiment, Ber&GO@Ti showed excellent antibacterial properties and inflammatory cells e.g., neutrophils had seldom been found. No visceral toxicity had been found. This multifunctional coating showed great potential in orthopedic implants.

Fabrication of crystalline submicro-to-nano carbon wire for achieving high current density and ultrastable current.

Crystalline carbon nanowire arrays were fabricated taking advantage of near-field electrospinning and stress decyanation. A novel fabrication method for carbon nanowires with radii ranging from ~2.15 µm down to ~25 nm was developed based on implementing nitrogen pretreatment on the silica surface and then aligning polymer nanofibers during near-field electrospinning at an ultralow voltage. Stress decyanation was implemented by subsequently pyrolyzing a polymer nanofiber array on the silica surface at 1000 °C for 1 h in an N2 atmosphere, thus obtaining a crystalline carbon nanowire array with a nanostructured surface. Various crystalline nanostructures were fabricated on the nanowire surface, and their electrochemical performance was evaluated by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Crystalline carbon wires with diameters ranging from micrometers to submicrometers displayed carbon nanoelectrode-like behavior with their CV curve having a sigmoidal shape. A highly crystalline carbon nanowire array showed distinct behavior, having a monotonically increasing straight line as its CV curve and a semicircular EIS spectrum; these results demonstrated its ultrastable current, as determined by electron transfer. Furthermore, nanocrystalline-structured carbon wires with diameters of ~305 nm displayed at least a fourfold higher peak current density during CV (4000 mA/m2) than highly crystalline carbon nanowires with diameters of ~100 nm and porous microwires with diameters of ~4.3 µm.

How does the perceived green human resource management impact employee's green innovative behavior? -From the perspective of theory of planned behavior.

Employees' green innovative behavior encouraged by enterprises plays an important role in the enterprise sustainable development. The study explores the impact of perceived green human resource management on employees' innovative behavior. Drawing upon the planned behavior theory, this study examines how perceived green human resource management impact employees' green innovation behavior. Through three-stage questionnaire survey, 207 samples are obtained and hierarchical regression is employed to test the hypothesis., Data analysis results show that perceived green human resource management has a directly positive effect on employees' green innovative behavior. Green behavior intention, self-efficacy of environmental protection behavior, and identity with the company's green environmental protection system are the mediators between perceived green human resource management and employees' green innovative behavior. Meanwhile, the results demonstrate that there is a chain mediating relationship among these variables. In addition, green supply chain management moderates the relationship between the identity of a green environmental protection system and employees' green innovative behavior. These conclusions transcend the macro perspective and open the black box between green human resource management and enterprise performance. Enterprise should take a holistic view to play the role of green human resource management and supply chain management in the implementation of environmental strategy.

Rapid sample preparation for detection of antibiotic resistance on a microfluidic disc platform.

Rapid, point-of-care (PoC) diagnostics for antibiotic susceptibility testing (AST) are critical in combating the antimicrobial resistance epidemic. While new, alternative technologies are capable of rapidly identifying antibiotic resistance, traditional AST methods, where a patient sample is incubated with different antibiotics, remain the most reliable and practical in determining antibiotic effectiveness. Here, we demonstrate a novel sample incubation technique on a microfluidic centrifugal disc (CD) as a proof of concept automated sample processing platform for AST. By using ribosomal RNA (rRNA) as a marker for cell growth, we demonstrated that incubation on the microfluidic CD was enhanced (>1.6 fold) for 11 out of 14 clinically relevant isolates of Escherichia coli compared to traditional shaker incubators. Finally, we utilize the system to identify antibiotic resistance of 11 E. coli isolates incubated with 5 different antibiotics in under 2 hours.

How much space of the spinal canal should be restored by hoisting the vertebrae-OPLL complex for sufficient decompression in anterior controllable antedisplacement and fusion? A multicenter clinical radiological study.

BACKGROUND CONTEXT: Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF. PURPOSE: To identify the possible prognostic factors for decompression outcomes after ACAF for cervical OPLL, to determine the critical value of radiological parameters for predicting good outcomes, and to establish a radiological standard for hoisting the VOC in ACAF. STUDY DESIGN: This was a retrospective multicenter study. PATIENT SAMPLE: A total of 121 consecutive patients with OPLL who underwent ACAF at a point between January 2017 and June 2018 at any one of seven facilities and were monitored for at least 1 year afterward were enrolled in a multicenter study. OUTCOME MEASURES: Japanese Orthopedic Association (JOA) scores, recovery rate (RR) of neurologic function, and surgical complications were used to determine the effectiveness of ACAF. METHODS: Patients were divided into two groups according to their RR for neurologic function. Patients with an RR of ≥50% and an RR of <50% were designated as having good and poor decompression outcomes, respectively. The relationship between various possible prognostic factors and decompression outcomes was assessed by univariate and multivariate analysis. The receiver operating characteristic curve was used to determine the optimal cutoff value of the radiological parameters for prediction of good decompression outcomes. Next, the patients were redivided into three groups according to the cutoff value of the selected radiological parameter (postoperative anteroposterior canal diameter [APD] ratio). Patients with postoperative APD ratios of ≤80.7%, 80.7%-100%, and ≥100% were defined as members of the incomplete, optimal, and excessive antedisplacement groups, respectively. Differences in decompression outcomes among the three groups were compared to verify the reliability of the postoperative APD ratio and assess the necessity of excessive antedisplacement. RESULTS: Multivariate logistic regression analysis showed that patients' age at surgery (odds ratio [OR]=1.18; 95% confidence interval [CI]=1.08-1.29; p<.01) and postoperative APD ratio (OR=0.83; 95% CI=0.77-0.90; p<.01) were independently associated with decompression outcomes. The optimal cutoff point of the postoperative APD ratio was calculated at 80.7%, with 86.2% sensitivity and 73.5% specificity. There were no significant differences in the postoperative JOA scores and RRs between the excessive antedisplacement group and optimal antedisplacement group (p>.05). However, a lower incidence of cerebrospinal fluid leakage and screw slippage was observed in the optimal antedisplacement group (p<.05). CONCLUSIONS: Patients' age at surgery and their postoperative APD ratio are the two prognostic factors of decompression outcomes after ACAF. The postoperative APD ratio is also the most accurate radiological parameter for predicting good outcomes. Our findings suggest that it is essential for neurologic recovery to restore the spinal canal to more than 80.7% of its original size (postoperative APD ratio >80.7%), and restoration to less than its original size (postoperative APD ratio <100%) will help reduce the incidence of surgical complications. This may serve as a valuable reference for establishment of a radiological standard for hoisting the VOC in ACAF.

[Literature research and status analysis on clinical application of Guizhi Fuling Formula].

Guizhi Fuling Formula was first seen in Synopsis of Golden Chamber by ZHANG Zhongjing. It is composed of Cinnamomi Ramulus, Poria, Moutan Cortex, Persicae Semen, Peony and other drugs, commonly used in the treatment of gynecological diseases such as hysteromyoma, ovarian cyst, endometriosis, pelvic inflammation, dysmenorrhea, etc. In addition, it is also used in internal medicine and urology. This reflects the modern doctors' recognition of the famous prescriptions in ancient books. However, whether Guizhi Fuling Formula is really suitable for these diseases still needs further study for verification. The author systematically searched CNKI, Wanfang, SinoMed, PubMed, EMbase, Cochrane Library database: 2 304 papers on clinical research of Guizhi Fuling, covering 13 systems and 128 diseases. Combined with the questionnaire of experts, we investigated the knowledge of experts of traditional Chinese medicine, Western medicine and combination of Chinese and Western medicine on the applicable indications of Guizhi Fuling Formula in this paper, systematically elaborated the clinical applications of Guizhi Fuling Formula, and summarized the applicable indications of Guizhi Fuling Formula, in order to provide a reference for the clinical rational application of Guizhi Fuling Formula, and provide a reference also for clinical medication.

Tumor-suppressor microRNA-139-5p restrains bladder cancer cell line ECV-304 properties via targeting Connexin 43.

BACKGROUND: In our previous paper, we demonstrated that Connexin 43 (CX43) was highly expressed in bladder cancer (BC) tissues. But the molecular mechanism about microRNAs (miRNAs) regulation upstream of CX43 in BC has not been well elucidated and remains to be further studied. MicroRNA-139-5p (miR-139-5p) is a tumor suppressor in progression of multifarious cancers including BC. Nevertheless, the underlying mechanisms of CX43/miR-139-5p in tumorigenesis of BC are still not well illustrated. The specific objective of our study was to inquiry the effect of CX43/miR-139-5p on BC progression and its underlying mechanism. METHODS: The bioinformatics analysis softwares were applied to predict the miRNAs in the upstream of CX43. First, the expression levels of miR-139-5p in BC tissues (tumor) and paracancer tissues (normal) were investigated using the data from The Cancer Genome Atlas database. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression level of miR-139-5p in three human BC cell lines 5637, T24, ECV-304 and a human bladder epithelial immortalized cell line SV-HUC-1 (normal control). Then si-CX43, si-control, miR-139-5p mimic, and its negative control (NC) were transfected into BC cell line ECV-304. The relationship of miR-139-5p and CX43 was analyzed by dual-luciferase reporter assay. The qRT-PCR and Western blotting were used to test the mRNA and protein expression level of CX43. The proliferation of ECV-304 and T24 cells were examined by cell counting kit-8. The migration and invasion of ECV-304 cells were tested by transwell assay. To determine whether miR-139-5p would affect cell proliferation, migration and invasion by targeting CX43, we executed the rescue assay. The comparison between two groups was analyzed by Student's t test, and comparisons among multiple samples were performed by one-way analysis of variance and a Bonferroni post hoc test. RESULTS: The expression of miR-139-5p was remarkably down-regulated in BC tissues (tumor vs. normal, 2.286 ±â€Š0.017 vs. 3.211 ±â€Š0.034, t = 11.540, P < 0.0001) and cell lines (P < 0.01 in all BC cell lines). Besides, we also indicated that over-expression of miR-139-5p reduced the proliferation of ECV-304 (P = 0.001) and T24 cells (P = 0.005). Moreover, miR-139-5p over-expression weakened the invasion (P = 0.001) and migration (P = 0.001) of ECV-304 cells. Furthermore, the relative luciferase activity of CX43-wild type construct was distinctly lessened by up-regulation of miR-139-5p (miR-139-5p mimic NC vs. miR-139-5p mimic, 0.916 ±â€Š0.063 vs. 0.356 ±â€Š0.048, t = 7.085, P = 0.002), nevertheless the activity of CX43-mutant type construct was untouched (miR-139-5p mimic NC vs. miR-139-5p mimic, 0.918 ±â€Š0.057 vs. 0.878 ±â€Š0.039, t = 0.577, P = 0.595). Finally, the rescue assay revealed that CX43 deletion enhanced the depressor effect of miR-139-5p on ECV-304 cell proliferation (P < 0.01), invasion (P = 0.028), and migration (P = 0.014). CONCLUSION: MiR-139-5p, as a tumor-suppressor, repressed cell proliferation, invasion, and migration in BC, which might be achieved by regulating CX43.

Determination of Mercury(II) on A Centrifugal Microfluidic Device Using Ionic Liquid Dispersive Liquid-Liquid Microextraction.

An integrated centrifugal microfluidic device was developed to preconcentrate and detect hazardous mercury (II) in water with ionic liquid as environmentally friendly extractant. An automatically salt-controlled ionic liquid dispersive liquid-liquid microextraction on a centrifugal microfluidic device was designed, fabricated, and characterized. The entire liquid transport mixing and separation process was controlled by rotation speed, siphon valves, and capillary valves. Still frame images on the rotating device showed the process in detail, revealing the sequential steps of mixing, siphon priming, transportation between chambers, and phase separation. The preconcentration of red dye could be clearly observed with the naked eye. By combining fluorescence probe and microscopy techniques, the device was tested to determine ppb-level mercury (II) in water, and was found to exhibit good linearity and low detection limit.

Stereoselectively Assembled Metal-Organic Framework (MOF) Host for Catalytic Synthesis of Carbon Hybrids for Alkaline-Metal-Ion Batteries.

Cost-effective metal-based nanostructured hybrids have been widely dedicated to potential energy storage and conversion applications. Herein, we develop a facile methodology for the synthesis of precise carbon-confined hybrid nanostructures by stereoselective assembly accompanied by catalytic pyrolysis. Polyacrylonitrile fiber films favors not only metal-polymer coordination, but also oriented assembly to ensure the well-defined nanostructure of the carbon hybrids. During chemical vapor deposition (CVD), cobalt-nanoparticle-catalyzed growth of carbon-nanotube branches driven by organic molecules (e.g. melamine) delivers hierarchical carbon hybrids. The resulting carbon hybrids exhibit outstanding electrochemical performance for metal-ion batteries, for example, a high specific capacity of 680 mAh g-1 after 320 cycles (Li-storage) and 220 mAh g-1 after 500 cycles (Na-storage) without decay.

Validation and implementation of Planova™ BioEX virus filters in the manufacture of a new liquid intravenous immunoglobulin in China.

There is a continuous need to improve the viral safety of plasma products, and we here report the development and optimization of a manufacturing-scale virus removal nanofiltration step for intravenous immunoglobulin (IVIG) using the recently introduced Planova™ BioEX filter. IVIG throughput was examined for various operating parameters: transmembrane pressure, temperature, protein concentration, and prefiltration methods. The developed procedure was based on filtering undiluted process solution (50.0 g/l IVIG) under constant transmembrane pressure filtration at 294 kPa and 25 °C following prefiltration with a 0.1 µm MILLEX VV filter. The recovery of IgG was approximately 98%, and no substantial changes in biochemical characteristics were observed before and after nanofiltration in scaled-up production. A viral clearance validation study with parvovirus under worst-case conditions performed at the National Institutes for Food and Drug Control of China (NIFDC) showed PPV logarithmic reduction value (LRV) > 4. Improved viral safety of IVIG can be assured by implementing a Planova BioEX nanofiltration step to ensure effective parvovirus clearance under conditions providing excellent protein recovery and no detectable impact on product biochemical properties. This plasma-derived IVIG product is the first to be certified for parvovirus safety by the NIFDC in China.

HIF1/2α mediates hypoxia-induced LDHA expression in human pancreatic cancer cells.

Glycolysis is a typical conduit for energy metabolism in pancreatic cancer (PC) due to the hypoxic microenviroment. Lactate dehydrogenase A (LDHA) catalyzes the conversion of pyruvate to lactate and is considered to be a key checkpoint of anaerobic glycolysis. The aim of the present study was to explore the mechanism of interactions between hypoxia, HIF-1/2α and LDHA, and the function of LDHA on PC cells by analyzing 244 PC and paratumor specimens. It was found that LDHA was over-expressed and related to tumor stages. The result of in vitro study demonstrated that hypoxia induced LDHA expression. To explore the relationship between HIF and LDHA, chromatin immunoprecipitation assay and luciferase assay were performed. The result showed that HIF-1/2α bound to LDHA at 89bp under the hypoxic condition. Furthermore, knockdown of endogenous HIF-1α and HIF-2α decreased the LDHA expression even in the hypoxic condition, which was accompanied with a significant decrease in lactate production and glucose utilization (p < 0.01). Immunofluorescence in the 244 specimens showed that HIF-1/2α was over-expressed and associated with LDHA over-expression (p < 0.0001). Forced expression of LDHA promoted the growth and migration of PC cells, while knocking down the expression of LDHA inhibited the cell growth and migration markedly. In summary, the present study proved that HIF1/2α could activate LDHA expression in human PC cells, and high expression of LDHA promoted the growth and migration of PC cells.

HIF-1α activates hypoxia-induced BCL-9 expression in human colorectal cancer cells.

B-cell CLL/lymphoma 9 protein (BCL-9), a multi-functional co-factor in Wnt signaling, induced carcinogenesis as well as promoting tumor progression, metastasis and chemo-resistance in colorectal cancer (CRC). However, the mechanisms for increased BCL-9 expression in CRC were not well understood. Here, we report that hypoxia, a hallmark of solid tumors, induced BCL-9 mRNA expression in human CRC cells. Analysis of BCL-9 promoter revealed two functional hypoxia-responsive elements (HRE-B and HRE-C) that can be specifically bound with and be transactivated by hypoxia inducible factors (HIF) -1α but not HIF-2α. Consistently, ectopic expression of HIF-1α but not HIF-2α transcriptionally induced BCL-9 expression levels in cells. Knockdown of endogenous HIF-1α but not HIF-2α by siRNA largely abolished the induction of HIF by hypoxia. Furthermore, there was a strong association of HIF-1α expression with BCL-9 expression in human CRC specimens. In summary, results from this study demonstrated that hypoxia induced BCL-9 expression in human CRC cells mainly through HIF-1α, which could be an important underlying mechanism for increased BCL-9 expression in CRC.

En Bloc Resection of Primary Malignant Bone Tumor in the Cervical Spine Based on 3-Dimensional Printing Technology.

OBJECTIVE: To investigate the feasibility and safety of en bloc resection of cervical primary malignant bone tumors by a combined anterior and posterior approach based on a three-dimensional (3-D) printing model. METHODS: Five patients with primary malignant bone tumors of the cervical spine underwent en bloc resection via a one-stage combined anteroposterior approach in our hospital from March 2013 to June 2014. They comprised three men and two women of mean age 47.2 years (range, 26-67 years). Three of the tumors were chondrosarcomas and two chordomas. Preoperative 3-D printing models were created by 3-D printing technology. Sagittal en bloc resections were planned based on these models and successfully performed. A 360° reconstruction was performed by spinal instrumentation in all cases. Surgical margins, perioperative complications, local control rate and survival rate were assessed. RESULTS: All patients underwent en bloc excision via a combined posterior and anterior approach in one stage. Mean operative time and estimated blood loss were 465 minutes and 1290 mL, respectively. Mean follow-up was 21 months. Wide surgical margins were achieved in two patients and marginal resection in three; these three patients underwent postoperative adjuvant radiation therapy. One vertebral artery was ligated and sacrificed in each of three patients. Nerve root involved by tumor was sacrificed in three patients with preoperative upper extremity weakness. One patient (Case 3) had significant transient radiculopathy with paresis postoperatively. Another (Case 4) with C 4 and C 5 chordoma had respiratory difficulties and pneumonia after surgery postoperatively. He recovered completely after 2 weeks' management with a tracheotomy tube and antibiotics in the intensive care unit. No cerebrovascular complications and wound infection were observed. No local recurrence or instrumentation failure were detected during follow-up. CONCLUSION: Though technically challenging, it is feasible and safe to perform en bloc resection of cervical primary bone tumors. This is the most effective means of managing cervical spine tumors. Preoperative 3-D printing modelling enables better anatomical understanding of the relationship between the tumor and cervical spine and can assist in planning the surgical procedure.

The valuation of using FDG PET-CT in detecting osteoid osteoma of the cervical spine.

STUDY DESIGN: Osteoid osteomas (OOs) are bone tumors that rarely occur in the cervical spine. The current study is a retrospective analysis on 10 patients who were diagnosed with this rare spinal bone tumor. We have excised OOs of the cervical spine with the use of FDG Positron emission tomography-computed tomography (PET-CT) for preoperative diagnosis. OBJECTIVE: With the help of the FDG PET-CT, we can confidently remove the nidus of the OOs, while minimize iatrogenic injury of the surrounding normal bone elements, and preserve the stability of the cervical spine. SUMMARY OF BACKGROUND DATA: OO of the cervical spine is frequently located at the nerve root adjacent to the vertebral artery, spinal cord. PET-CT is a sensitive tool with applications in the detection of bone lesions, especially in patients with difficult diagnosis or continuing misdiagnosis of tumors. MATERIALS AND METHODS: Ten patients (8 male and 2 female patients) underwent surgery for tumor removal using PET-CT in our department. Various diagnostic imaging modalities including x-ray, magnetic resonance imaging, CT, bone scintigraphy, and PET-CT were used. PET-CT scan results were measured using standard uptake value. (The size of the cases series was from 4×5 mm to 12×15 mm.) Pain was evaluated using the visual analogue score. Clinical outcome was evaluated immediately postoperatively and at a mean follow-up of 49.8±0.2 months (range, 7-92 mo). RESULTS: All tumors were successfully diagnosed with the use of PET-CT. The average standard uptake value was 2.7±0.1 (range, 2.0-3.4). The nidus of the OO was detected and removed, and the peripheral elements were preserved. The visual analogue score was 8.1±0.1 preoperation, and it significantly decreased to 2.5±0.3 (P<0.01) postoperation and 0.2±0.1 (P<0.01) at the final visit. Immediately after surgery, the patients were relieved of their pain symptoms. There was no injury of the vertebral artery, leakage of cerebrospinal fluid, infectious complications, and neurological injury during the procedure. CONCLUSIONS: It is valuable of using of PET-CT to diagnose OOs of the cervical vertebra. Subsequently, it is a good way that helps us in efficient removal of the OOs completely.

Controlling the recurrence of pelvic endometriosis after a conservative operation: comparison between Chinese herbal medicine and western medicine.

OBJECTIVE: To compare the clinical effect of Chinese medicine (CM) and Western medicine (WM) for controlling the recurrence of pelvic endometriosis after a conservative operation. METHODS: The study was a multi-center, randomized, parallel controlled and prospective clinical trial. Patients were randomly divided into two groups: CM group (106 cases) and WM group (102 cases). Drugs were given to patients during 1-5 days of the first menstruation after a conservative operation in both groups. Patients with stages I and II (revised American Fertility Society) were treated for 3 months, while the patients with stages III and IV were treated for 6 months. The patients in the CM group were treated using three types of Chinese herbal medicine based on syndrome differentiation. Patients in the WM group were treated using gonadotropin releasing hormone agonist (GnRH-a) or gestrinone. Patients treated with GnRH-a received add-back therapy of Tibolone Tablets once a day after 4 months of treatment. Any cases of dysmenorrheal chronic pelvic pain, menstruation and any adverse reactions of patients were recorded once a month during the preoperative and postoperative periods and once every 3 months during the follow-up period. During the preoperative, postoperative and the follow-up periods, patients underwent type B ultrasonography of the pelvis and measurements of serum CA125 levels, gynecologic examination, routine evaluations of blood, urine, hepatic function (glutamate pyruvate transaminase), renal function (blood urea nitrogen) and electrocardiograms. During the follow-up period they underwent type B pelvic ultrasonography, measurement of serum CA125 levels and further gynecologic examinations. The two treatments were compared for clinical recurrence rates, pregnancy rates and the incidence of adverse reactions. RESULTS: The incidence and timing of recurrence of endometriosis were not significantly different between the two groups. The first pregnancy achieved by the patient in the CM group was significantly earlier than that in the WM group (P <0.05). Moreover, the incidence of adverse reactions in the WM group was significantly higher than in the CM group (P <0.01). CONCLUSIONS: Treatment with Chinese herbal medicines prevented the recurrence of endometriosis after a conservative operation, improved the conception rate and showed fewer and lighter adverse reactions than did treatment with WM therapy. Treatment with Chinese herbal medicine meets the need of patients wishing to have a child following endometriosis and is an appropriate form of clinical treatment.