TFA-Promoted Intermolecular Friedel-Crafts Alkylation of Arenes with 2,2,2-Trifluoroethylaryl Sulfoxides.

The classical Pummerer rearrangement of 2,2,2-trifluoroethylaryl sulfoxide with trifluoracetic anhydride (TFAA) affords the S,O-acetal efficiently. In the presence of trifluoracetic acid (TFA) as the co-solvent, the S,O-acetal can regenerate reactive thionium intermediate of Pummerer rearrangement. When employing arenes as nucleophiles, this strategy produces corresponding 1-thiyl-2,2,2-trifluoroethyl arenes with excellent yields under metal-free conditions.

anti-Markovnikov Iodofluorination of Alkenes.

The fluorination of alkenes with electrophilic N-F type reagents usually occurs through a Markovnikov-type addition, and the anti-Markovnikov-type addition may require the use of a transition metal catalyst or an expensive catalyst. Herein we describe a convenient anti-Markovnikov iodofluorination of alkenes with Selectfluor/n Bu4 NI. A wide substrate scope and good functional group tolerance were observed. The process allows for the construction of various C-F bonds, especially tertiary C-F bonds. The remarkable features make this protocol attractive, including convenient operations, simple reaction conditions, and the installation of an iodine atom which provides possibilities for further transformations.

Anterior Cervical Corpectomy and Fusion Versus Posterior Laminoplasty for Cervical Oppressive Myelopathy Secondary to Ossification of the Posterior Longitudinal Ligament: A Meta-analysis.

The purpose of this study was to compare the clinical effect of anterior cervical corpectomy with fusion vs laminoplasty for cervical ossification of the posterior longitudinal ligament. The outcome measures included the Japanese Orthopaedic Association score, neurological recovery rate, and complication rate. Subgroup A represented studies with the mean preoperative canal occupying ratio being less than 50%, whereas subgroup B represented studies with the mean canal occupying ratio being 50% or greater. In subgroup A, no difference was found between the 2 groups in the postoperative Japanese Orthopaedic Association score and neurological recovery rate. In subgroup B, the anterior cervical corpectomy with fusion group had a higher postoperative Japanese Orthopaedic Association score and neurological recovery rate. The authors recommend anterior cervical corpectomy with fusion for cervical ossification of the posterior longitudinal ligament when the canal occupying ratio is 50% or greater, and they prefer laminoplasty when the canal occupying ratio is less than 50%. [Orthopedics. 2019; 42(3):e309-e316.].

Percutaneous endoscopic decompression via transforaminal approach for lumbar lateral recess stenosis in geriatric patients.

PURPOSE: We aimed to investigate the surgical strategy, safety, and efficacy of percutaneous endoscopic decompression via transforaminal approach for lumbar lateral recess stenosis in geriatric patients. METHODS: From January 2012 to June 2014, 25 elderly patients (18 males and 7 females) with symptomatic lumbar lateral recess stenosis were performed percutaneous endoscopic transforaminal decompression. The ages of patients ranged from 70 to 93 years (mean 79.6 years). Clinical outcomes were assessed mainly by leg pain visual analogue scale (VAS), Oswestry disability index (ODI) score, MacNab criteria, and post-operative computerized tomographic (CT) scanning. RESULTS: The surgery was successfully completed in all patients with an average operation time of 75 minutes (range, 50-110 min). The lumbar CT images at two days after the operation demonstrated distinct enlargement of the foramen intervertebrale as well as satisfactory decompression of the lumbar lateral recess. And 24 patients of the group were followed up for a mean duration of 29 ± six months (range, 12-44 months). The leg pain VAS score decreased from 8.52 ± 1.11 pre-operatively to 1.80 ± 0.63, 1.33 ± 0.89, 1.05 ± 0.69, and 0.71 ± 0.50 at one, three, six and 12 months after the operation, respectively. Besides, the ODI score also dropped from 59.43 ± 10.04 pre-operatively to 29.42 ± 10.33, 20.13 ± 8.18, 13.98 ± 6.16, and 9.86 ± 5.03 at one, three, six and 12 months during the post-operative follow-up period. Statistically significant differences existed in both VAS score and ODI score at each follow-up time point when compared with the pre-operative scores (P < 0.05). The mean reciprocal angulation change of the operated segment in dynamic lumbar lateral view was 3.2° ± 1.6° at the last follow-up. And there were 18 excellent cases, three good cases, and three fair cases according to the MacNab criteria, and the excellent and good rate was 87.5% at 12 months after the operation. There was no aggravation of the coexisting medical conditions after operation in this group. Only 1 case was found complicated with lower extremity numbness, which was recovered by conservative treatment for two weeks. No persistent neurological deficit or soft tissue infection occurred in all patients post-operatively. CONCLUSIONS: We considered that percutaneous endoscopic transforaminal decompression achieved satisfactory results and provided a safe, effective, and less invasive alternative for treating lumbar lateral recess stenosis in geriatric patients.

AKR1B1 Upregulation Contributes to Neuroinflammation and Astrocytes Proliferation by Regulating the Energy Metabolism in Rat Spinal Cord Injury.

Spinal cord injury (SCI) is one of the most common and serious condition, which leads to permanent neurological dysfunction and poor prognosis in patients. Hyperglycemia impairs neural functional recovery after SCI resulting in the overproduction of reactive oxygen species (ROS) and inflammatory cytokines. However, the effect of glucose metabolism in the spinal cord after injury remains unclear. AKR1B1, one member of the aldo/keto reductase superfamily, is involved in the energy metabolism of plasm glucose and ROS production. The role of AKR1B1 in cancer cell proliferation and invasion has been confirmed. Meanwhile, Akt, one pivotal transcription factor particularly, is involved in the regulation of cell cycle and ROS-mediated secondary injury in the lesion site. In our study, we established an acute SCI rat model to identify the expression of AKR1B1 and its role in neural recovery processes. Western blotting revealed the expression of AKR1B1 protein was elevated after injury, peaked at 3 days and declined gradually to normal at 14 days. Similar results was illustrated in immunohistochemistry staining of white matter. Double immunofluorescence staining showed AKR1B1 was expressed in glial cells and its expression was significantly increased in proliferative astrocytes during the pathological processes. Further experiments showed AKR1B1 was co-located with Akt protein in GFAP positive cells and immunoprecipitated with Akt in injured spinal cord as well. In summary, the present study demonstrated AKR1B1 played a vital role in astrocytes proliferation through Akt pathway, associated with the metabolism of hyperglycemia induced by SCI.