Synthesis of pyrazino[1,2-]indazoles cascade cyclization of indazole aldehydes with propargylic amines.

An efficient intermolecular annulation of indazole aldehydes with propargylic amines has been developed for the synthesis of pyrazinoindazoles under catalyst- and additive-free conditions. This straightforward methodology was found to feature a wide substrate scope, high atom economy and environmental advantages. The bioactivity results of these new pyrazino[1,2-]indazoles showed that some of them exhibited significant antifungal activity.

Synthesis and anti-gastric cancer activity evaluation of novel triazole nucleobase analogues containing steroidal/coumarin/quinoline moieties.

A series of novel triazole nucleobase analogues containing steroidal/coumarin/quinoline moieties have been synthesized based on copper-catalyzed azide-alkyne cycloaddition (CuAAC). The anti-cancer activity of the new triazole nucleobase analogues was studied in gastric cancer cell lines (MGC-803, SGC-7901) and normal gastric epithelial cells (GES-1) in vitro. Some of the synthesized compounds could significantly inhibit the proliferation of these tested cancer cells.

Three-Dimensional-Printed Individualized Guiding Templates for Surgical Correction of Severe Kyphoscoliosis Secondary to Ankylosing Spondylitis: Outcomes of 9 Cases.

Objective: To report the outcomes of severe kyphoscoliosis secondary to ankylosing spondylitis (AS) corrected with 3D-printed individualized guiding templates.

Methods: Computed tomography (CT) data of patients with severe kyphoscoliosis secondary to AS were used to reconstruct 3D models of the spine and to develop a surgical plan. An asymmetric wedge pedicle subtraction osteotomy (PSO) was simulated using medical computer design software.

Design, synthesis and biological evaluation of new steroidal β-triazoly enones as potent antiproliferative agents.

β-Triazoly enones are biologically interesting scaffolds, incorporation of such scaffolds into the steroid nucleus may generate new bioactive steroids and further enrich structural types of steroids. In this work, a series of new steroidal β-triazoly enones were synthesized based on click chemistry and Claisen-Schmidt condensation reaction and further evaluated for their antiproliferative activity against a panel of cancer cells. Most of these compounds showed better potency against PC-3 and MGC-803 cells.

[Case-control study of therapeutic effects between extreme lateral interbody fusion and conventional posterior operation for the treatment of upper lumbar disc herniation].

Objective: To evaluate the clinical outcomes between extreme lateral interbody fusion and conventional posterior operation in the treatment of upper lumbar disc herniation.

Methods: Among 60 patients with upper lumbar disc herniation were treated with extreme lateral interbody fusion(XLIF) or conventional posterior operation from June 2010 to December 2014, 30 patients(19 males and 11 females) were treated with XLIF (XLIF group); and the other 30 patients(17 males and 13 females) were treated with conventional posterior operation (conventional group). In XLIF group, the lesions occurred at T₁₂L₁ segments in 2 patients, at L₁,₂ segments in 6 patients, at L₂,₃ segments in 10 patients, and at L₃,₄ segment in 12 patients.

Expert consensus for PVCR in severe, rigid and angular spinal deformity treatment: The Kunming consensus.

In the past decades, an increasing number of surgeons started using posterior vertebral column resection (PVCR) to treat severe, rigid and angular spinal deformities. Little high-level evidence is available to guide surgical treatment. The aims of our study were to identify important surgical strategies and key technical points of Chinese experts who have extensive experience in the management of severe, rigid and angular spinal deformities using PVCR, and to standardize and unify the current core concepts.

Surgical Site Infections Following the Transoral Approach: A Review of 172 Consecutive Cases.

Study Design: A retrospective review.

Objective: The aim of this study was to discuss the characteristics, treatment, and incidence of surgical site infection (SSI) following transoral approach surgery.

Summary Of Background Data: One of the primary risks associated with transoral approach surgery is postoperative SSI.

An 11-Year Review of the TARP Procedure in the Treatment of Atlantoaxial Dislocation.

Study Design: Retrospective study.

Objective: The aim of the study was to introduce the surgical techniques and evaluate the clinical outcomes of transoral atlantoaxial reduction plate (TARP) for the treatment of atlantoaxial dislocation.

Summary Of Background Data: Researchers have reported on transoral plate internal fixation for the treatment of irreducible atlantoaxial dislocation (IAAD) without long-term follow-up and detailed clinical experience.

Treatment of irreducible atlantoaxial dislocation using the transoral atlantoaxial pedicle screw technique. A report of 10 cases.

Objective: The purpose of this work is to evaluate the outcome of the transoral atlantoaxial pedicle screw technique for the treatment of irreducible atlantoaxial dislocation (IAAD).

Patients And Methods: A total of 10 patients with IAAD were treated using the transoral atlantoaxial pedicle screw technique. We compared preoperative and postoperative JOA (Japanese Orthopedic Association) scores and observed bone graft fusion rate of the atlantoaxial joint, and examined whether our technique was suitable for the treatment of IAAD.

The application of atlantoaxial screw and rod fixation in revision operations for postoperative re-dislocation in children.

Introduction: We evaluate the feasibility, safety, and efficacy of atlantoaxial screw and rod fixation for revision operations in the treatment of re-dislocation after atlantoaxial operations in children.

Methods: Eight consecutive children with atlantoaxial instability required a revision operation due to atlantoaxial re-dislocation caused by the failure of the initial posterior wire fixation. The children were 5-11 years of age with an average age of 8.

The development and evaluation of individualized templates to assist transoral C2 articular mass or transpedicular screw placement in TARP-IV procedures: adult cadaver specimen study.

Objectives: The transoral atlantoaxial reduction plate system treats irreducible atlantoaxial dislocation from transoral atlantoaxial reduction plate-I to transoral atlantoaxial reduction plate-III. However, this system has demonstrated problems associated with screw loosening, atlantoaxial fixation and concealed or manifest neurovascular injuries. This study sought to design a set of individualized templates to improve the accuracy of anterior C2 screw placement in the transoral atlantoaxial reduction plate-IV procedure.

Transoral approach for revision surgery of os odontoideum with atlantoaxial dislocation.

Revision surgery for os odontoideum with irreducible atlantoaxial dislocation with a transoral approach is not commonly seen. Typically, management of this type of atlantoaxial dislocation is through posterior fixation and fusion or transoral decompression and posterior fusion. This report describes revision surgery in a patient with os odontoideum who was treated with a transoral approach.

Application of three-dimensional model in the management of irreducible atlanto-axial dislocation.

Objective: The aim of this study was to describe the application of the rapid prototyping (RP) life-size 3-dimensional model used to improve accuracy of screw insertion in irreducible atlanto-axial dislocation (IAD).

Methods: The study included 10 patients with IAD. All patients were assessed using the Japanese Orthopedic Association (JOA) score.

Clinical application of computer-aided design-rapid prototyping in C1-C2 operation techniques for complex atlantoaxial instability.

Study Design: This is a retrospective clinical study.

Objective: To evaluate the clinical efficacy of computer-aided design-rapid prototyping (CAD-RP) techniques in surgical treatments for atlantoaxial instability (AAI).

Summary Of Background Data: The complexity of the upper cervical anatomic structures makes the procedures for the treatment of AAI particularly challenging for surgeons.

Treatment of basilar invagination with atlantoaxial dislocation: atlantoaxial joint distraction and fixation with transoral atlantoaxial reduction plate (TARP) without odontoidectomy.

Purpose: Although direct transoral decompression and one-stage posterior instrumentation can obtain satisfactory cord decompression for the treatment of basilar invagination with atlantoaxial dislocation, surgical injuries run high as combinative anterior-posterior approaches were necessary. Furthermore, the complications will rise notably when involvement of dens and/or clivus in the decompression necessitates relatively complicated surgical techniques. First initiated in 2005, transoral atlantoaxial reduction plate (TARP) works as an internal fixation for the treatment of basilar invagination with irreducible atlantoaxial dislocation.

Anterior pedicle screw fixation of C2: an anatomic analysis of axis morphology and simulated surgical fixation.

Study Design: Human cadaveric study measuring the morphology of C2 vertebra, description of anterior placement of pedicle screw with post-fixation computed tomography (CT) analysis.

Objective: To assess the potential feasibility and safety anterior placement of C2 pedicle screws.

Summary Of Background Data: Posterior pedicle screw fixation has become an established technique for upper cervical reconstruction.

New clinical classification system for atlantoaxial dislocation.

The purpose of this study was to define a new clinical classification of atlantoaxial dislocation based on its clinical manifestations, namely reducible atlantoaxial dislocation (RAAD), irreducible atlantoaxial dislocation (IAAD), and fixed atlantoaxial dislocation (FAAD). A total of 107 patients with atlantoaxial dislocation were respectively treated based on this clinical classification, including 66 patients with RAAD, 39 patients with IAAD, and 2 patients with FAAD. Six of the 66 patients with RAAD with rotatory atlantoaxial dislocation were treated with traction and a cervical collar, 9 with fresh type II dens fracture were treated with cannulated screw fixation, and 51 were treated with posterior atlantoaxial or occipitocervical arthrodesis.

Treatment of dens fractures with posterior atlantoaxial dislocation with transoral atlantoaxial reduction plate surgery: case report and introduction of a novel treatment option.

Study Design: Case report.

Objective: To describe a rare old dens fracture with posterior atlantoaxial dislocation that was treated with transoral atlantoaxial reduction plate surgery.

Summary Of Background Data: Dens fractures with posterior atlantoaxial displacement are not common and cause ventral compression of the spinal cord.

Systematic review of cohort studies comparing surgical treatment for multilevel ossification of posterior longitudinal ligament: anterior vs posterior approach.

There have been no standards or guidelines for the treatment of ossification of posterior longitudinal ligament, especially multilevel ossification of posterior longitudinal ligament. The purpose of this study was to compare results of major surgical treatment for multilevel ossification of posterior longitudinal ligament. Databases including MEDLINE, EMBASE, the Cochrane library, and bibliographies of identified and review articles were searched to find randomized, controlled trials or retrospective cohort studies comparing anterior and posterior approach from 1980 to December 2010.

Transoral atlantoaxial reduction plate internal fixation with transoral transpedicular or articular mass screw of c2 for the treatment of irreducible atlantoaxial dislocation: two case reports.

Study Design: Retrospective report of two surgical cases and review of the literature.

Objective: To report the clinical application of transoral atlantoaxial reduction plate (TARP) internal fixation with a novel technique of transoral transpedicular or articular mass screw of C2 in the treatment of irreducible atlantoaxial dislocation and basilar invagination with ventral spinal cord compression.

Summary Of Background Data: Current surgical treatments for IAAD have various disadvantages, such as posterior decompression followed by atlantoaxial or occipitocervical fusion with unsatisfactory decompression, transoral decompression, and one-stage posterior instrumentation needing two approaches although with satisfactory decompression, resection of dens and/or clivus with potential risk of spinal cord injury and CSF leakeage.

[Risk factors for postoperative pulmonary complications following transoral operation for the atlanta-axis disorders].

Objective: to evaluate the risk factors for postoperative pulmonary complications following transoral operation for the atlanta-axis disorders.

Methods: total 104 cases were collected from January 2005 to June 2009. Twelve variables among patients with PPCs and without PPCs were analyzed by logistic regression analysis.

Personalised modified osteotomy using computer-aided design-rapid prototyping to correct thoracic deformities.

The correction of severe thoracic deformities is challenging. However, the usual imaging modalities are not sufficient for performing the surgery. Our objective was to describe the procedure and results of posterior modified wedge osteotomy aided by the techniques of computer-aided design-rapid prototyping (CAD-RP) to correct thoracic deformities.

[Diagnosis and treatment for complicated atlantoaxial dislocation].

Objective: To explore the clinical characteristics and treatment methods for complicated atlantoaxial dislocation.

Methods: A retrospective evaluation was done to summarize and analyze the clinical characteristics and complicated factors of 54 patients with complicated atlantoaxial dislocation who could not to be treated effectively by using conventional therapy in our hospital from February 2005 to October 2008. According to different complicated factors, different treatment methods mainly including transoral atlantoaxial reduction plate-III (TARP-III) operation, decompression procedure with deep grinding guided by computer aided design-rapid prototyping (CAD-RP), screw placement technique with CAD-RP guide plate and extensile approach surgery were performed.

Transoral atlantoaxial reduction plate internal fixation for the treatment of irreducible atlantoaxial dislocation: a 2- to 4-year follow-up.

Objective: To evaluate the mid-term outcomes of transoral atlantoaxial reduction plate (TARP) internal fixation for the treatment of irreducible atlantoaxial dislocation.

Methods: From April 2003 to April 2005, 31 patients with irreducible atlantoaxial dislocation were treated with TARP internal fixation. The average age was 37.