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Inflammatory responses of nucleus pulposus (NP) can induce imbalanced anabolism and catabolism of extracellular matrix, and the cytosolic dsDNA accumulation and STING–NF–κB pathway activation found in NP inflammation are considered as fairly important cause of intervertebral disc (IVD) degeneration. Herein, we constructed a siSTING delivery hydrogel of aldehyde hyaluronic acid (HA-CHO) and poly(amidoamine) PAMAM/siRNA complex to intervene the abnormal STING signal for IVD degeneration treatment, where the formation of dynamic Schiff base bonds in the system (siSTING@HPgel) was able to overcome the shortcomings such as low cellular uptake, short half-life, and rapid degradation of siRNA-based strategy. PAMAM not only formed complexes with siRNA to promote siRNA transfection, but also served as dynamic crosslinker to construct hydrogel, and the injectable and self-healing hydrogel efficiently and steadily silenced STING expression in NP cells. Finally, the siSTING@HPgel significantly eased IVD inflammation and slowed IVD degeneration by prolonging STING knockdown in puncture-induced IVD degeneration rat model, revealing that STING pathway was a therapeutic target for IVD degeneration and such novel hydrogel had great potential for being applied to many other diseases for gene delivery., Graphical abstract Image 1, Highlights • STING-NF-κB pathway activation was identified an important cause of intervertebral disc degeneration. • PAMAM was employed as both linker and gene vector for siRNA delivery. • The injectable self-healing hydrogel could significantly ease the IVD inflammation and degeneration by prolonging STING knockdown. • This novel hydrogel system opened new ways of thinking and had great potential for gene delivery.

PurposeIn this study, a dynamic contracting model is developed between a venture capitalist (VC) and an entrepreneur (EN) to explore the influence of asymmetric beliefs regarding output-relevant parameters, agency conflicts and complementarity on the VC's posterior beliefs through the EN's unobservable effort choices to influence the optimal dynamic contract.Design/methodology/approachThe authors construct the contracting model by incorporating the VC's effort, which is ignored in most studies. Using backward induction and a discrete-time approximation approach, the authors solve the continuous-time contract design problem, which evolves into a nonlinear ordinary differential equation (ODE).FindingsThe optimal equity share that the VC provides to the EN decreases over time. In accordance with the empirical evidence, the EN's optimistic beliefs regarding the project's profitability positively affect its equity share. However, the interactions between the optimal equity share, project risk and both partners' degrees of risk aversion are not monotonic. Moreover, the authors find that the optimal equity share increases with the degree of complementarity, which indicates that the EN is willing to cooperate with the VC. This study’s results also show that the optimal equity shares at each time are interdependent if the VC is risk-averse and independent if the VC is risk-neutral.Research limitations/implicationsIn conclusion, the authors highlight two potential directions for future research. First, the authors only considered a single VC, whereas in practice, a risk project may be carried out by multiple VCs, and it is interesting to discuss how the degree of complementarity affects the number of VCs that ENs contract. Second, the authors may introduce jumps and consider more general multivariate stochastic volatility models for output dynamics and analyze the characteristics of the optimal contracts. Third, further research can deal with other forms of discretionary output functions concerning complementarity, such as Cobb–Douglas and constant elasticity of substitution (See Varian, 1992).Social implicationsThe results of this study have several implications. First, it offers a novel approach to designing dynamic contracts that are specific and easy to operate. To improve the complicated venture investment situation and abate conflict between contractual parties, this study plays a good reference role. Second, the synergy effect proposed in this study provides a theoretical explanation for the executive compensation puzzle in economics, in which managers are often “rewarded for luck” (Bertrand and Mullainathan, 2001; Wu et al., 2018). This result indicates a realistic perspective on financing and establishing cooperative relationships, which enhances the efficiency of venture investment. Third, from an empirical standpoint, one can apply this framework to study research and development (R&D) problems.Originality/valueFirst, the authors introduce asymmetric beliefs and Bayesian learning to study the dynamic contract design problem and discuss their effects on equity share. Second, the authors incorporate the VC's effort into the contracting problem, and analyze the synergistic effect of effort complementarity on the optimal dynamic contract.

Prospective cohort study.To assess the differences in the clinical and radiological outcomes between oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).Nowadays, there is still a controversy regarding whether OLIF is superior to MI-TLIF in the management of degenerative lumbar disease.Between August 3, 2019 and February 3, 2020, 137 patients were assigned to OLIF or MI-TLIF at their request and the surgeon's discretion: 71 in the OLIF group and 66 in the MI-TLIF group. The perioperative data, patient-reported outcomes, radiographic outcomes, and complications were compared between the two groups.The OLIF group showed shorter operation time (110.5 vs.183.8 minutes, P 0.001), lesser estimated blood loss (123.1 vs. 232.0 mL, P 0.001), shorter length of hospital stay (5.5 vs. 6.7 days, P 0.001), and lower serum creatine kinase (CK) (1 day postoperatively) (376.0 vs. 541.8 IU/L, P 0.01) than that of MI-TLIF group. Both groups showed no significant differences in the visual analog scale (VAS) scores of lower back and leg pain and the Oswestry Disability Index (ODI) scores preoperatively and at 1, 3, and 12 months postoperatively, respectively (P 0.05). Compared with the MI-TLIF group, the OLIF group showed better restoration of disc height (DH) (4.7/4.6/4.7 vs. 3.7/3.7/3.7 mm, P 0.01) and lumbar lordosis angle (LLA) (10.5°/10.8°/11.1° vs. 5.8°/5.7°/5.3°, P 0.001), but not the value of segmental lordosis angle (SLA) (P 0.05) at 1 day, 1 month, and 1 year postoperatively, respectively. The complication rate of OLIF was higher than that of MI-TLIF (29.4% vs. 9.7%, P 0.01).Compared with MI-TLIF, OLIF showed similar results in terms of patient-reported outcomes, restoration of SLA and fusion rate, and superior results with respect to restoration of DH and LLA, operation time, estimated blood loss, length of hospital stay, and serum CK levels (1 day postoperatively). Even though the complication rate of OLIF is higher than that of MI-TLIF, it does not bring persistent and substantial damage to the patients.Level of Evidence: 3.

Objective The aim of the present paper was to evaluate cases of lumbar degenerative diseases treated with oblique lateral interbody fusion (OLIF) using a modified lateral approach (i.e. anteroinferior psoas exposure under direct vision) and to analyze the effect and safety of this approach. Methods From June 2016 to April 2019, a total of 226 patients with an average age of 65.5 ± 16.2 years (98 men and 128 women) with degenerative lumbar diseases who underwent the AIP approach of OLIF were followed up and analyzed retrospectively. Data concerning operative and clinical parameters were collected, including operative time, intraoperative estimated blood loss, duration of postoperative hospital stay, and time to ambulation after surgery. For the assessment of clinical outcomes, the visual analogue scale (VAS) score (for back pain) and the Oswestry disability index (ODI) were calculated. Complications were also recorded as surgical exposure approach‐related complications. More than 6 months after surgery, 132 patients consented to having MRI examinations to evaluate the psoas muscle atrophy when they were followed up. Results The mean operative time was 82.5 ± 31.6 min. The mean operative time for each segment of OLIF was 43.3 ± 15.5 min. The mean blood loss was 48.0 ± 11.6 mL. The mean blood loss for each segment of OLIF was 25.3 ± 10.1 mL. No patients needed blood transfusion intraoperatively or postoperatively. The mean hospital stay was 4.1 ± 2.1 days. All patients were followed up for 12–31 months (mean 18.2 months). Clinical assessment showed that the VAS and ODI scores at 6 months after surgery were markedly lower than the preoperative scores (P 0.05). There was no significant difference in percentage changes of the cross‐sectional area of the lean psoas muscle and the T2 signal intensity ratio of gross psoas to quadratus lumborum muscles between the left side (operative side) and the right side (nonoperative side) (P > 0.05). A total of 11 surgical exposure approach‐related complications were reported, with an incidence of 4.9%: transient thigh pain/numbness, psoas weakness (2.2%), sympathetic chain injury (1.3%), cage subsidence (0.9%), and segmental artery injury (0.4%). There was no permanent motor neurological deficit, and no injury of vascular, ureter or peritoneal membranes. Conclusion The anteroinferior psoas approach for OLIF is safe and can preserve the psoas and lumbar plexus., We presented a modified lateral approach (i.e. anteroinferior psoas exposure under direct vision) for OLIF and found that it is safe and can preserve the psoas and the lumbar plexus.

Background A postoperative discal pseudocyst (PDP) is a cystic lesion that is formed in the operation area of the intervertebral disc, leading to recurrence or even worse symptoms. To our knowledge, to date, there is no research focusing specifically on PDP following percutaneous endoscopic interlaminar discectomy (PEID). Case presentation We present the case of a 27‐year‐old man with L5S1 intervertebral disc herniation who was treated with PEID after failed conservative treatment. His leg pain was relieved immediately but reoccurred on the 40th day. MRI showed a PDP. Because loxoprofen and bedrest were ineffective and the patient was anxious, we performed a cystectomy. The patient's symptoms were significantly relieved, and a 6‐month follow up showed no recurrence both clinically and on MRI. Conclusion A PDP is more likely to form using the interlaminar approach than the transforaminal approach. For patients with mental stress, severe pain, and neurological symptoms, surgery is suggested to remove the cyst. Discectomy cannot be performed when disc degeneration is mild., We present the case of a 27‐year‐old man with L5S1 intervertebral disc herniation who was treated with PEID after failed conservative treatment. His leg pain was relieved immediately but reoccurred on the 40th day. MRI showed a PDP. Because loxoprofen and bed rest were ineffective and the patient was anxious, we performed a cystectomy. The patient's symptoms were significantly relieved, and a 6‐month follow‐up showed no recurrence both clinically and on MRI.

Study design A rat model of multifidus muscles injury and atrophy after posterior lumbar spine surgery. Objective We determined the effect of ascorbic acid (AA) on the postoperative multifidus muscles in rat model. Summary of background data Previous studies show oxidative stress and inflammation are two main molecular mechanisms in multifidus muscle injury and atrophy after posterior lumbar surgery. AA may have a protective effect in postoperative multifidus muscles. Methods Rats were divided into sham surgery, control surgery, and surgery plus AA groups. Multifidus muscles of the control and AA groups were excised from the osseous structures. The muscles were retracted continuously for 2 hours. In the sham and AA groups, AA was administered via oral gavage daily in the first week. In each group, the oxidative stress was evaluated by measuring malondialdehyde (MDA) and Total superoxide dismutase (T-SOD). The inflammation, fat degeneration, or fibrosis of multifidus muscle were evaluated by quantitative real-time polymerase chain reaction (q-PCR), histology, or immunohistochemical analysis. Results T-SOD activity was significantly lower in the control group than that in the AA group in the first week. MDA levels were significantly higher in the AA group. Interleukin-6 and tumor necrosis factor-α in multifidus muscles also showed significant differences when treated with AA. The inflammation score on histology was significantly lower in the AA group postoperatively in the first week. In the long run, marker genes for fibrosis and fat degeneration, and fibrosis and fat degeneration scores, were significantly lower in the AA than the control group on days 14 and 28 postoperatively. Conclusion In conclusion, AA attenuated the oxidative stress and inflammation response in the postoperative multifidus muscles, and remarkable differences were observed from the histological assessment and related marker genes expression. Our results provided important insight into the anti-inflammatory and anti-oxidative effects of AA in the postoperative multifidus muscles. Level of evidence N/A.

Experimental study evaluated magnetic resonance imaging (MRI) and histologic changes in the multifidus muscle after anterior spinal fusion. To determine the effect of spinal fusion on the multifidus muscle in an anterior rabbit model through the use of MRI and histologic evaluation. Retraction and splitting approach are known to be important factors in postoperative injury and atrophy of the multifidus muscle. The effect and possible mechanism of spinal fusion as an independent factor remains unknown. Thirty-six New Zealand white rabbits were divided into two groups. Animals in the fusion group underwent two-level anterior spinal fusion whereas those in the control group underwent similar surgery without spinal fusion. The status of the multifidus muscle was evaluated with MRI and histological analysis at preoperative, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperatively. All rabbits in the fusion group achieved solid fusion. The mean T1-weighted and T2-weighted signal intensity ratios of gross multifidus to psoas muscles were all approximately 1.0 postoperatively, with no remarkable difference between the groups. The mean lesser diameter of myofibrils in either group did not significantly differ between the preoperative and postoperative specimens. There was no significant fibrotic change or fatty degeneration for either group. Decrease in acetylcholine activity or granular degeneration of the neuromuscular junction were not observed, and normal shape and size were found in nearly all samples at all time points in both groups (P > 0.05). After two-segment anterior spinal fusion, multifidus atrophy was not observed throughout a 12-month follow up. The rabbit model of anterior fusion is better suited to study the effect of fusion alone on the status of the multifidus muscle. Level of Evidence: 3

Objectives: Large sample and high-quality evidence to evaluate the preliminary safety of the mobilizations and massage for cervical vertigo are not yet available. Thus, the present study aimed to i...

Osteoporosis is caused by an imbalance between bone formation and bone resorption. Receptor activator of nuclear factor-κB ligand (RANKL) promotes the activity and differentiation of osteoclasts via activating the nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways. IMD 0354 is a selective molecular inhibitor of inhibitor of NF-κB kinase subunit beta (IKKβ) and effective for treatment of acute and subacute inflammatory diseases through the suppression of NF-κB activation. However, the effect of IMD 0354 on bone homeostasis is unknown. In this study, we demonstrated that IMD 0354 significantly attenuated ovariectomy-induced bone loss and inhibited osteoclastogenesis in mice, whereas bone formation was not affected. Additionally, IMD 0354 dramatically inhibited osteoclast differentiation and function induced by RANKL and macrophage colony-stimulating factor in bone marrow monocytes as verified by tartrate-resistant acid phosphatase (TRAP) staining as well as bone resorption assay in vitro. Subsequently, we found that activation of NF-κB signaling and the ERK/c-Fos axis were blunted during osteoclast formation induced by RANKL. Transcription factors nuclear factor of activated T cells c1 (NFATc1) and c-Fos were suppressed with the decreased expression of osteoclast-related genes by IMD 0354. Our findings suggest that IMD 0354 could be a potential preventive and therapeutic drug for osteoporosis.

BACKGROUND: Many studies have explored the relationship between facet tropism and facet joint osteoarthritis, disc degeneration and degenerative spondylolisthesis. However, the associations between facet orientation and tropism, and paraspinal muscles have not been studied. OBJECTIVE: To analyze the associations between facet orientation and tropism, and parameters of paraspinal muscles in patients with chronic low back pain. METHODS:Ninety-five patients withchronic low back pain were consecutively enrolled. Their facet joint angles weremeasured on computed tomography (CT) while gross cross-sectional area (GCSA), functional cross-sectional area (FCSA) and T2 signal intensity of lumbar paraspinal and psoas muscle were evaluated on magnetic resonance imaging (MRI). RESULTS: The GCSA and FCSA were significantly smaller for multifidus muscle ( P< 0.001), but significantly larger for erector spinae and psoas muscles ( P< 0.001), in coronally-orientated group than those in sagittally-orientated group. The differences of bilateral GCSA and FCSA of multifidus muscle were significantly larger in facet tropism group than those in no facet tropism group (P = 0.009 and P = 0.019). CONCLUSIONS: Muscular asymmetries may develop in the lumbar region of the spine, which are associated with facet asymmetry in patients with chronic low back pain. Longitudinal studies are needed to understand the causal relationship between facet orientation and tropism and muscular asymmetry in future.

Modic changes are the MRI signal changes of degenerative lumbar vertebral endplate and which lead to or accelerate intervertebral disc degeneration. NLRP3, caspase-1, and interleukin-1β (IL-1β) play a pivotal role in the pathogenesis of many inflammatory diseases, such as osteoarthritis. However, the roles of IL-1β and its activators caspase-1 and NLRP3 are unclear in the degenerative endplate. We asked: (1) What are the degenerative changes of the histologic features and chondrogenic markers’ gene expressions between the cartilaginous endplates of patients with Modic changes and trauma (control)? (2) How does the NLRP3/caspase-1/IL-1β axis in the cartilaginous endplates of patients with Modic changes compare with control (trauma) specimens? Surgical specimens of cartilaginous endplates were divided into Modic changes (n = 56) and the trauma control (n = 16) groups. Hematoxylin and eosin and safranin O staining of cartilaginous endplate tissues were done to evaluate the extracellular matrix. Reverse transcription-polymerase chain reaction was performed on these tissues to investigate mRNA expression of type II collagen (Col II), SOX-9, matrix metalloproteinase-3, and a disintegrin like and metalloproteinase thrombospondin type I motifs-5. NLRP3, caspase-1, and IL-1β were evaluated by reverse transcription-polymerase chain reaction and immunohistochemistry. Hematoxylin and eosin and safranin O staining showed the extracellular matrix degraded in the cartilaginous endplates of patients with Modic changes but not in the control cartilaginous endplates. Chondrogenic Col II (p = 0.024) and SOX9 (p = 0.053) were downregulated in the Modic changes group compared with the control group. In contrast to the control group, the transcriptional levels of NLRP3 (p < 0.001), caspase-1 (p = 0.054), and IL-1β (p = 0.001) were all upregulated in the Modic changes group. The expression of NLRP3, caspase-1, and IL-1β was upregulated in the patients with low back pain and Modic changes on MRI compared with patients with vertebral burst fracture without degenerative changes on MRI. The data suggest the NLRP3/caspase-1/IL-1β axis may be implicated in lumbar cartilaginous endplate degeneration. The NLRP3/caspase-1/IL-1β axis is active in cartilaginous endplates of patients with Modic changes and inflammatory cascades can exacerbate the cartilaginous endplate degeneration which may act as a trigger for intervertebral disc degeneration and low back pain. If these findings can be confirmed by others, we hope that new and effective therapy could be developed directed against this target.

Study design A transcriptional expression assessment of human samples. Objective To evaluate 12 new candidate nucleus pulposus (NP) markers in degenerative disc disease in a Chinese population. Summary of background data Disc degeneration is a major contributor of low back pain. However, no specific and reliable markers of degeneration of NP are available. Methods Specimens of NP were collected from 81 patients and grouped into the degenerated disc group (undergoing discectomy and fusion with significant signs of disc degeneration) and the trauma control group (undergoing anterior vertebral body and disc excision and fusion without signs of disc degeneration). Lumbar spine magnetic resonance imaging, hematoxylin-eosin staining, and safranin O staining of sections of NP tissues were conducted to evaluate the severity of the disc degeneration in all samples. Quantitative reverse transcription polymerase chain reaction was performed to investigate the levels of mRNA expression of these genes, as well as those of aggrecan, type II collagen, and SRY-box 9 (SOX-9). Degenerated samples were also divided into groups according to Pfirrmann grading system to elucidate the association of severity of degeneration and gene transcriptional levels. We also tested the relationship between mRNA levels of these genes and clinical characteristics such as hypertension and diabetes mellitus. Results We demonstrated that 11 of the 12 candidates showed significant differential expression in degenerated discs. Changes in the expression of these 11 genes were determined to be risk factors in degenerative disc diseases. The expression of neurochondrin (NCDN), keratin 8 (KRT8), and matrix Gla protein (MGP) even showed significant changes among subgroups of patients with degenerative disc disease stratified according to the Pfirrmann grading system. The expression of keratin 18 (KRT18), cadherin 2 (CDH2), synaptosomal-associated protein 25 (SNAP25), KRT8, and NCDN was significantly decreased in patients with hypertension. In contrast, the expression of MGP and cartilage oligomeric matrix protein was significantly upregulated in patients with diabetes mellitus. Conclusion Overall, we demonstrated the clinical utility of 11 novel NP markers for degenerative disc disease. Among them, the expression of NCDN, KRT8, and MGP may indicate the severity of disc degeneration. Level of evidence N/A.

The intervertebral disc degeneration changes and paraspinal muscles changes are believed to be risk factors for lumbar degenerative spondylolisthesis (LDS). But there is limited quantitative information about this progression. This study is to reveal their changes the in the progression of LDS.Data were gathered from 149 middle-aged degenerative spondylolisthesis patients and same amount of age- and sex-matched control group with both lumber spine MRI and X-ray. Narrowed disc space were measured in percent as anterior inferior disc height (DHIA)/anterior superior disc height (DHSA), inferior disc height (DHI)/superior disc height (DHS), and posterior inferior disc height (DHIP)/posterior superior disc height (DHSP). Signal intensity ratio of multifidus muscle (RM) and erector spinae (RES) to psoas muscle, muscle atrophy ratio of lean CSA (LCSA) to gross CSA (GCSA) of paraspinal muscles were calculated.In the case group the most common slipped vertebra was L4 (75.84%). Disc height (DHIA/DHSA, DHI/DHS) and multifidus muscle atrophy ratio (M-LCSA/M-GCSA) tended to be lower than those in the control group, whereas the disc degeneration degree and T2 signal intensity ratio (RM,RES) of the paraspinal muscles and erector spinae muscle atrophy ratio were higher than control group. The difference between the two groups was statistically significant (P0.05). Using multivariate logistic regression analysis, it was confirmed that ES-LCSA/ES-GCSA, especially RM are independent predisposing factors to lumbar spondylolisthesis (OR1, P0.05) while DHIA/DHSA, M-LCSA/M-GCSA are independent protective factors (OR1, P0.05).Decreased anterior disc height and multifidus muscle atrophy are found in the LDS patients and thy could be the cause of LDS. The presence of erector spinae hypertrophy could be a compensatory mechanism to compensate for the instability.

Intervertebral disc degeneration (IVDD) is a multifactorial disease and responsible for many spine related disorders, causes disability in the workforce and heavy social costs all over the world. Honokiol, a low molecular weight natural product, could penetrate into and distribute in IVDs to achieve therapeutic effect in a rat tail model. Therefore, the present study was undertaken to examine the antiinflammatory, antioxidation and IVD-protective effect of honokiol using nucleus pulposus cells and investigate its mechanisms to provide a new basis for future clinical treatment of IVDD. In the current study, we demonstrated that honokiol inhibits the H2O2-induced apoptosis (caspase-9, caspase-3, and bax), levels of oxidative stress mediators (ROS, MDA), expression of inflammatory mediators (Interleukin-6, COX-2, and iNOS), major matrix degrading proteases (MMP-3, MMP-13, ADAMTS5, and ADAMTS4) associated with nucleus pulposus degradation. Furthermore, we found nucleus pulposus protective ability of honokiol by up-regulating extra cellular matrix anabolic factors like type II collagen (Col II) and SOX9 in nucleus pulposus. We also found that honokiol suppressed the phosphorylation of NF-kB and JNK, and activation of TXNIP-NLRP3 inflammasome in H2O2-stimulated nucleus pulposus cells, thereby inhibiting the activation of downstream inflammatory mediators such as Interleukin-1β. Furthermore, honokiol showed a cartilage protective effect in the progression of IVDD in a rat model induced by puncture. Thus, our results demonstrate that honokiol inhibited the H2O2 induced apoptosis, oxidative stress, and inflammatory responses through the depression of TXNIP/NLRP3/caspase-1/ Interleukin − 1β signaling axis and the activation of NF-kB and JNK. Honokiol possess nucleus pulposus protective properties and may be of value in suppressing the pathogenesis of IVDD.

Experiments on the dynamic behavior of ice in compression were carried out by means of SHPB apparatus. The specimens were to-10°C~-25°C and the tested strain rate ranged from 700/s to 1000/s. Strain-rate effects and the influence of freezing preserve time were studied. It was observed that the dynamic compressive strength of ice has an effect of strain-rate enhancement and the freezing preserve time has no influence to its dynamic compressive strength. In addition, a Pulse shaping technique to avoid the specimen failing before stress uniformity in ice specimen was presented.

In this paper, we carried out a randomized controlled clinical trial to explore the effect of 12-words-for-life-nurturing exercise on patients presenting with cervical spondylosis. After exercise intervention, the mean VAS and NDI scores of the patients decreased significantly and the scores of BP, VT, and MH in SF-36 Health Questionnaire were significantly higher. Exercise therapy showed significant effect on relieving pain and improving vitality and mental health. The 12-words-for-life-nurturing exercise may be a potential effective therapy for patients with cervical spondylosis.

The binding studies of imidacloprid to bovine serum albumin (BSA) were investigated by UV-Vis absorption spectrum, fluorescence spectrum and synchronous fluorescence spectrometry. Under the simulative physiological conditions, fluorescence data revealed the presence of a single class of binding site on BSA and the dynamic quenching constants () were 6.851×104 L.mol-1 and 5.813×104 L.mol-1 at 310 and 315 K, respectively, proving the mode of action of imidacloprid with BSA as a static quenching. In addition, according to the Vant Hoff equation, ΔGθ θ θ> 0, indicated an electrostatic interaction process. At the same time, synchronous fluorescence spectrum of BSA could tell us whether the conformation of BSA was changed by imidacloprid.

The approach-related morbidity resulting from iatrogenic erector spinae injury in posterior lumbar surgery has become an increasing concern for spine surgeons. Many studies have explained the injury mechanisms and reported new surgical approaches to prevent this iatrogenic injury from their own point of views, but there is still no systemic information for a thorough understanding of this iatrogenic erector spinae injury that may give spine surgeons practical advices in their individual operations. We consequently reviewed the literature on the anatomy of erector spinae, causes of injury, and relative minimally invasive approaches. We found that the local anatomic structures make the erector spinae vulnerable to injury during posterior lumbar surgery, especially the medial multifidus which is innervated only by the medial branch of the dorsal ramus, with no intersegmental nerve supply as in the other paraspinal muscles, and the injury factors mainly include dissection, retraction, denervation, and immobility. Studies suggest that the goal of prevention is to preserve the physiological structure of erector spinae and to avoid or limit the injury causes: approaches through spatium intermusculare and approaches with endoscope and tubular retractor system can prevent the erector spinae from injury by less dissection and retraction; non-fusion techniques may prevent the erector spinae from disuse atrophy by preserving the segmental motion and the adjacent erector spinae activity.

Influences of normalizing and tempering temperature on mechanical properties and microstructure of steel casting were investigated in this paper. The results showed that as the normalizing temperature increased, tensile strength increased, while tensile stretch increased slowly at first and decreased at last. Steel casting got best comprehensive mechanical properties after a 970°C normalizing treatment. Normalized at 970°C and tempered at the rage of 500 °C and 550°C, steel casting got best comprehensive mechanical properties. The relation between mechanical properties and temperature was gotten using Matlab Software. The microstructure was ferrite and pearlite after normalizing, and tempered sorbite after high tempering.

In this paper, orange peel was utilized as low-cost adsorbent to remove carbofuran from aqueous solution by adsorption. All the experiments were conducted at 30°C to investigate the effects of initial concentration, adsorbent dosage, contact time, ionic strength, and pH on carbofuran adsorption. The results showed that it was effective to remove carbofuran in the alkalic medium and the equilibrium adsorption was practically achieved in 60 min. The presence of NaCl inhibited the adsorption of carbofuran onto orange peel. Langmuir model provided the better correlation of the experimental data and could interpret the adsorption process and the maximum monolayer adsorption capacity was found to be 84.49 mg/g at the temperature of 30°C. The pseudo-second-order kinetic model could describe the adsorption kinetics rationally and the rate-limiting step was the intraparticle diffusion process. It was implied that orange peel may be suitable as adsorbent material for adsorption of N-methyl carbamate insect...

The influence of admixture on concrete pore structure was analyzed by using the mercury intrusion method and the rapid frozen-thaw method under the condition of the same water/binder ratio in this paper, and thus the relationship between pore structure and frost resistance of concrete were analyzed. When the compound mineral ad-mixture is mixed, the porosity rate of concrete can be decreased and the harmful hole is in-creased, the less-harm hole and the no-harmful hole are decreased. The early strength of concrete is not decreased. But the strength has the increasing trend in the late, which is more favorable for the impermeability and corrosion resistance. But the improvement of the freezing resistance is not obvious. The admixture of air entraining agent can increase the porosity and more-harmful hole, and the concrete strength will be decreased, which will be not favorable for the freezing resistance of concrete. If these two substances are admixed at the same time, the concrete porosity is increased, and the pore size distribution of concrete can be reasonable. The decrement of concrete strength is not obvious, but it is favorable for the freezing resistance of concrete.

The aim of this study was to evaluate early ASD at short-term follow-up in fused and unoperated patients with degenerative disc disease, using quantitative magnetic resonance imaging (MRI) analysis of the area, signal intensity and their product, i.e., MRI index of the central bright area of the disc as well as measures of intervertebral disc height and Pfirrmann grading scale. The further purpose was to determine whether fusion accelerates ASD compared with non-surgical treatment in short-term follow-up.One hundred and eight chronic low back patients diagnosed as L4/L5 degeneration undertook either one-level instrumented posterior lumbar interbody fusion or conservative treatment. They were followed up for about 1 year. Finally 46 fused and 45 conservatively treated patients with MRI follow-up were included. Pre- and post-treatment MRIs were compared to determine the progression of disc degeneration at the two cranial adjacent segments.The area, signal intensity and MRI index of the central bright area of the adjacent discs decreased in the operated and unoperated groups from pre-treatment to follow-up, except for an insignificant decrease of signal intensity at the second adjacent segment in the unoperated group. The changes in these parameters were statistically greater at the first than the second adjacent segment in the fused group, but not in the unoperated group. And the changes in the fused group were more pronounced than those at both neighbouring levels in the unoperated group. However, the Pfirrmann grading scale and intervertebral disc height did not detect any changes at adjacent discs in either group.Decrease in the parameters of quantitative MRI analysis indicated early degeneration at discs adjacent to lumbar spinal fusion. Fusion had an independent effect on the natural history of ASD during short-term follow-up. Continued longitudinal follow-up is required to determine whether these MRI changes lead to pathologic changes.

This study explored interactions between m-phenylenediamine (MPD) and bovine serum albumin (BSA) by spectrophotometry. The Stern-Volmer equation and UV-vis spectra examination at different temperatures and pH were used to explore different quenching mechanisms. Under simulated physiological conditions, the binding distance between MPD and BSA was 5.18 nm with a ratio of 1:1. The quenching effect of MPD on BSA intrinsic fluorescence depended strongly on pH, and maximum quenching was observed at alkaline pH. Moreover, the thermodynamic parameters of the MPD-BSA system showed that the predominant acting force between MPD and BSA was a hydrophobic force. The impact of MPD on the conformation of BSA and the effects of co-ions on binding interactions were also examined. Copyright © 2012 John Wiley & Sons, Ltd.

The influences of the oxidative modification, coupling treatment and dispersing agent for carbon fiber dispersion and binding properties were investigated, and the relationships of different ratio of carbon fiber with the physical strength and electrical conductivity of the paper were analyzed. Meanwhile fiber surface morphology, zeta potential and absorbance slurry were tested. The result showed that: coupling modification significantly improved the dispersion performance of carbon fiber, superior than oxidative modification, the increase of the dispersion would enhance the conductivity of carbon fiber network, the effect of CPAM was best in four kinds of surface-active agent, and 30% content of carbon fiber achieved the "percolation threshold” of conductive material.

Adsorption of cefradine onto peanut husk from aqueous solution was investigated in the paper. All the experiments were conducted at the same adsorbent dose (1.0 g/ml) and the same temperature of 293 K to investigate the effects of initial concentration of cefradine, contact time, ionic strength and solution pH. The results showed that it was effective to remove cefradine in the acidic medium and the equilibrium adsorption was practically achieved in 60 min. The presence of NaCl or MgCl2 inhibited the adsorption of cefradine onto peanut husk, while the presence of CaCl2 enhanced the adsorption capacity. The pseudo-second order kinetic equations could describe the adsorption kinetics rationally and the rate-limiting step was the intraparticle diffusion process. The Langmuir model provided the best correlation of the experimental data and could interpret the adsorption process and the Langmuir adsorption capacity was found to be 35.73 mg/g. Chemical modification of peanut husk could help to improve ...

In the present study, we analyzed the origin of pressure fluctuation of ceramic filter during recoiling washing process and found that reducing such pressure fluctuation necessitates the use of an accumulator. From functions, types, volume to define the types of accumulators, and by employing the TT-12 type of ceramic filter machine as an example, according to known conditions and through calculation and analysis, we determined the air pressure and accumulator volume and chose the NXQA-16/10-L-A accumulator. With the use of this type of accumulator, we demonstrated that the pressure fluctuation was reduced to be within 0.02 MPa when the air pressure was 0.1 MPa, which satisfied the requirements for recoiling washing.

Carbon fiber paper was coated with multiple layers coating composed by conductive and magnetic fillers. The electromagnetic shielding and conductive properties of the coating were investigated. The effluencing factors such as the ratio of conductive and magnetic fillers, the composition of magnetic fillers, the contrast of coating method, the structure of shielding layer were assessed according with effectiveness. The results showed the best component for the coating layer was: conductive substrate, conductive coating layer and magnetic coating layer sequently. The compound of magnetic fillers with differenet electromagnetic interaction mechanism would produce a complementary magnetic loss, and display a high absorption in broader frequency band. The shielding effectiveness of multi-layer coated carbon fiber paper at 1.5 GHz was shown up to 45 dB.

A synergistic combination of electrocoagulation and electrooxidation was introduced for the treatment of CTMP wastewater in which most of the colloids and charged species had been removed by electrocoagulatio, then small organics could be mineralized by electrooxidation effectively.The mainly influencing factors for electrocoagulation such as electrolyte, sodium chloride dosage, voltage intensity, current intensity and reaction time were assessed. The optimum conditions were obtained, and the results showed that sodium chloride dosage of 1g/L, voltage intensity of 7.5V, current intensity of 0.6A, 60 min reaction time, its color removal rate was above 90% and CODCr removal rate was about 40%. After electrocoagulation the electrooxidation could further reduce CODCr above 80%.

The native and chemically modified corncobs were utilized as low-cost and efficient adsorbent to remove bromate from aqueous solution in this study. The parameters of the adsorbent i.e. adsorption capacity, selectivity, regenerability were investigated. All the experiments were conducted at the same adsorbent dose (0.2 g/200 ml) and the same temperature of 30°C to investigate the effects of initial concentration of bromate, contact time, ionic strength and solution pH, then the optimal experimental conditions were ascertained. The results showed that the optimum conditions for the removal of bromate were at the aqueous solution with low ion concentration, pH of about 9.0 and equilibrium time of 80 min, respectively. Freundlich model fi tted the adsorption data quite reasonably (R2 > 0.92) and the maximum adsorption capacity was 101.01 mg/g. The experimental data followed the pseudo-second-order kinetic model very well. In addition, the removal percentages (%) of bromate by corncob modifi ed by 80% isoprop...

The vast area of distribution of soft clay with poor engineering property of our country, on the soft clay subgrade treatment by drainage consolidation method. As a kind of drainage consolidation method, vacuum preloading consolidation of soft soil foundation in recent years have been widely used, and achieved very good engineering and economic benefits. The theory research about vacuum preloading behind the engineering practice, restricted the further development of the technology and engineering application, it is necessary to make a systematic study. Through the comparative analysis of the test results, the vacuum causes soil consolidation, on this basis, the surcharge preloading and vacuum preloading contrast of the vacuum preloading mechanism, analyzes various factors foundation reinforcement finally strengthening effect by vacuum preloading.

Photocatalytic mineralization of dimethoate using nanosized TiO2 at different conditions has been investigated. The objective of this work was to study the influence on the photocatalytic mineralization of dimethoate, of various parameters and identify intermediates formed during photocatalytic treatment. The mineralization efficiency of dimethoate increased with elevated concentration of humic acid up to 5 mg/L, while the efficiency reduced when the concentration was above 5 mg/L due to competitive adsorption. The presence of CH3COCH3 can significantly inhibit dimethoate mineralization and the half-life of mineralization efficiency was increased by about 3 times. The photo mineralization efficiency changed with increasing concentrations of inorganic ions. With respect to the ions of Fe3+, Cu2+, Zn2+, HCO3− and NO3−, the mineralization efficiency increased with increasing concentration of ions and reached a maximum at optimal concentrations, which was followed by a decrease with a further increase in ion concentrations. By contrast, the mineralization of dimethoate was strongly inhibited by Cl− and Cr3+ ions. Intermediate products from dimethoate were identified by means of GC–MS and four possible by-products were identified. A proposed mineralization pathway for dimethoate is presented.

Objective: To determine differences in paraspinal muscle injury between a modified minimally invasive approach (MMIA) and a traditional operative approach (TOPA) for one-level instrumented posterior lumbar inter-body fusion (PLIF). Methods: From March 2006 to May 2008, a consecutive series of 91 patients who underwent a one-level instrumented PLIF procedure using one of two different approaches (MMIA in 41 patients and TOPA in 50), and who were operated on by one group of surgeons at a single institution, was studied. The following data were compared between the two groups: surgical time, blood loss, and changes in postoperative serum concentration of creatinine kinase (CK). More than 1 year post operation, low back pain was evaluated by a visual analog scale (VAS) and the Oswestry disability index (ODI). Some patients were also evaluated by MRI to allow comparison of the preoperative and postoperative cross sectional area (CSA) and fat degeneration grades at the operative level. Results: There was no statistically significant difference in surgical time, but blood loss, serum concentration of CK, and scores of the VAS and ODI were markedly less in the MMIA group compared with the TOPA group. In the TOPA group, the postoperative CSA of the multifidus muscles was significantly smaller than it was pre-operatively. In contrast, there was no significant difference between the pre- and post-operative CSA of the multifidus muscles in the MMIA group. There was more fatty infiltration postoperatively than preoperatively in both the TOPA and MMIA groups, the increase in fatty infiltration being greater in the TOPA than in the MMIA group. Conclusion: Compared with TOPA, MMIA can significantly lessen paraspinal muscle injury, and reduce the incidence of low back pain.

We set out to determine whether a minimally invasive approach for one-level instrumented posterior lumbar interbody fusion reduced undesirable changes in the multifidus muscle, compared to a conventional open approach. We also investigated associations between muscle injury during surgery (creatinine kinase levels), clinical outcome and changes in the multifidus at follow-up. We studied 59 patients treated by one team of surgeons at a single institution (minimally invasive approach in 28 and conventional open approach in 31, voluntarily chosen by patients). More than 1 year postoperatively, all the patients were followed up with the visual analogue scale (VAS) and Oswestry disability index (ODI), and 16 patients from each group were evaluated using MRI. This enabled the cross-sectional area (CSA) of lean multifidus muscle, and the T2 signal intensity ratio of multifidus to psoas muscle, to be compared at the operative and adjacent levels. The minimally invasive group had less postoperative back pain (P

The adsorption equilibria of single-component and binary mixtures of levulinic/formic acids in the aqueous solution on three different types of basic polymeric adsorbents were experimentally measured at 30 °C. Adsorption isotherms such as Langmuir, Freundlich and Sips were applied to correlate the single-solute adsorption data. Results demonstrated that the adsorption isotherms of both acids on all three adsorbents were best described by the Sips model, and that formic acid has higher adsorption capacity and stronger affinity on all three resins. The adsorption of binary mixtures of formic/levulinic acids reveals that formic acid is preferentially adsorbed and levulinic acid can be competitively displaced by formic acid. Binary Sips model and the ideal adsorbed solution (IAS) theory were employed to simulate the binary competitive adsorption data. The binary Sips model cannot predict the competitive adsorption behavior. The IAS model was successfully coupled with Sips isotherm parameters determined from single-component adsorption data to predict the binary competitive adsorption behavior of levulinic/formic acids on all three resins.

// Xianfeng Lin 1,2,* , Xiangqian Fang 1,2,* , Qiang Wang 1,2,* , Zhijun Hu 1,2 , Kai Chen 3 , Zhi Shan 1 , Shuai Chen 1,2 , Jiying Wang 1,2 , Jian Mo 1,2 , Jianjun Ma 1,2 , Wenbing Xu 1,2 , An Qin 4 and Shunwu Fan 1,2 1 Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China 2 Institute of Micro-Invasive Surgery of Zhejiang University, Hangzhou, China 3 Department of Orthopaedic Surgery, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou, China 4 Department of Orthopedics, Shanghai Key Laboratory of Orthopedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China * These authors have contributed equally Correspondence to: Shunwu Fan, email: // An Qin, email: // Keywords : intervertebral disc, decellularization, extracellular matrix, disc degeneration, mesenchymal stem cell, Pathology Section Received : November 26, 2015 Accepted : February 18, 2016 Published : February 25, 2016 Abstract Intervertebral disc degeneration is associated with back pain and disc herniation. This study established a modified protocol for intervertebral disc (IVD) decellularization and prepared its extracellular matrix (ECM). By culturing mesenchymal stem cells (MSCs)(3, 7, 14 and 21 days) and human degenerative IVD cells (7 days) in the ECM, implanting it subcutaneously in rabbit and injecting ECM microparticles into degenerative disc, the biological safety and efficacy of decellularized IVD was evaluated both in vitro and in vivo . Here, we demonstrated that cellular components can be removed completely after decellularization and maximally retain the structure and biomechanics of native IVD. We revealed that allogeneic ECM did not evoke any apparent inflammatory reaction in vivo and no cytotoxicity was found in vitro . Moreover, IVD ECM can induce differentiation of MSCs into IVD-like cells in vitro . Furthermore, allogeneic ECM microparticles are effective on the treatment of rabbit disc degeneration in vivo . In conclusion, our study developed an optimized method for IVD decellularization and we proved decellularized IVD is safe and effective for the treatment of degenerated disc diseases.

Study Design. Establishment of a novel in vivo animal model of cervical spondylosis. Objective. To investigate apoptotic, degenerative, and inflammatory changes occurring in the cervical intervertebral discs of rats. Summary of Background Data. Cervical degeneration occurs as the result of imbalance of both static and dynamic spinal stabilizers. The disc degeneration that occurs is characterized by increased local inflammation and increased apoptosis of intervertebral disc cells. Methods. By excising the paraspinal musculature and posterior cervical spinal ligaments of rats, both static and dynamic cervical stabilizers were disrupted. The resultant biomechanical imbalance resulted in biochemical and histologic changes, which were characterized by light microscopy, electron microscopy, immunostaining, enzyme-linked immunosorbent assay, polymerase chain reaction, and in situ hybridization. Results. Histologic analysis showed characteristic degenerative changes of the intervertebral discs and vertebral endplates following surgery. Ultrastructural examination revealed apoptotic changes, which were verified by immunostaining. Instability also resulted in significant up-regulation of inflammatory factors, as shown by enzyme-linked immunosorbent assay, polymerase chain reaction, and in situ hybridization. Conclusions. By creating static and dynamic posterior instability of the cervical spine, this novel model of cervical spondylosis results in rapid intervertebral disc degeneration characterized by increased apoptosis and local inflammation, such as that seen clinically.

Supplemental Digital Content is available in the text, Background: There is a lack of high-quality evidence supporting the use of manipulation therapy for patients with cervical radiculopathy (CR). This study aimed to evaluate the effectiveness of Shi-style cervical manipulations (SCMs) versus mechanical cervical traction (MCT) for CR. Methods: This was a randomized, open-label, controlled trial carried out at 5 hospitals in patients with CR for at least 2 weeks and neck pain. The patients received 6 treatments of SCM (n = 179) or MCT (n = 180) over 2 weeks. The primary outcome was participant-rated disability (neck disability index), measured 2 weeks after randomization. The secondary outcomes were participant-rated pain (visual analog scale) and health-related quality of life (36-Item Short Form Health Survey [SF-36]). Assessments were performed before, during, and after (2, 4, 12, and 24 weeks) intervention. Results: After 2 weeks of treatment, the SCM group showed a greater improvement in participant-rated disability compared with the control group (P = .018). The SCM group reported less disability compared with the control group (P

To identify the affect of chronic low back pain on multifidus muscle atrophy and fatty infiltration.From March 2010 to August 2013, a retrospective study were carried out in the department of orthopedics of patients with low back pain. Finally 31 cases were selected to this study including 19 males and 12 females with an average age of 36.4 years ranging from 23 to 55 years. The main symptoms of these patients were repeated back pain. Duration was more than 1 year. X-ray, CT, MRI showed no obvious abnormalities. The changes of net cross-sectional area of multifidus and T2 signal ratio of the same patient were measured at different time by MRI. VAS and Oswestry disability scores were recorded in two MRI examination. Correlation between these change of multifidus net area and T2 signal ratio in two times measurement and duration of low back pain, VAS, Oswestry disability scores were analyzed to find the affection of low back pain on paraspinal multifidus muscle.The net multifidus cross-sectional area in same case by the second follow-up MRI is significantly smaller than that of the first follow-up, T2 signal ratio at second was significantly higher than that of the first (P0.05). The net cross sectional area of multifidus muscles reduced rate were positively correlated with VAS scores, duration and of Oswestry disabilitry scores (P0.001). The rate of increase in T2 signal ratio was not correlated with VAS scores,duration and the Oswestry disability scores (P0.05).Chronic low back pain is one of the most important reasons of paraspinal multifidus muscle atrophy and fatty. The duration, VAS and Oswestry disability scores of chronic low back pain were positively correlated with the multifidus muscle atrophy.

Study design This study investigated the expression of 2 types of ADAMTS in human intervertebral cartilage endplate (CEP) and related mechanisms concerning tumor necrosis factor α (TNF-α)-induced nuclear factor κB signaling pathway. Objective To determine which type of ADAMTS is more strongly expressed and the role of TNF-α in CEP. Summary of background data ADAMTS-4 and ADAMTS-5 were proven to be essential in the degeneration of articular cartilage and intervertebral disc. CEP is an important structure adjacent to the disc. However, the activities of ADAMTS in CEP are unclear. Methods CEPs were obtained from subjects after spinal surgery and categorized as members of either the Modic change group or the control group. Sections of these tissues were stained with hematoxylin-eosin, safranin O, and immunohistochemistry procedures for ADAMTS-4, ADAMTS-5, and TNF-α. Transcriptional levels of aggrecan, type I collagen, type II collagen, type X collagen, ADAMTS-4, ADAMTS-5, and TNF-α were investigated by quantitative real-time polymerase chain reaction. In addition, the effect of TNF-α on ADAMTS-5 and its potential mechanisms are investigated in cultured bovine endplate chondrocytes in vitro. Results Our data demonstrated that the degenerative changes associated with the expression of extracellular matrix proteins were correlated with increased levels of ADAMTS-5, but not ADAMTS-4, in the CEP of patients with Modic changes. The expression levels of TNF-α in the Modic change group were significantly increased, which was correlated with the enhanced expression of ADAMTS-5. Additional in vitro investigation confirmed that TNF-α could upregulate the expression of ADAMTS-5 by activating nuclear factor κB pathway in cultured bovine endplate chondrocytes. Conclusion We conclude that the upregulation of TNF-α and ADAMTS-5, but not ADAMTS-4, may play an important role in degenerative CEP-induced low back pain. Level of evidence N/A.

To study differences of multifidus muscle injury between Wiltse intermuscular approach and intramuscular stripping approach in one-level small incision transforaminal lumbar interbody fusion (TLIF) surgery.A total of 46 patients with unilateral lumbar degenerative disease underwent small incision TLIF from August 2009 to February 2011 by one group of surgeons at a single institution. The decompression side of all patients adopted intra-muscular stripping approach; for the non-decompression side, 22 patients adopted Wiltse intermuscular approach (group A),and 24 patients adopted intra-muscular striping approach (group B). In group A, there were 13 males and 9 females, ranging in age from 36 to 74 years old,averaged 52.7 +/- 9.2; 1 patient had disease in L3, 4 12 in L4,5 and 9 in L5S1. In group B,there were 11 males and 13 females,ranging in age from 32 tio 72 years old, averaged 51.8 +/- 8.7; two patients had disease in L3,4, 14 in L4,5, and 8 in L5S1. The following data were compared between the 2 groups: surgical time from skin incision to completion of pedicle screw placement, suturation time, blood loss. Clinical effects were evaluated by VAS score pre-operatively, as well as 1, 6 and 12 months post-operatively. At the latest follow-up, all the patients were evaluated by MRI. This enabled the cross-sectional area (CSA) of lean multifidus muscle, and the T2 signal intensity ratio of multifidus to psoas muscle, to be compared at the operative level.There was no obvious difference in suturation time, but less surgical time from skin incision to completion of pedicle screw placement, less blood loss, less postoperative back pain in Wiltse intermuscular approach group. For the comparison between the two groups or paired comparison between sides in the Wiltse group, the reduction of lean CSA and increase in the multifidus:psoas T2 signal intensity ratio were all significant lower in Wiltse intermuscular approach group or side.The Wiltse intermuscular approach is an easy way for pedicle screw placement, and caused less paraspinal muscle damage than intra-muscular stripping approach, and had positive effects on less back pain.

Background: Multifidus muscle injury and atrophy are common after posterior lumbar spine surgery and are associated with low back pain and functional disability. In theory, muscle-splitting and retraction with a self-retaining retractor are considered to be the major surgical factors. The effects and mechanisms of retraction have been well studied, but the exact effect and possible mechanism of injury and atrophy after muscle-splitting still lack experimental evidence. Methods: New Zealand White rabbits were divided into two groups. In group S, through a skin and lumbodorsal fascial incision, the bilateral multifidus muscles were dissected from the osseous structures in the standard fashion, while in group C, only a skin and lumbodorsal fascial incision was made. In each group, the multifidus muscle was evaluated by magnetic resonance imaging (MRI) and by histological analysis at three and forty-eight hours and at one, three, six, twelve, and twenty-four weeks after surgery. Results: In group C, there was no injury or atrophy of the multifidus muscle after surgery. In group S, the mean T2-weighted signal intensity ratios of gross multifidus to psoas on fat-suppressed T2-weighted cross-sectional MRI scans peaked on week 3 and returned to baseline on week 24. Necrosis and inflammation of the multifidus muscle were evident and became more severe at one week. Fibrotic change was mainly seen at three and six weeks after surgery, and fatty degeneration mainly occurred at twelve and twenty-four weeks. Decreased acetylcholine activity and granular degeneration of the neuromuscular junction were observed at all follow-up times, and the numbers of degenerating neuromuscular junctions increased significantly with time after surgery. Conclusions: The splitting approach is an important cause of multifidus muscle injury and atrophy in posterior lumbar spine surgery. Denervation and disuse may be important factors in multifidus muscle atrophy in the splitting approach. Clinical Relevance: This study provides a basis for the prevention of multifidus muscle injury and atrophy after posterior lumbar surgery.

Study design A reliability study was conducted. Objective To estimate the intra- and intermeasurement errors in the measurements of functional cross-sectional area (FCSA), density, and T2 signal intensity of paraspinal muscles using computed tomography (CT) scan and magnetic resonance imaging (MRI). Summary of background data CT scan and MRI had been used widely to measure the cross-sectional area and degeneration of the back muscles in spine and muscle research. But there is still no systemic study to analyze the reliability of these measurements. Methods This study measured the FCSA and fatty infiltration (density on CT scan and T2 signal intensity on MRI) of the paraspinal muscles at L3-L4, L4-L5, and L5-S1 in 29 patients with chronic low back pain. Two experienced musculoskeletal radiologists and one superior spine surgeon traced the region of interest twice within 3 weeks for measurement of the intra- and interobserver reliability. Results The intraclass correlation coefficients (ICCs) of the intra-reliability ranged from fair to excellent for FCSA, and good to excellent for fatty infiltration. The ICCs of the inter-reliability ranged from fair to excellent for FCSA, and good to excellent for fatty infiltration. There were no significant differences between CT scan and MRI in reliability results, except in the relative standard error of fatty infiltration measurement. The ICCs of the FCSA measurement between CT scan and MRI ranged from poor to good. Conclusion The reliabilities of the CT scan and MRI for measuring the FCSA and fatty infiltration of the atrophied lumbar paraspinal muscles were acceptable. It was reliable for using uniform one image method for a single paraspinal muscle evaluation study. And the authors preferred to advise the MRI other than CT scan for paraspinal muscles measurements of FCSA and fatty infiltration.

（0.5 0.4 0.5 0.4 0.5 0.5 0.5 0.5 0.5 0.4 0.4 0.5 0.4 0.5 0.4 0.4 0.5 0.4 0.5 0.5） Excellent (0.4595) (0.4714 0.4571 0.4500) (111) 2 (0.5 0.4 0.4 0.5 0.4 0.5 0.4 0.5 0.4 0.4 0.3 0.4 0.5 0.4 0.5 0.3 0.4 0.4 0.4 0.4 ) Good

This thesis has put forward a kind of new data presentation and analysis model based on XML and script language, it can express data information with the form that accords with the specification of XML , so makes it have good nature witch is unconcerned with platform, and it can be effective to have so alleviated the burden of server end using customer end resource. This kind of model has provided one new way for the electronic commerce system development.