Alternate levels versus all levels mini-plate fixation in C3-6 cervical laminoplasty: a retrospective comparative study.

OBJECTIVE: The purpose of this study is to compare radiological and clinical outcomes between alternate levels (C4 and C6) and all levels mini-plate fixation in C3-6 unilateral open-door laminoplasty. METHODS: Ninety-six patients who underwent C3-6 unilateral open-door laminoplasty with alternate levels mini-plate fixation (54 patients in group A) or all levels mini-plate fixation (42 patients in group B) between September 2014 and September 2019 were reviewed in this study. Radiologic and clinical outcomes were assessed. Clinical results included Visual Analogue Scale (VAS) of axial neck pain and Japanese Orthopedic Association (JOA) score. Radiographic results included cervical range of motion (ROM), cervical curvature index (CCI), and the spinal canal expansive parameters including open angle, anteroposterior diameter (APD), and Pavlov`s ratio. RESULTS: There was no significant difference in VAS, JOA score, ROM, and CCI between two groups. There was no significant difference in canal expansion postoperatively between two groups. However, open angle, APD, and Pavlov`s ratio in group A decreased significantly during the follow-up. In group B, APD, Pavlov`s ratio, and open angle were maintained until the final follow-up. There was no hardware failure or lamina reclosure occurred in both groups during the follow-up. The mean cost of group B was higher than that of group A. CONCLUSIONS: Despite the differences in the maintenance of canal expansion, alternate levels mini-plate fixation can achieve similar clinical outcomes as all levels mini-plate fixation in C3-6 unilateral open-door laminoplasty. As evidenced in this study, we believe C3-6 laminoplasty with alternate levels (C4 and C6) mini-plate fixation is an economical, effective, and safe treatment method.

Bridging the cervicothoracic junction during posterior cervical laminectomy and fusion for the treatment of multilevel cervical ossification of the posterior longitudinal ligament: a retrospective case series.

BACKGROUND: The purpose of this study was to investigate the surgical efficacy of crossing the cervicothoracic junction during posterior cervical laminectomy and fusion for the treatment of multilevel cervical ossification of the posterior longitudinal ligament (OPLL). METHODS: From October 2009 to October 2017, 46 consecutive patients with multilevel cervical OPLL underwent posterior cervical laminectomy and crossing the cervicothoracic junction fusion were obtained in the study. Their medical records were retrospectively collected. Cervical lordosis and cervical sagittal balance were used to assess radiographic outcomes. Japanese Orthopedic Association (JOA), axial symptom, C5 root palsy, blood loss, and operation time were used to assess clinical outcomes. The mean follow-up period was 20.7 ± 8.3 months. RESULTS: The operation time was 205.2 ± 39.8 min and the intraoperative blood loss was 352.2 ± 143.7 ml. Analysis of the final follow-up data showed significant differences in JOA score (P < 0.01), C2-C7 lordosis angle (P < 0.01), and C2-C7 SVA (P < 0.01). CT confirmed that grafted bone was completely fused in all patients and progression of OPLL was observed in two patients (4.3%) at final follow-up. No adjacent segment disease (ASD) or instrument failure occurred in any patients. CONCLUSIONS: Cervical laminectomy and crossing the cervicothoracic junction fusion are effective and safe methods to treat multilevel cervical OPLL. Randomized controlled studies compared constructs ending at cervical vertebrae or thoracic vertebrae are needed to confirm these results.

Separation of charge carriers and generation of reactive oxygen species by TiO2 nanoparticles mixed with differently-coated gold nanorods under light irradiation.

Combinations of semiconductor nanoparticles (NPs) with noble metal NPs enable an increase in the photoactivity of semiconductor NPs into the visible and near-infrared regions. The design rationale of the semiconductor-metal hybrid nanostructures for the optimization of charge carrier separation and reactive oxygen species (ROS) generation remains unclear. In this study, the interactions of Au nanorods (AuNRs) with TiO2 NPs were modulated by controlling their surface charges. Positively charged AuNRs formed aggregates with the negatively charged TiO2 NPs (AuNR@CTAB/TiO2) upon mixing, suggesting that Schottky junctions may exist between Au and TiO2. In contrast, negatively charged AuNRs (AuNR@PSS) remained spatially separated from the TiO2 NPs in the mixed suspension (AuNR@PSS/TiO2), owing to electrostatic repulsion. We used electron spin resonance (ESR) spectroscopy to detect the separation of charged carriers and ROS generation in these two mixtures under simulated sunlight irradiation. We also explored the role of dissolved oxygen in charge carrier separation and ROS generation by continuously introducing oxygen into the AuNR@CTAB/TiO2 suspension under simulated sunlight irradiation. Moreover, the generation of ROS by the AuNR@CTAB/TiO2 and AuNR@PSS/TiO2 mixtures were also examined under 808 nm laser irradiation. Our results show that the photogenerated electrons of excited semiconductor NPs are readily transferred to noble metal NPs simply by collisions, but the transfer of photogenerated hot electrons from excited AuNRs to TiO2 NPs is more stringent and requires the formation of Schottky junctions. In addition, the introduction of oxygen is an efficient way to enhance the photocatalytic activity of semiconductor NPs/noble metal NPs system combinations.

Strategy for establishing sensitive fluorescent sensor toward p-nitrophenol integrating magnetic molecularly imprinted materials and carbon dots.

In this work, a sensitive fluorescent sensor toward p-nitrophenol (4-NP) integrating magnetic molecularly imprinted materials and carbon dots (CDs) was proposed. Magnetic material and CDs derived from K3 [Fe(CN)6] and glucose were simultaneously obtained through simple one-step hydrothermal process. Introducing of molecularly imprinted materials based magnetic solid phase extraction (MSPE) endowed the constructed fluorescent sensor with higher sensitivity and selectivity. The significant factors affecting the sensitivity of the sensor toward 4-NP were optimized. Good linearity was obtained between fluorescent intensity of CDs and different concentration of 4-NP from 0.08 to 62.5 µg L-1. The sensitivity of constructed sensor was very low with detection limit of 0.02 µg L-1. Reliable applicability was also proved by the well-pleasing recoveries of 94.2-97.8% with different spiked concentrations of 4-NP in real environmental waters.

Construction of fluorescent sensor array with nitrogen-doped carbon dots for sensing Sudan Orange G and identification of various azo compounds.

In this study, nitrogen-doped carbon dots (N-CDs) were facilely fabricated by one-pot hydrothermal method with levulinic acid and triethanolamine. A fluorescent sensor array was established for identifying azo compounds including Sudan Orange G (SOG), p-diaminoazobenzene, p-aminoazobenzene, azobenzene and quantitative detection of SOG. Experimental results revealed that azo compounds could quench the fluorescent intensity of N-CDs. Owing to various azo compounds showing different affinities to N-CDs, the sensor array exhibited different fluorescence quenching changes, which were further analyzed with principal component analysis to discriminate azo compounds. The sensor array was able to differentiate and recognize diverse concentrations of azo compounds from 0.25 to 2 mg/L. Simultaneously, a variety of factors affecting the detection of SOG were optimized. Under the optimized conditions, the sensor showed excellent stability and sensitivity. The sensor possessed marvelous linearity in the range of 0.1-1 mg/L and 1-4 mg/L and the detection limit was 27.82 µg/L. Spiked recoveries of 90.8-98.2 % were attained at spiked levels of 0.2 mg/L and 1 mg/L, demonstrating that the constructed fluorescence sensor was dependable and feasible for sensing SOG in environmental water samples.

[Relationship between physical activity and the incidence of metabolic syndrome in Chinese adults: a prospective cohort study].

OBJECTIVE: To investigate the association between physical activity (PA) and the incidence of metabolic syndrome (MS) in Chinese adults. METHODS: Data on PA and other variables were obtained at the baseline examination of China Multi-center study of Cardiovascular Epidemiology in 1998 and of International Collaborative study of Cardiovascular Disease in Asia(InterASIA) during 2000 - 2001. Follow-up study was conducted in 2007 - 2008. A total of 11 512 Chinese adults aged 35 - 74 years (5563 men and 5949 women) were included in the final data analysis. Information on demographics, PA, smoking and alcohol consumption were obtained and components of MS were examined. Participants were divided into four groups according to quartile of total metabolic equivalent (MET) values per day. In addition, subjects were grouped into the following categories according to occupational PA: inactive, light, moderate and vigorous. Binary logistic model was used to examine the association between PA and the incidence of MS. RESULTS: A total of 2527 cases with MS were documented during an average following up of 8.1 years. The annual incidence rate of MS was 2.71% (2527/93 178.68). After multivariate logistic regression analysis, compared with participants with total PA volume < 32.0 MET×h×d(-1) (annual incidence rate was 3.19% (697/21 830.74)), the RR (95%CI) value of participants with total PA volume during 32.00 - 37.85, 37.86 - 52.29, and ≥ 52.30 MET×h×d(-1) was 1.05(0.92 - 1.19), 0.98(0.86 - 1.12), and 0.68(0.59 - 0.80), respectively (χ(2)trend = 34.23, P < 0.05), with corresponding annual incidence rates of 2.82% (690/24 504.25), 2.73% (661/24 179.36) and 2.11% (479/22 664.33). In addition, compared to inactive occupational PA (annual incidence rate was 2.76% (402/14 588.33)), the corresponding RR (95%CI) value was 0.80 (0.69 - 0.92), 0.70 (0.59 - 0.82), and 0.54 (0.45 - 0.65) (χ(2)trend = 42.34, P < 0.05), and the annual incidence rates were 2.86% (648/22 663.41), 2.40% (455/18 956.14) and 1.89% (344/18 173.86) in participants with light, moderate and vigorous occupational PA, respectively. CONCLUSION: Both increased total PA volume and occupational PA intensity are significantly associated with decreased risk of incidence of MS.

The availability, price, and characteristics of low sodium salt based on an online salt market survey in China: Implications for scaling up its use.

Low sodium salt (LSS) is an effective way to reduce the primary source of sodium from home cooking. To investigate the availability, price and characteristics of LSS, price gap between LSS and regular salt, and the potential size of subsidy needed to equalize the price of LSS and regular salt. A market survey of salts was conducted using two major online shopping sites JD and Taobao from November to December 2022. Of 360 salts, 76 (21.1%) are LSS and 284 (78.9%) are regular salt. The average proportion of potassium chloride is low (16.8%), and half of the brands contain less than 15% and only 6.6% contains ≥25%. The mean price of LSS is slightly but not significantly higher than that of regular salts (1.82 versus 1.67 yuan/100 g, p = .07). In the lowest quartile by price, the cost of LSS is significantly higher than regular salts (difference 0.13, p = .0048). Further, when comparing the lowest price LSS to the lowest price regular since within the same brand, the mean price LSS is 2.11-fold that of the regular salt (1.66 versus 0.79 yuan/100 g, p < .05). The price of iodized LSS is also significantly higher than that of iodized regular salt (1.86 verse 1.44 yuan/100 g, p = .044). An annual subsidy based on the difference in price in the first quartile would cost 4.75 yuan per capita. A variety of LSS are available in China's salt market.

Enhanced chiroptic properties of nanocomposites of achiral plasmonic nanoparticles decorated with chiral dye-loaded micelles.

The development of circularly polarized luminescence (CPL)-active materials with both large luminescence dissymmetry factor (glum) and high emission efficiency continues to be a major challenge. Here, we present an approach to improve the overall CPL performance by integrating triplet-triplet annihilation-based photon upconversion (TTA-UC) with localized surface plasmon resonance. Dye-loaded chiral micelles possessing TTA-UC ability are designed and attached on the surface of achiral gold nanorods (AuNRs). The longitudinal and transversal resonance peaks of AuNRs overlap with the absorption and emission of dye-loaded chiral micelles, respectively. Typically, 43-fold amplification of glum value accompanied by 3-fold enhancement of upconversion are obtained simultaneously when Au@Ag nanorods are employed in the composites. More importantly, transient absorption spectra reveal a fast accumulation of spin-polarized triplet excitons in the composites. Therefore, the enhancement of chirality-induced spin polarization should be in charge of the amplification of glum value. Our design strategy suggests that combining plasmonic nanomaterials with chiral organic materials could aid in the development of chiroptical nanomaterials.

Bottom-Up Synthesis of Helical Plasmonic Nanorods and Their Application in Generating Circularly Polarized Luminescence.

Chiral growth and chirality transfer associated with plasmonic nanostructures have rejuvenated the field of chirality. As the precise regioselective growth of inorganic crystals into chiral shapes at the nanoscale is extremely challenging, "bottom-up" synthesis of intrinsically chiral nanoparticles with structural stability is obviously attractive and important. With the thiolated bimolecular cosurfactants, we demonstrated a chemical strategy for the synthesis of intrinsically helical plasmonic nanorods (HPNRs) with strong and tailorable plasmonic circular dichroism (PCD) responses, deriving from the zwitterionic interactions between the -NH3+ and -COO- groups of the cysteine molecules (Cys). The influence of structural parameters of HPNRs on PCD responses was analyzed systematically by theoretical simulations. Among the different structural parameters, the pitch depth was found to have the greatest impact on the PCD signals, in agreement with the experimental results. Moreover, the obtained HPNRs with the strong, tunable, and stable chiroptical properties were found to be able to induce circularly polarized luminescence of achiral luminophores. Due to the generality of this effect, this chiral plasmonic nanostructure may have great potential for use in the fields of chiral sensors, chiral catalysis, and displays.

Constructing chiral gold nanorod oligomers using a spatially separated sergeants-and-soldiers effect.

A sergeants-and-soldiers (S&S) effect is very useful to the fabrication of supramolecular chirality. This strategy has not yet been explored in the construction of chiral plasmonic superstructures. Herein, we demonstrate a spatially separated S&S effect in fabricating plasmonic superstructures and modulating their chiroptical responses. Specifically, chiral cysteine (Cys) molecules, acting as sergeants, are sandwiched between a gold nanorod (AuNR) core and a Au shell via AuNR-templated Au overgrowth. Cationic surfactants, CTAB (cetyltrimethylammonium bromide) or CPC (cetylpyridinium chloride), are modified on the AuNR@Cys@Au shell surface, thus spatially separating from the chiral sergeants. During the assembly process, the surfactants act as soldiers which could transfer and amplify the local chirality induced by the adsorbed chiral molecules from the plasmonic monomers to the oligomers. Huge PCD signals could be achieved in the plasmonic oligomers by finely tuning chiral sergeants and achiral soldiers, indicating the feasibility of the S&S effect in fabricating chiral plasmonic superstructures.

Gold Nanorod-Based Nanoplatform Catalyzes Constant NO Generation and Protects from Cardiovascular Injury.

Cardiovascular disease is a leading cause of death, and one of the effective therapeutic strategies for cardiovascular disease is to provide a controlled, constant supply of nitric oxide (NO) in a mild manner; however, this has proved challenging in the clinic. To address this problem, we built a nitric oxide synthase (NOS)-like nanoplatform (NanoNOS) that consists of a noble metal nanoparticle core and a mesoporous silica shell and demonstrated the ability of NanoNOS to catalyze production of NO in vitro. Mechanistic studies show that the catalysis consists of a three-step reaction: the oxidation of NADPH to produce O2-via oxidase-like activity and the subsequent dismutation of O2- to H2O2via SOD-like activity, followed by H2O2-mediated oxidation of l-arginine to produce NO via a nonenzymatic pathway. The generation of NO is precisely regulated by both the content of the NanoNOS species and the plasmon excitation. We found that NanoNOS greatly suppressed injury-driven monocyte-endothelial cell adhesion, suggesting the NanoNOS treatment could help prevent cardiovascular disease. With such a design as well as plasmon excitation that allows for controlled and constant catalytic activity, NanoNOS technology could have a variety of biomedical applications.

Initiation of protective autophagy in hepatocytes by gold nanorod core/silver shell nanostructures.

The high reactivity of silver nanoparticles leads to their broad applications in the anti-bacterial field; however, the safety of silver nanoparticles has attracted increasing public attention. After exposure to silver nanoparticles in vivo, the liver serves as their potential deposition site; however the potential biological effects of such nanoparticles on hepatocytes at low dosages are not well understood. Here, we study the interaction between gold nanorod core/silver shell nanostructures (Au@Ag NRs) and human hepatocytes, HepG2 cells, and determine that Au@Ag NRs at sub-lethal doses can induce autophagy. After uptake, Au@Ag NRs mainly localize in the lysosomes where they release silver ions and promote the production of reactive oxygen species (ROS). The ROS then suppress the AKT-mTOR signaling pathway and activate autophagy. In addition, oxidative stress results in lysosomal impairment, causing decreased ability for lysosomal digestion. Moreover, oxidative stress also affects the structure and function of mitochondria, leading to the initiation of protective autophagy to eliminate the damaged mitochondrion. Our study shows that at sub-lethal dosages, silver nanomaterials may alter the physiological functions of hepatic cells by activating protective autophagy and cause potential health risks, indicating that cautious consideration of the safety of nanomaterials for certain applications is necessary.

Aromatic thiol-modulated Ag overgrowth on gold nanoparticles: tracking the thiol's position in the core-shell nanoparticles.

The employment of strong covalent interactions, such as between thiol and a metal, is a unique way to regulate the morphology and/or endow plasmonic nanostructures (PNSs) with new functionalities. However, the regulation effect of thiols and the underlying mechanism in controlling the growth of PNSs are yet to be revealed. Herein, we found that aromatic thiols (ATs) with functional groups, such as hydroxyl and carboxyl groups, were able to accelerate the Ag deposition. Theoretical calculations indicated that the benzene ring can enhance the electron donating capability of these groups and thus boost their interactions with Ag+. In addition, the PNSs modulated by ATs were exposed with high-index facets. Furthermore, taking advantage of the Ag+-assisted oxidative coupling of 4-ATP molecules pinned on the surface of Au cores, the formed DMAB molecules can be used as a Raman internal reference to trace the spatial trajectory of freshly adsorbed 4-ATP molecules, which modulated the Ag deposition. Our findings highlight the flexibility and diversity of thiol-based ligands in manipulating the particle growth and tuning the particle morphology.

Fabricating chiroptical starfruit-like Au nanoparticles via interface modulation of chiral thiols.

The surface/interface matters as the size of materials enters the nanoscale. Control of surface/interface, therefore, plays an important role in creating novel nanostructures with unusual properties and in obtaining devices with high performance. Herein, we demonstrate unique interface regulation in fabricating nanostructures with strong plasmonic circular dichroism (PCD). With chiral cysteine (Cys) as surface-modulating molecules, starfruit-like Au nanoparticles (NPs) with high PCD responses are obtained via Au overgrowth on Au nanorods (AuNRs). Pre-incubation of the AuNRs with Cys is vital in achieving strong and reproducible PCD responses. Instead of contributing to PCD signals, the pre-adsorbed Cys molecules are found to play a major role in manipulating the Au growth mode and thus the formation of hotspots within the shell. Strong PCD signal mainly comes from the entrapped Cys molecules within the hotspots and is enhanced via local field effect. The distinct roles of the same ligands at different surfaces/interfaces are elucidated. Furthermore, our findings contribute to the strategy of utilizing interface modulation to fabricate complex nanostructures with novel properties.

Influence of diabetes mellitus on long-term clinical and economic outcomes after coronary artery bypass grafting.

BACKGROUND: China has the most patients with diabetes mellitus (DM) in the world and, annually, approximately 1 million Chinese become diabetic. We investigated both clinical and economic outcomes in a large Chinese cohort of diabetic patients undergoing coronary artery bypass graft surgery (CABG). METHODS: All 9,240 consecutive patients who underwent isolated, primary, elective CABG between January 1999 and December 2008 were included and analyzed for long-term major adverse cardiovascular and cerebrovascular events and economic outcomes up to 2 years after the procedure. The DM patients were divided into DM subgroups controlled by diet (n = 375), medication (n = 1,826) or insulin (n = 481). RESULTS: During the study period, the proportion of patients undergoing CABG who have DM increased from 20.1% to 31.8% in China. None of the DM subgroups was independently associated with in-hospital death, but DM was an independent predictor for long-term major adverse cardiovascular and cerebrovascular events (hazard ratio 1.29, 95% confidence interval: 1.14 to 1.46). Medically controlled DM and insulin-dependent DM, but not diet-controlled DM were independent predictors of long-term outcomes after CABG. Cost for initial hospitalization was higher for DM patients (76,782 Ren Min Bi [RMB] versus 65,521 RMB, respectively; p < 0.001). At 2 years after CABG, costs for DM patients were 11,261 RMB (approximately US $1,623) higher than for non-DM patients (p < 0.001). CONCLUSIONS: CABG for patients with DM was significantly more expensive and was associated with worse long-term outcomes compared with non-DM patients. The rising incidence of DM, combined with the significant incremental costs represents significant clinical, economic, and social challenges for the Chinese healthcare system.