BACKGROUND:Percutaneous mesh-container-plasty (PMCP), a modified traditional percutaneous kyphoplasty (PKP) technique, is increasingly being used to treat osteoporotic vertebral compression fractures with up-endplate injury. This retrospective study aimed to compare the clinical and radiological results of PKP and PMCP for the treatment of this disease. METHODS:We retrospectively analyzed the medical records of patients with osteoporotic compression fractures and upper endplate injuries treated at our hospital between January 2019 and December 2021. A total of 192 patients who met the inclusion and exclusion criteria were enrolled. Of these, 103 underwent PKP and 89 underwent PMCP. Key outcome measures included surgical safety, clinical efficacy, and radiological results. RESULTS:Both the PKP and PMCP groups showed significant improvements in visual analog scale and Oswestry Disability Index scores postoperatively. Additionally, anterior vertebral body height ratio and Cobb's angle improved in both groups, though no statistically significant difference was observed between them. The hospital stay duration was similar between the 2 cohorts. Notably, the PMCP group required a larger volume of bone cement injection yet exhibited a significantly lower incidence of cement leakage and adjacent vertebral fractures (9/89 and 2/89, respectively) compared to the PKP group (24/103 and 11/103, respectively) (P < 0.05). Moreover, the PMCP group had shorter operation times (34.64 ± 9.88 minutes) and reduced fluoroscopy frequency (35.43 ± 5.46 instances) compared to the PKP group (27.23 ± 8.54 minutes and 23.87 ± 5.59 instances, respectively) (P < 0.05). CONCLUSIONS:PMCP provided superior clinical outcomes for the management of osteoporotic compression fractures with upper endplate injuries. It was associated with reduced operation and fluoroscopy times, as well as lower risks of adjacent vertebral fractures and cement leakage, compared to PKP.

PurposeTo comprehensively investigate multifactorial influences on postoperative pain in patients with degenerative lumbar spine disease undergoing posterior lumbar interbody fusion (PLIF), thereby guiding targeted rehabilitation.Patients and methodsWe reviewed 316 patients (age >40) who underwent PLIF from January 2022 to May 2024. Based on postoperative Numeric Rating Scale (NRS) scores and pain duration, they were divided into a non-pain group (210 cases) and a pain group (106 cases). We assessed paraspinal muscle indices (PMI, MMI), Self-Rating Anxiety Scale (SAS), postoperative exercise duration, surgical segments, drainage removal time, and mannitol usage. Univariate and multivariate logistic regression analyses were conducted.ResultsNo significant differences were found in age, BMI, education, surgical duration, drainage time, disease duration, time to first ambulation, or mannitol usage (P > 0.05). However, gender, SAS scores, surgical segments, drainage volume at removal, PMI, MMI, average standing time in the first 2 weeks, and duration of straight-leg raise exercises differed significantly (P < 0.05). Multivariate analysis identified surgical segment (P = 0.008), drainage volume at removal (P = 0.008), MMI (P < 0.001), average standing time (P = 0.010), and straight-leg raise exercise duration (P = 0.012) as independent risk factors.ConclusionParaspinal muscle health and early postoperative exercise are crucial factors influencing PLIF-related postoperative pain. Tailored rehabilitation, enhanced muscle function, and optimized early exercise may reduce postoperative pain and improve outcomes.

OBJECTIVE:The refracture of the previously cemented vertebrae occurs rarely following percutaneous kyphoplasty (PKP). The present study was designed to assess the therapeutic efficacy of repeated PKP for refractures. METHODS:We conducted a retrospective analysis of 36 patients who underwent repeat PKP for refractures in same cemented vertebrae. The study evaluated the cement distribution pattern, restoration of middle vertebral height (MVH), and kyphosis angle (KA). Clinical efficacy was evaluated using visual analog scale (VAS) and the Oswestry Disability Index. A multivariate logistic regression model evaluated age, sex, cement volume, and bone mineral density, with the group's average pain reduction measured at 4.86 points on the VAS. RESULTS:Preoperative VAS scores averaged 7.75 ± 1.23, significantly decreasing to 2.89 ± 0.92 after surgery (P < 0.05). The Oswestry Disability Index significantly improved from 73.83 ± 14.58 preoperatively to 35.97 ± 9.85 postoperatively (P < 0.05). The MVH significantly increased from 12.49 ± 2.95 preoperatively to 16.83 ± 3.49 postoperatively (P < 0.05). The KA significantly increased from 19.22 ± 4.28 preoperatively to 12.01 ± 4.59 postoperatively (P < 0.05). The mean of the correction of KA was 7.17 ± 5.10 and the mean of the restoration rate of MVH was 17.09 ± 9.68. Cement volumes of up to 4.5 ml had about a 40% probability of achieving a minimum 4.86-point VAS reduction, while volumes of at least 4.5 ml showed an 84.6% probability. CONCLUSIONS:Repeated PKP effectively alleviates pain and restores spinal function in patients with refractures. A minimum cement volume of 4.5 ml appears optimal for achieving significant pain relief.

Objective To explore the clinical effect of percutaneous kyphoplasty (PKP) via process-rib-pedicle approach for upper and middle thoracic osteoporosis fractures with pedicle stenosis. Methods This study is a retrospective observational study. In this study, we retrospectively analyzed the data of 62 patients with upper thoracic vertebral bone loss compression fracture treated via the process-rib-pedicle pathway PKP at the First Affiliated Hospital of Soochow University from January 2020 to December 2022. The patients were divided into group A (unilateral PKP, 38 cases) and group B (bilateral PKP, 24 cases). The aspects of surgical safety, clinical efficacy, and radiological outcome were investigated. Results All 62 patients successfully completed the surgery without any spinal cord, nerve, or vascular injury, and there were no complications such as infection and vascular embolism. The differences in visual analog scale scores（P < 0.05）, Oswestry disability index functional index（P < 0.05）, and Cobb angle（P < 0.05） were significant when comparing preoperative and postoperative periods, and the differences were not significant when comparing the postoperative periods (P > 0.05). There were no statistically significant differences in days of hospital stay (P = 0.653) and the rate of bone cement leakage (P = 0.537) between the 2 groups. Conclusions For upper middle osteoporotic thoracic vertebral fractures with pedicle stenosis, puncture via the process-rib-pedicle path is a safe and reliable puncture route, and more than 2.5 ml of cement can achieve good clinical outcomes, regardless of bilateral or unilateral PKP.

Infectious bone defects are one of the thorny problems faced by orthopedists. Developing prosthetic materials with antimicrobial osteogenic features is a key solution. Biodegradable Polyacrylic acid (PAA)-based hydrogels have gained attention for their exceptional qualities. However, the influence of zinc ions on PAA-based mineralized hydrogels remains understudied. In this paper, Poly (acrylic acid)-calcium-zinc (PA-CZ) biomineralized hydrogel was prepared through ionic cross-linking and biomineralization. In vitro bacterial and cell tests demonstrated the hydrogel’s exceptional biocompatibility, antibacterial, and osteogenic traits, along with good mechanical strength. The PA-CZ mineralized hydrogel lays the foundation for developing orthopedic implants with antimicrobial osteogenic features and offers a promising approach for treating infected bone defects.

Background: Percutaneous mesh-container-plasty（PMCP），a modified traditional percutaneous kyphoplasty（PKP）technique，is increasingly being used to treat osteoporotic vertebral compression fractures（OVCF） with up-endplate injury. This retrospective study aimed to compare the clinical and radiological results of PKP and PMCP for the treatment of this disease. Methods: We reviewed the records of patients with osteoporosis compression fracture and upper endplate injury in our hospital from January 2019 to December 2021.One hundred and ninety-two patients who sustained osteoporosis compression fracture and upper endplate injury without neurological deficits were included in this study according to the inclusion and exclusion criteria.103 patients underwent PKP surgery，and 89 patients underwent PMCP surgery. Results: The VAS and ODI scores improved in the PKP and the PMCP. The anterior vertebral body height ratio (AVBHr) and Cobb's angle showed recovery, but there was no significant statistical difference between BMCP and PKP groups. The amount of bone cement injection and the duration of patient hospitalization were similar between the two groups. But the incidence of cement leakage and adjacent vertebral fracture was lower in the PMCP group (9/89 and 3/89) than in the PKP group (24/103 and 12/103) (p < 0.05). The operation time and fluoroscopy time in the PMCP group (35.23 ± 8.54 minutes and 13.26 ± 3.34 minutes) were significantly lower than that in the PKP group（44.64 ± 9.88 minutes and 18.43 ± 4.87 minutes）(p < 0.05). Conclusions：The BMCP group demonstrated favorable treatment outcomes in managing osteoporotic compression fractures with up-endplate injury. Additionally, it showed shorter operation and fluoroscopy times. Moreover, the postoperative probabilities of adjacent vertebral fractures and bone cement leakage were lower.

Developing practical optical materials with strong third-order nonlinear optical (NLO) responses attracts increasing attention. Efforts in this area extend to the activation of appropriate materials and the magnification of their low NLO responses. Herein, we propose a stepwise assembly-amplification strategy to enhance the NLO responses of low NLO-active metal sulfide clusters. Through a self-assembly process, W/Cu/S cluster-based tetrahedral and octahedral cages are successfully obtained, both exhibiting weak NLO responses in solution that are not apparent for the unassembled components. Their incorporation into polyvinyl alcohol (PVA), followed by spin-coating, results in the formation of cluster@PVA composite membranes with controlled thicknesses. Remarkably, the effective nonlinear absorption coefficients β for 12-layered membranes are 10 4 times higher than those of the respective cage solutions. The octahedral cage delivers a stronger response than the tetrahedral cage, which likely reflects the higher degree of aggregation of the clusters. This work showcases a new approach for amplifying NLO responses, greatly facilitating the development of integrated photonic devices.

Two novel compounds of the alternating donor (D)/acceptor (A) system were designed and synthesized. In BSB (A-n-D-n-A) and SBS (D-n-A-n-D), thiophene, 2,1,3-benzothiadiazole (BTD) and ethylene act as donor, acceptor groups and n-bridge moiety, respectively. Z-scan experiments at 532 nm with various pulse durations show a transition from saturable absorption to reverse saturable absorption and self-defocusing effects in both compounds. The different alternating modes of D-A units lead to an order of magnitude increment in the secondorder hyperpolarizability gamma of SBS (4.4 x 10-28 esu) compared to BSB. Ultrafast transient absorption spectroscopy was carried out to analyze the enhancement of second-order hyperpolarizability. Results indicate that this enhancement originates from excited state absorption of the long-lived intramolecular charge transfer state. Using quantum chemical calculations, the stronger symmetrical intramolecular charge transfer in SBS can be demonstrated by the difference between the ground- and excited-state dipole moments Delta mu ge. It is shown intuitively in the S0-S1 hole-electron analysis. All of the experimental and theoretical results suggest that changing the D-A alternation in organic molecules can effectively modulate the third-order nonlinear optical behavior, which may serve as a guide for future molecular design.

The abundant nonlinear optical responses of a squaraine derivative (2, 4-bis[4-(diethylamino)-2-hydroxyphenyl] squaraine, SQ-640) are explored at visible and near-infrared (NIR) regions. The sign and magnitude of the thirdorder (intensity depend) nonlinear absorption and refraction for SQ-640 are determined under different pluses with Z-scan method. The results of this work show reverse saturable absorption (RSA) of SQ-640 at visible and NIR region and its potential for optical limiting (OL) application. Moreover, SQ-640 shows self-focusing at visible wavelength while shows self-defocusing at NIR wavelengths. The transient refraction dynamics indicate that positive excited-state refraction causes self-focusing at visible region while negative nonlinear refraction at NIR region mainly originates from bound electron response (Kerr effect) and negative excited state refraction. Besides, the nonlinear refraction index of SQ-640 under 532 nm ranges from - 10-19 m2/W at femtosecond pulses to - 10-16 m2/W at nanosecond pulses and the second order hyperpolarizability is about 4 x 10-28 esu at nanosecond case. The Kerr refraction coefficient is about -6.54 x 10-19 m2/W at 700 nm under femtosecond laser pulses. The obtained OL thresholds at 532 nm are - 26.8 mJ/cm2 for picosecond pulses and - 85.6 mJ/cm2 for nanosecond pulses. The enriching information extracted from NLR in SQ-640 may offer an optional perspective to understand the structure-property relationships in these compounds. The results of optical nonlinearities in SQ-640 gained from this study may be of assistance to its better applications in laser protection and optical switching.

Optical nonlinearities of two all-carbon twistacenes, DPyA and DPyN, with the different π-conjugated central bridges were investigated. The nonlinear absorption properties of these compounds were measured using the femtosecond Z-scan with wavelengths between 650 and 900 nm. It has been found that the nonlinear absorption originated from two-photon absorption (TPA) and TPA-induced excited state absorption (ESA), wherein DPyA demonstrates higher performance than DPyN. The TPA cross section of DPyA (4300 GM) is nearly 4.3 times larger than that of DPyN at 650 nm. Moreover, the different central structures modulate the intensity of ESA at 532 nm, and DPyA exhibits an excellent ESA at 532 nm with multi-pulse excitation. Meanwhile, the result of data fitting and quantum chemistry calculation shows that the enhancement of nonlinear absorption in DPyA is due to the extended π- conjugated bridge and improved delocalization of π-electrons. These all-carbon twistacenes could yield potential applications in optical power limiting (OPL) technology.

End-substituted planar and twisted isomers (C1 and C2) of pyrene-containing twistacenes were designed and synthesized to investigate the modulation of ectopic substitution on nonlinear optical (NLO) properties. Results of ultrafast transient absorption spectra reveal that C1 exhibits broad-band excited state absorption (ESA), meanwhile C2 displays an additional electronic delocalized state due to charge transfer. The twisted structure caused by large steric hindrance in C2 is thought to be the cause of enhancement according to the density functional theory calculation. Moreover, the evolution of ESA regarding the transition from local excited (LE) to intramolecular charge transfer (ICT) state is observed in the transient spectra. The performance of reverse saturable absorption at 480 nm, 5 ns, is improved by ESA originating from ICT in C2. The extension of It -con-jugated system results in a significant enhancement of the two-photon absorption (TPA) cross-section of C1/ toluene from 235 to 737 GM at 532 nm. With different substitution positions of terminal group in isomers, TPA and ESA of these chromophores can be dramatically modulated. This work may provide an idea for the opti-mization of nonlinear functional isomeric materials.

To improve self-targeting abilities towards organelles, four fluorescent dyes (1a-1d) were designed by connection of dicyanoisophorone to phenylpiperidinol (1a), naphthalenol (1b), indazole (1c) and pyrene (1d) unit with a double bond. Their absorption maxima were located at 423-517 nm; and emission maxima were at 565-682 nm with large Stokes shifts of 142-191 nm. Moreover, their fluorescence intensities increased 11-117 fold in glycerol compared to phosphate buffer solution, which might be due to the long excited state lifetimes (up to 1 ns) by transient absorption spectra. Furthermore, laser confocal experiments with HeLa cells proved that dyes 1a-1d were self-target fluorescent markers at 10-20 mu M for lysosomes, endoplasmic reticulum, mitochondria and lipid droplets respectively; and they could be used for the fluorescent probes at 2 mu M for viscosity detection within corresponding organelles by influence of ionophores. In addition, these dyes were able to detect viscosity changes in a Parkinson's disease model with PC-12 cells.

Reactions of [Et4N][Tp*WS3(CuCl)3] (1) (Tp* = hydridotris(3,5-dimethylpyrazol-1-yl)borate) with 2 equiv. of AgOTf (OTf- = trifluoromethanesulfonate) and 1 equiv. of several bidentate pyridine ligands including 2,5-bis(pyridine-4-yl)thiazolo[5,4-d]thiazole (L1), 2,7-di(pyridin-4-yl)-9H-fluorene (L2), 2,7-di(pyridin-4-yl)-9H-carbazole (L3), and 2,7-di(pyridin-4-yl)-9H-fluoren-9-one (L4) afforded four W/Cu/S cluster-based supramolecular compounds [(Tp*WS3Cu2Cl)2(L1)] (2), {[(Tp*WS3Cu3)2(μ-Cl)2(μ4-Cl)]2(L2)2}(OTf)2 (3), {[(Tp*WS3Cu3)2(μ-Cl)2(μ4-Cl)]2(L3)2}(OTf)2 (4) and {[(Tp*WS3Cu3)2(μ-Cl)2(μ4-Cl)]2(L4)2}(OTf)2 (5). Compounds 2-5 were characterized by elemental analysis, IR, UV-vis, 1H NMR, and single-crystal X-ray diffraction analysis. The neutral cluster 2 behaves as a supramolecular wire constructed by L1 bridging two butterfly-shaped [Tp*WS3Cu2Cl] cores. The cluster cations of 3-5 contain two [(Tp*WS3Cu3)2(μ-Cl)2(μ4-Cl)]+ cores linked by two L2, L3, or L4 ligands, which finally formed a cationic supramolecular rectangle. The third-order nonlinear-optical (NLO) properties of 3-5 in DMF were also investigated by Z-scan techniques and their NLO responses were enhanced compared to those of their precursor 1.

By using a unique temperature-dependent, chloride-mediated approach, two atom-precise silver nanoclusters [Cl@Ag14(Tab)12-(C5H4NCl)12](PF6)13(Cl@Ag14) and [Cl3@Ag24(Tab)20(C5H4NCl)11]Cl(PF6)20(Cl3@Ag24) (Tab = 4-(tnmethylammomo)benzenethiolate, C5H4NCl = 3-chloropyridine) were obtained successfully. Notably, the number of chloride ions encapsulated inside the Ag-S shell could be regulated by the slow dissolution of almost insoluble KCl at various temperatures. The inclusion of additional core chloride ions results in the expansion of the surrounding Ag-S shell. This article provides a promising synthetic approach for controlling the number of Ag atoms that form a shell around the anionic core, in addition to offering a potential pathway for the introduction of other inorganic anions into silver clusters. More broadly, through the use of related ligands, the synthetic strategy offers scope for generating new families of silver thiolate clusters of varying size and composition.

Objective To evaluate the safety and efficacy of O‐arm‐guided minimally invasive pedicle screw fixation combined with percutaneous kyphoplasty for metastatic spinal tumors with posterior wall destruction. Methods Patients who underwent minimally invasive pedicle screw fixation combined with percutaneous kyphoplasty for pathological vertebral fractures with posterior wall defects from January 2015 to December 2017 were followed up for 1 year. Visual analogue scale (VAS), SF‐36 scores, middle vertebral height, posterior vertebral height, and the accuracy of pedicle screws were assessed preoperatively, postoperatively, and 1 year after surgery. The operation time, time from operation to discharge, blood loss, volume of bone cement, and leakage of bone cement were recorded. Results Twenty‐three patients (13 females and 10 males) who met our criteria were followed up for 1 year. The operation time of these patients was 162.61 ± 33.47 min, the amount of bleeding was 230.87 ± 93.76 mL, the time from operation to discharge was 4.35 ± 2.42 days, and the volume of bone cement was 3.67 ± 0.63 mL. The VAS score decreased from 7.04 ± 1.07 to 2.65 ± 0.93 before surgery ( P = 0.000) and remained at 2.57 ± 0.79 1 year after surgery. Compared with the preoperative SF‐36 scores for physical pain, physiological function, energy, and social function, the postoperative scores were significantly improved ( P = 0.000). The height of the middle vertebral body increased from 14.47 ± 2.96 mm before surgery to 20.18 ± 2.94 mm ( P = 0.000), and remained at 20.44 to 3.01 mm 1 year after surgery. The height of the posterior vertebral body increased from 16.56 ± 3.07 mm before operation to 22.79 ± 4.00 mm ( P = 0.000), and 22.45 ± 3.88 mm 1 year after surgery. The 23 patients had a total of 92 pedicle screws; 85 screws were Grade A and 7 screws were Grade B. There was no leakage of bone cement after surgery. Conclusion In the short term, O‐arm‐guided minimally invasive pedicle screw fixation combined with kyphoplasty is safe and effective in the treatment of metastatic spinal tumors with posterior wall destruction.

Polyurethane (PU) and polyurea (PUA) materials have shown significant potential for application in tissue repair. Herein, we design a glycerol ethoxylate (PEG)-based poly(urethane-urea) for bone tissue repair. The polymer precursor was prepared from the reaction of PEG and isophorone diisocyanate (IPDI). The cystine dimethyl ester was used as a cross-linker for the preparation of poly(urethane-urea) elastomers. The material was further strengthened by physical blending of nano-hydroxyapatite (nHA). The physical and biological properties of final material were evaluated by mechanical testing, scanning electron microscopy characterization, degradation tests, cell proliferation and cell differentiation assays. The obtained scaffolds showed good mechanical strength, excellent biocompatibility and osteogenic capability. All the evidences demonstrated that this type of materials has good prospects for bone tissue repair application.

Background: Kyphoplasty (KP) is a palliative treatment for patients with metastatic vertebral tumors. The distribution pattern of cement affects safety and efficacy. The distribution pattern of cement has not been previously reported for patients with metastatic vertebral tumors. Material/Methods: From January 2013 to December 2017, patients with metastatic vertebral tumors who met our criteria were divided into cement fusion (n=91) and separation (n=97) groups. Visual analogue scale (VAS) and middle vertebral height (MVH) were evaluated preoperatively, postoperatively, and 1 year after surgery. Spinal Instability Neoplastic Score, fluoroscopy time, operation time, cement volume, cement leakage, and vertebral fractures were recorded and evaluated. Results: Compared with the fusion group, the separation group had significantly different (P<0.001) operation time, fluoroscopy time, and cement volume. Compared with preoperative status, VAS and MVH were significantly improved 3 days postoperatively and 1 year postoperatively in both groups (P<0.001). The difference in cement leakage between the 2 groups (P<0.05) and in the number of adjacent vertebral fractures between the 2 groups (P<0.05) were significant. Conclusions: The distribution patterns of the bone cement had a good analgesic effect and preventive effect on vertebral collapse. However, the separation of bone cement may be safer.

Background L3 vertebral fractures with posterior dislocation are rare and usually secondary to high-energy trauma. To assess the outcome of a valuable distraction technique, using long-tail multiaxial pedicle screw which we have employed in reduction of L3 vertebral fracture with posterior dislocation, and emphasize the importance of preoperative blood vessel evaluation. Case presentation A 47-year-old patient fell from a height of 4 m and was paralyzed. Computed tomography scan revealed a three-column ligamentous injury with posterior fracture-dislocation of the L3 vertebral body. Computed tomography angiography showed that the third lumbar artery was ruptured without active bleeding. The patient underwent posterior approach with reduction, transpedicular fixation, and posterolateral fusion with autologous bone graft. Finally, Vertebral reduction and sagittal balance were achieved and patients recovered well after operation. Conclusion Preoperative blood vessel evaluation is very important to avoid massive bleeding during the surgery, and the standard technique which can achieve good reduction is easy to understand, perform, and is reproducible.