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An environmentally friendly approach inspired by pulping was proposed to convert industrial furfural residue, which was difficult to further convert into nanocellulose, lignin, and nano-scale lignin.

Background: Cellulose, having huge reserves of natural polymers, has been widely applied in pharmaceutical and biomedicine fields due to its good biocompatibility, biodegradability, non-toxicity and excellent mechanical properties. At present, water- resistant metal-based and petroleum-based materials applied in the medical field have obvious problems of poor biocompatibility and high cost. Therefore, water-resistant cellulose- based materials with good biocompatibility and low price have become an attractive alternative. This review aims to summarize the preparation of water-resistant cellulose- based materials and their potential application in pharmaceutical and biomedical in recent years. Methods: Common hydrophobic treatments of cellulose fibers or paper were overviewed. The preparation, properties and applications of water-resistant cellulose- based materials in the pharmaceutical and biomedical fields were summarized. Results: Common hydrophobic treatments of cellulose fibers or paper were divided into chemical modification (graft polymerization, crosslinking, solution casting or dip-coating), physico-chemical surface modifications (plasma treatments, surface patterning, electrostatic spraying and electrowetting) and physical processing (electrostatic spinning, SAS process and 3D EHD printing). These hydrophobically processed cellulose fibers or paper could be prepared into various water-resistant cellulose-based materials and applied in pharmaceutical excipients, drug-loaded amphiphilic micelles, drug-loaded composite fibers, hydrophobic biocomposite film/coatings and paper-based detectors. They presented excellent water resistance and biocompatibility, low cytotoxicity and high drug loading ability, and stable drug release rate, etc., which could be used for water-insoluble drugs carriers, wound dressings, and medical testing equipment. Conclusion: Currently, water-resistant cellulose-based materials were mainly applied in water-insoluble drugs delivery carriers, wound dressing and medical diagnosis and presented great application prospects. However, the contradiction between hydrophobicity and mechanical properties of these reported water-resistant cellulose-based materials limited their wider application in biomedicine such as tissue engineering. In the future, attention will be focused on the higher hydrophobicity of water-resistant cellulose-based materials with excellent mechanical properties. In addition, clinical medical research of water-resistant cellulose-based materials should be strengthened.

Background Adjacent segmental degeneration (ASD) is one of the common complications after posterior lumbar interbody fusion (PLIF). Both whole body vibration (WBV) and osteoporosis are important factors associated with the biomechanics of the lumbar spine. However, to the best of our knowledge, no studies have investigated the effects of osteoporosis on ASD after PLIF under WBV. Methods In the present study, using one normal model, one PLIF model and one PLIF with osteoporosis model of the L1–S1 segment were developed. A 5-Hz, 40-N sinusoidal vertical load was imposed on the superior surface of L1 of each model to simulate WBV, and the dynamic responses and maximal values of intradiscal pressure, shear stress on annulus fibrosus, total deformation, and disc bulge were evaluated in the L1-L2, L2-L3, L3-L4, and L5-S1 segments. Results At the L1-L2, L2-L3, and L3-L4 levels, the differences in the dynamic responses and maximal values in intradiscal pressure, shear stress, total deformation, and disc bulge between the PLIF and PLIF with osteoporosis models were slight. However, at the L5-S1 level, the dynamic response curves and maximal intradiscal pressure, shear stress, and disc bulge values in the PLIF with osteoporosis model were significantly lower than those in the PLIF model. Conclusions Osteoporosis can mitigate the development of ASD in the lower adjacent segment but has no obvious influence on the upper adjacent segments during WBV.

Hydrogels with fascinating adhesion have been demonstrated great potential in various applications. However, most hydrogels lose their adhesion in wet or underwater environments due to the influence of interfacial water. Inspired by mussel, an underwater adhesive hydrogel was facilely fabricated by introducing electrostatic interactions, which consisted of poly (acrylic acid) (PAA), quaternized xylan (QAX) and tannic acid (TA). In this hydrogel, -COO

Inspired by mussel chemistry, adhesive hydrogels represented by polydopamine (PDA) have been widely studied in many fields such as biomedical applications and bioelectronics. However, the process of producing PDA from dopamine often requires specific conditions, which oxidize some of the effective groups and reduce the adhesion effect. So it is important to develop a simple and effective method for fabrication and application of adhesive hydrogels. In this work, an adhesive hydrogel composed of xylan, polyacrylic acid (PAA) and tannic acid (TA) was developed using a facile approach, which exhibited excellent mechanical and adhesion properties. The xylan and TA both from plants could endow the hydrogels with unique properties such as biocompatibility and biodegradability. Surprisingly, the resultant hydrogels exhibited excellent stretchability (extension ratio up to 4600%) and adhesive strength (up to 25 kPa). Besides, the synthesized hydrogels displayed excellent antioxidant and antibacterial properties, while the scavenging rate of 2, 2-Diphenyl-1-picrylhydrazyl (DPPH) radical reached to 94.12%. This study provides a new insight for the design of hydrogels with stretchable, adhesive, antioxidant and antibacterial abilities.

A xylan-based antimicrobial additive agent was prepared and studied for use in paper products against Escherichia coli bacteria. The derived cationic-xylan-grafted-guanidine polymer (CX-g-PHGH) was successfully synthesized by graft copolymerization of cationic-xylan with polyhexa-methylene guanidine hydrochloride (PHGH) using ceric ammonium nitrate as an initiator. The obtained CX-g-PHGH had a maximum PHGH grafting ratio of 18.4% and efficiency of 58.4% and showed good viscosity and thermal stability. Furthermore, the paper samples prepared in this work were reinforced noticeably with the addition of CX-g-PHGH, after which exhibited improved mechanical properties. Compared to the reference paper without any of the xylan derivatives, the index of tensile, tear, burst, and folding endurance of the paper were increased by up to 20.1%, 25.3%, 30.2%, and 77.8%, respectively. Moreover, the prepared CX-g-PHGH paper exhibited efficient antimicrobial barrier properties against E. coli bacteria, by which many applications based on the new xylan derived additive agent obtained in this work could be found, especially in field of antimicrobial paper products against E. coli bacteria from contaminated food.

Objective: To compare the effectiveness of fire needle versus Western medicine in the treatment of herpes zoster. Methods: Randomized controlled trials comparing fire needle with Western medicine in the treatment of herpes zoster were identified using 8 databases. A meta-analysis was performed using RevMan 5.3 software. Results: Eight trials involving 569 patients were included in this meta-analysis, and the results showed that fire needle was superior to Western medicine comparing the effective rate [risk ratio (RR)=1.13, 95% confidence interval (CI): 1.06 to 1.20; P=0.0002], the visual analog scale (VAS) score [mean difference (MD)=−7.95, 95% CI: −10.71 to −5.20; P

Human umbilical cord mesenchymal stem cell (hucMSC) derived exosomes (EXOs) have been investigated as a new treatment for spinal cord injury (SCI) because of their anti-inflammatory, anti-apoptotic, angiogenesis-promoting, and axonal regeneration properties. The CAQK peptide found in the brains of mice and humans after trauma has recently been found to specifically bind to the injured site after SCI. Thus, we developed a nanocarrier system called EXO-C@P based on hucMSC exosomes remodelled by the CRISPR/Cas9 plasmid to control inflammation and modified by the CAQK peptide. EXO-C@P was shown to effectively accumulate at the injury site and saturate the macrophages to significantly reduce the expression of inflammatory cytokines in a mouse model of SCI. Moreover, EXO-C@P treatment improved the performance of mice in behavioural assessments and upregulated soluble tumour necrosis factor receptor-1 (sTNFR1) in serum and at the trauma site after SCI surgery, but lowered the proportion of iNOS

The effects of nano-ZnO and nano-SiO2 on the properties of PVA/xylan composite films were investigated in this work. Results showed that nano-ZnO and nano-SiO2 could effectively improve the mechanical strength, moisture and oxygen barrier properties and surface hydrophobic property of the composite films. The results of FTIR and XRD indicated the interaction of hydrogen bonds between nanoparticles and PVA and xylan. When the contents of nano-ZnO and nano-SiO2 in the composite films were 3%, the tensile strength was increased to 20.4 MPa and 22.5 MPa, respectively, while water vapor permeability (3.14 and 3.03 × 10−11 g·m−1·s−1·Pa−1) and oxygen permeability (5.28 and 5.003 cm3·m−2·24 h−1·0.1 MPa−1) reached the minima. With the increase of nano-ZnO and nano-SiO2 dosage, the solubility of composite films was increased. When the contents of nano-ZnO and nano-SiO2 were 3% and 4%, respectively, the contact angles of the films was increased up to 101° and 78°. Besides, the composite films with nano-ZnO exhibited UV shielding performance, whereas the ones with nano-SiO2 had similar UV light-transparency to the pure PVA/xylan composite films.

Ancient papers, facing the threat of acidification, aging and microbial corrosion, need to be repaired due to their significance of history, art and culture research. In this work, a new and highly efficient approach was proposed to deacidify and strengthen aging paper by in-situ quaternization for the conservation, in which MgO nanoparticles dispersed in hexamethyldisiloxane was coated on the paper surface and the aqueous alkaline solution and the 2, 3-epoxypropyl trimethyl ammonium chloride/isopropyl alcohol/water mixture were sprayed in a closed reactor. Results showed that properties of ageing papers were improved after MSCE-8/2 treatment. The pH value was in the range of 7.5–9.0 and the maximum amount of alkali storage was 220 mmol/Kg. The tensile strength and folding endurance were increased by 28.05% and 80%, respectively. The fluctuation range of brightness and chromatic aberration was 0.14 and 1.27. Moreover, treated paper also had the great anti-bacteria and anti-aging effects.

Background. Tuina, acupuncture, traction, and Chinese herbs play an important role in the treatment of lumbar disc herniation. However, the comparative effectiveness and safety of the four commonly utilized treatment modalities are still unclear. Objective. To compare the effectiveness and safety of the four interventions for lumbar disc herniation. Methods. Randomized controlled trials comparing any two of the four interventions in the treatment of lumbar disc herniation were identified using the following databases: PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang data, and network meta-analysis was performed using STATA 14.0. Results. One hundred and twenty-one studies involving a total of 13075 patients were included. In all the outcome measurements, traction demonstrated a worst effectiveness, and Tuina and acupuncture demonstrated a best effectiveness, but no significant differences were found between Tuina and acupuncture. Compared with Tuina or acupuncture, Chinese herbs showed a similar effectiveness in Visual Analogue Score and Japanese Orthopedic Association Scores, but an inferior effectiveness in invalid rate and cure rate. Conclusions. In the treatment of lumbar disc herniation, Tuina and acupuncture were superior to traction or Chinese herbs, and the effectiveness of traction was the worst. However, considering the limitations of this review, more high-quality trials, especially those comparing Chinese herbs with the other three interventions, should be carried out in the future to further confirm the current findings.

Although aluminum (Al) exclusion via root exudation of organic matters is a common resistance mechanism adopted by many plant species, whether root exudation of benzoxazinoids, such as hydroxamic acids (HAs), confers Al resistance remains unclear. We performed physiological characterization for an Al-resistant maize cultivar TY and a sensitive maize cultivar ZD. First, Al exposure induced HA exudation from the root tip of TY, but not from ZD. Second, HAs formed non-toxic Al chelation complexes in vitro and exogenous HAs alleviated root damage and improved root growth under Al stresses. Third, both Al and exogenous salicylic acid (SA) treatments induced accumulation of endogenous SAs in the root apices of TY, which in turn enhanced root HA exudation and Al resistance in TY. Furthermore, an SA biosynthesis inhibitor significantly decreased Al resistance in TY and abolished the beneficial effects of exogenous SA on Al resistance, suggesting a key role of the endogenous SAs in induction of Al resistance. Finally, it was the root-tip HA exudation but not the root-tip HA contents that determined Al resistance in maize. We have revealed a unique Al exclusion mechanism underlying Al resistance via Al and SA-mediated root HA efflux in maize.

Objective: To investigate the biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion (PLIF). Methods: This study was designed and conducted in the Traumatology and Orthopedics Laboratory, School of Chinese Medicine, Jinan University, Guangzhou, China, between December 2019 and February 2020. A healthy finite element model of L3-S1 was developed along with one PLIF model and one PLIF with osteoporosis model. Based on a hybrid test method, the inferior surface of S1 was entirely fixed, and a preload of 400N combined with an adjusted moment was imposed on the superior surface of L3 in each model to simulate flexion, extension, lateral bending and axial rotation. The intradiscal pressure (IDP), shear stress on annulus fibrosus, and the range of motion (ROM) of L3-L4 and L5-S1 were calculated and compared. Results: In each direction, the highest value of IDP and shear stress on annulus fibrosus at L3-L4 and L5-S1 was found in the PLIF model, and the lowest value in the healthy model. The largest ROM at L4-L5 appeared in the healthy model, and the smallest value in the PLIF model in each direction. At L3-L4 and L5-S1, the highest ROM in most directions was found in the PLIF model, followed by the PLIF with osteoporosis model, and the lowest value in the healthy model. Conclusions: Osteoporosis can decrease IDP, shear stress on annulus fibrosus, and ROM at adjacent levels, and slow down the development of ASD after PLIF. doi: https://doi.org/10.12669/pjms.37.2.3223 How to cite this:Zhang C, Chang M, Zhang R, Tang S. Biomechanical effects of osteoporosis on adjacent segments after posterior lumbar interbody fusion: A finite element study. Pak J Med Sci. 2021;37(2):403-408. doi: https://doi.org/10.12669/pjms.37.2.3223 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background Immune cell infiltration and neuroinflammation are heavily associated with spinal cord injury (SCI). C-C motif chemokine ligand 2/C-C chemokine receptor type 2 (CCL2/CCR2) axis has been identified as a critical role player during the invasion of immune cells to lesions in many diseases. γδ T cells, a subgroup of T cells, manage the course of inflammation response in various diseases; however, it remains unknown whether γδ T cells are recruited to injury site through CCL2/CCR2 signaling and exert the regulation effect on neuroinflammation after SCI. Methods Basso Mouse Scale (BMS), regularity index, cadence, max contact area, and motor-evoked potential testing (MEP) were measured to determine the neurological function recovery after spinal cord injury. Nissl staining was performed to identify the number of surviving motor neurons at lesion epicenter. Immunofluorescence, Western blot, enzyme-linked immunosorbent assays (ELISA), and quantitative real-time polymerase chain reaction (QRT-PCR) also were employed to evaluate the expression of associated proteins and genes. Results In this study, we demonstrated that TCRδ−/− mice present improved neurological recovery after SCI. γδ T cell recruitment to the SCI site was significantly reduced and motor functional improvement enhanced in CCL2−/− and CCR2−/− mouse strains. Furthermore, reconstitution of TCRδ−/− mice with γδ T cells extracted from CCR2−/− mice also showed similar results to CCL2 and CCR2 deficient mice. Conclusions In conclusion, γδ T cell recruitment to SCI site promotes inflammatory response and exacerbates neurological impairment. CCL2/CCR2 signaling is a vital recruitment mechanism of γδ T cells to the SCI site, and it may be taken as a novel therapeutic target for future SCI.

BACKGROUND Adjacent segment degeneration is a common complication following anterior lumbar interbody fusion (ALIF). Osteoporosis is becoming increasingly prevalent in the elderly population and thus patients undergoing ALIF may experience osteoporosis with age. However, the influence of osteoporosis on adjacent segment degeneration after ALIF remains unclear. METHODS Three finite element models of the L3-S1 segment, including a healthy model, an ALIF model, and an ALIF with osteoporosis model, were used for analysis. ALIF was simulated at the L4-L5 segment. Based on a hybrid test method, the models were imposed with a preload of 400 N and an adjusted moment in flexion, extension, lateral bending, and axial torsion. Intradiscal pressure, shear stress on anulus fibrosus, and range of motion at L3-L4 and L5-S1 were calculated and compared. RESULTS In each direction, the maximal values of intradiscal pressure and shear stress on anulus fibrosus at L3-L4 and L5-S1 were found in the ALIF model, and the minimal values were found in the healthy model. At L3-L4 and L5-S1, the maximal values of range of motion in most directions were found in the ALIF model followed by the ALIF with osteoporosis model, and the minimal values were found in the healthy model. However, the maximal value of range of motion at L5-S1 in axial torsion was found in the ALIF with osteoporosis model. CONCLUSIONS Osteoporosis may mitigate the adverse influence of ALIF on adjacent segments.

Objective To compare the effectiveness of exercise therapy with surgery for lumbar spinal stenosis. Methods Five English databases PubMed, the Cochrane Library, Web of science, OVID and PEDro database were searched for randomized controlled trials comparing surgical procedures with exercise therapy for lumbar spinal stenosis. Information on patients, study design, inclusion criteria, intervention and follow-up, outcomes, treatment details and adverse events were extracted. Meta-analysis was performed using Review Manager Version 5.3. Results Two randomized controlled trials and one mixed design trial with a total of 897 patients were included. The pooled results showed a significant difference between exercise and surgery in Oswestry Disability Index at two years (MD= 3.85, 95%CI: 0.48 to 7.22; P=0.03), but no significant difference at six months (MD= 2.18, 95%CI: -2.80 to 7.17; P=0.39) and one year (MD= 4.26, 95%CI: -1.79 to 10.32; P=0.17). In terms of physical function of 36 Items Short Form Health Survey, there were no significant differences between exercise and surgery at six months (MD= -2.23, 95% CI: -7.46 to 2.99; P=0.40), one year (MD= -2.17, 95% CI: -7.44 to 3.10; P=0.42) and two years (MD= -0.67, 95% CI: -6.16 to 4.82; P=0.81). Conclusion In brief, the current evidence demonstrated a trend that exercise therapy had a similar effect for lumbar spinal stenosis compared with decompressive laminectomies. However, for the small sample size and low methodology quality of the included trials, some rigorously designed and large-scaled RCTs need to be performed to confirm the conclusion.

Neuroinflammation is critically involved in the repair of spinal cord injury (SCI), and macrophages associated with inflammation propel the degeneration or recovery in the pathological process. Currently, efforts have been focused on obtaining efficient therapeutic anti-inflammatory drugs to treat SCI. However, these drugs are still unable to penetrate the blood spinal cord barrier and lack the ability to target lesion areas, resulting in unsatisfactory clinical efficacy. Herein, a polymer-based nanodrug delivery system is constructed to enhance the targeting ability. Because of increased expression of matrix metalloproteinases (MMPs) in injured site after SCI, MMP-responsive molecule, activated cell-penetrating peptides (ACPP), is introduced into the biocompatible polymer PLGA-PEI-mPEG (PPP) to endow the nanoparticles with the ability for diseased tissue-targeting. Meanwhile, etanercept (ET), a clinical anti-inflammation treatment medicine, is loaded on the polymer to regulate the polarization of macrophages, and promote locomotor recovery. The results show that PPP-ACPP nanoparticles possess satisfactory lesion targeting effects. Through inhibited consequential production of proinflammation cytokines and promoted anti-inflammation cytokines, ET@PPP-ACPP could decrease the percentage of M1 macrophages and increase M2 macrophages. As expected, ET@PPP-ACPP accumulates in lesion area and achieves effective treatment of SCI; this confirmed the potential of nano-drug loading systems in SCI immunotherapy.

Xylan-g-/P(AA-co-AM)/Graphene oxide (GO) hydrogels were prepared and used in the removal of heavy mental ions. Acrylamide (AM), acrylic acid (AA), and xylan were used as the raw materials to prepare the hydrogels with ammonium persulfate (APS) as the initiator. The prepared hydrogels were characterized by Fourier transform infrared (FTIR), thermogravimetric analysis (TGA), and energy dispersive X-ray (EDX). Some important properties of nanocomposite hydrogels such as swelling behavior, mechanical property, and adsorption capacity were also examined as well as the regeneration of the hydrogels. The results showed that the prepared hydrogels reached the equilibrium state of swelling after 12 h, and the compressive strength of the hydrogel with 30 mg of GO could reach up to 203 kPa. Compared with traditional hydrogel, the mechanical properties of the hydrogels with GO were obviously improved. The maximum adsorption capacity of hydrogels for Pb2+, Cd2+, and Zn2+ could reach up to 683 mg/g, 281 mg/g, and 135 mg/g, respectively. After five cycles of adsorption and desorption, the recovery rate of the hydrogels on Pb2+, Cd2+, and Zn2+ was still up to 87%, 80%, and 80%, respectively&mdash, all above 80%.

Xylan-g-/P(AA-co-AM)/Graphene oxide (GO) hydrogels were prepared and used in the removal of heavy mental ions. Acrylamide (AM), acrylic acid (AA), and xylan were used as the raw materials to prepare the hydrogels with ammonium persulfate (APS) as the initiator. The prepared hydrogels were characterized by Fourier transform infrared (FTIR), thermogravimetric analysis (TGA), and energy dispersive X-ray (EDX). Some important properties of nanocomposite hydrogels such as swelling behavior, mechanical property, and adsorption capacity were also examined as well as the regeneration of the hydrogels. The results showed that the prepared hydrogels reached the equilibrium state of swelling after 12 h, and the compressive strength of the hydrogel with 30 mg of GO could reach up to 203 kPa. Compared with traditional hydrogel, the mechanical properties of the hydrogels with GO were obviously improved. The maximum adsorption capacity of hydrogels for Pb2+, Cd2+, and Zn2+ could reach up to 683 mg/g, 281 mg/g, and 135 mg/g, respectively. After five cycles of adsorption and desorption, the recovery rate of the hydrogels on Pb2+, Cd2+, and Zn2+ was still up to 87%, 80%, and 80%, respectively—all above 80%.

Pore-forming agents have a significant influence on the pore structure of hydrogels. In this study, a porogenic technique was employed to investigate the preparation of macroporous hydrogels which were synthesized by radical copolymerization of carboxymethyl xylan with acrylamide and N-isopropylacrylamide under the function of a cross-linking agent. Six kinds of pore-forming agents were used: polyvinylpyrrolidone K30, polyethylene glycol 2000, carbamide, NaCl, CaCO3, and NaHCO3. The application of these hydrogels is also discussed. The results show that pore-forming agents had an important impact on the pore structure of the hydrogels and consequently affected properties of the hydrogels such as swelling ratio and mechanical strength, while little effect was noted on the thermal property of the hydrogels. 5-Fluorouracil was used as a model drug to study the drug release of the as-prepared hydrogels, and it was found that the drug release was substantially improved after using the NaHCO3 pore-forming agent: a cumulative release rate of up to 71.05% was achieved.

High strength hydrogels open new possibilities in the fields of bioengineering and biomedical. In this paper, a highly efficient one-pot strategy was developed to prepare carboxymethyl xylan-g-poly (acrylic acid) (CMX-g-PAA) hydrogels with high compression strength, high elongation and high elasticity by using the metal coordination and the reinforcement of hydroxylate multi-walled carbon nanotubes (HCNTs). Prepared hydrogels were characterized by means of FTIR, XRD, SEM, rheological measurements as well as their swelling and mechanical properties. Results showed that the Fe3+-carboxyl coordination and HCNTs imparted hydrogels with high strength and good rapid recovery properties, in which the maximum high compressive strength and elongation at break were achieved to 10.4 MPa and 1032%, and the shape of hydrogels almost returned to the original shape after the external force was removed after 30 cycles of compression. These hydrogels also exhibited Fe3+-triggered shape memory properties. Therefore, as-prepared hydrogels possessing high strength, rapid recovery and shape memory properties, could broaden access for application in intelligent toys, electronic skin, biosensing, and tissue engineering.

Background Vertebroplasty (VP), kyphoplasty (KP), SpineJack system (SJ), radiofrequency kyphoplasty (RFK), Kiva system (Kiva), Sky kyphoplasty system (SK), and conservative treatment are widely used in the treatment of osteoporotic vertebral compression fractures (OVCFs). However, it is still unknown which is the best intervention. The aim of the current study was to evaluate the effectiveness and safety of VP, KP, SJ, RFK, Kiva, SK, and CT in the treatment of OVCFs. Methods Randomized controlled trials and cohort studies comparing VP, KP, SJ, RFK, Kiva, SK, or CT for the treatment of OVCFs were identified on the basis of databases including PubMed, the Cochrane Library, Web of Science, and Springer Link. A network meta-analysis was performed using STATA 15.1. Results A total of 56 studies with 6974 patients and 7 interventions were included in this study. The results of the surface under the cumulative probability demonstrated that SK was the best intervention in decreasing VAS scores and recovering middle vertebral height, RFK was the best intervention in improving ODI scores and decreasing incidence of new fractures, SJ was the best intervention to restore kyphosis angle, and Kiva was the best intervention to reduce incidence of bone cement leakage. Cluster analysis showed that SK was the preferable intervention on the basis of the outcomes of VAS, ODI, middle vertebral height, and kyphotic angle, and RFK was the preferable treatment in decreasing the incidence of adverse events. In our network meta-analysis, node-splitting analysis and loop inconsistency analysis showed no significant inconsistencies. Conclusions SK may be the most effective treatment in relieving pain, improving the quality of life, and recovering vertebral body height and kyphotic angle, while RFK may be the safest intervention for OVCFs. However, considering the limitations of this study, more high-quality trials are needed in the future to confirm the current conclusion.

High strength and self-healing properties of hydrogels are of great interest in tissue engineering and biomedical fields. In this paper, nanocomposite hydrogels were prepared by freeze-thaw cycle method via fabricating physical cross-links into chemical-crosslinked formed polymer network. The properties of nanocomposite hydrogels were characterized by FTIR, XRD, SEM, rheological analysis, swelling analysis and mechanical test. The results showed that the electrostatic interaction between CNC and QAX and the high amount of PVA (20 wt%) were favorable to improve the mechanical properties of nanocomposite hydrogels, in which the maximum compressive strength and elongation at break of nanocomposite hydrogels were 1.56 MPa and 771 %, respectively. Prepared hydrogels achieved self-healing without any external stimuli at room temperature with the help of hydrogen bonds and the entanglement of long polymer chains, the healing efficiency was 37.03 % within 48 h. These hydrogels with high strength and self-healing properties will offer new insights for xylan application.

Introduction Both moxibustion and western medicine are widely used in the treatment of Ankylosing Spondylitis in China. However, which is better for the disease? Up to now, no review and meta-analyses have been published and the answer is still unclear. The aim of this research was to compare the effectiveness of moxibustion versus western medicine in the treatment of ankylosing spondylitis. Methods The PubMed, Cochrane Library, EMBASE, China Biology Medicine Data, Web of Science, CNKI, VIP, and Wanfang database were searched from their inception through November 1st, 2019. A meta-analysis was performed using the RevMan 5.3 software and the evidence level was assessed using the GRADE system. Results Seventeen studies with 1235 patients were included. Pooled analysis showed a favorable effect of moxibustion in total effective rate (RR = 1.14, 95 % CI: 1.07–1.21; P Conclusion Compared with western medicine, moxibustion had a favorable effect in alleviating pain, improving lumbar activity and reducing inflammatory reaction in people with ankylosing spondylitis. However, considering the limitations of this study, the evidence is not conclusive and high quality trials are needed in the future to further confirm this conclusion.

Background:: Biosensors are widely applied for the detection of bio-molecules in blood glucose , cholesterol, and gene. Cellulose as the most dominating natural polymer has attracted more and more interest, especially in the field of medicine such as advanced medical diagnosis. Cellulose could endow biosensors with improved biocompatibility, biodegradability and nontoxicity, which could help in medical diagnosis. This mini-review summarizes the current development of cellulose-based biosensors as well as their applications in medical diagnosis in recent years. Methods: After reviewing recent years’ publications we can say that, there are several kinds of cellulose used in biosensors including different cellulose derivatives, bacterial cellulose and nanocellulose. Different types of cellulose-based biosensors, such as membrane, nano-cellulose and others were briefly described in addition to the detection principle. Cellulose-based biosensors were summarized as in the previous papers. The description of various methods used for preparing cellulose-based biosensors was also provided. Results: Cellulose and its derivatives with their unique chemical structure proved to be versatile materials providing a good platform for achieving immobilizing bioactive molecules in biosensors. These cellulose-based biosensors possess various desirable properties such as accuracy, sensitivity, convenience, low cost and fast response. Among them, cellulose paper-based biosensors have the advantages of low cost and easy operation. Nano-cellulose has unique properties such as a large aspect ratio, good dispersing ability and high absorption capacity. Conclusion: Cellulose displays a promising application in biosensors which could be used to detect different bio-molecules such as glucose, lactate, urea, gene, cell, amino acid, cholesterol, protein and hydroquinone. In future, the attention will be focused on designing miniaturized, multifunctional, intelligent and integrated biosensors. Creation of low cost and environmentally friendly biosensors is also very important.

Three fixation modalities including suture suspensory, anchor, and titanium plate are used extensively in unilateral open-door cervical laminoplasty. Nevertheless, up to now no systematic review and network meta-analysis have been published, and the differences in efficacy and safety of the three fixation modalities are still unclear. The purpose of this study is to compare the effectiveness and safety of the three fixation modalities including suture suspensory, anchor, and titanium plate in unilateral open-door cervical laminoplasty. Randomized controlled trials and cohort studies which compared the three interventions in unilateral open-door cervical laminoplasty were identified using the following databases: PubMed, Cochrane Library, Embase, Web of science, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang data. Network meta-analysis was performed using R 3.4.3 software and STATA version 14.0. The results revealed that compared with suture suspensory, titanium plate and anchor showed the same effects in Japanese Orthopedic Association Scores, operative time, and blood loss. However, titanium plate showed superiority in postoperative range of motion of cervical spine, incidence of axial symptoms, and C5 paralysis; in terms of cervical curvature, titanium plate also showed better effectiveness than suture suspensory, but similar as anchor. Our network meta-analysis suggests that titanium plate is preferable to suture suspensory or anchor with more range of motion and lower incidence of axial symptoms and C5 paralysis. However, considering the limitations of this research, high-quality trials are needed in the future to evaluate the outcomes.

Posterior lumbar interbody fusion and lumbar interspinous non-fusion technique are common surgical procedures for lumbar degenerative diseases, but the effectiveness and safety of these two techniques are still unclear. We performed this network meta-analysis to evaluate the comparative effectiveness and safety of posterior lumbar interbody fusion and the three commonly used interspinous devices including Coflex, Wallis, and X-stop for lumbar degenerative diseases. Randomized controlled trials and cohort studies comparing among posterior lumbar interbody fusion, Coflex, Wallis, and X-stop for lumbar degenerative diseases were identified using the databases including PubMed, the Cochrane Library, Web of Science, the China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang data. A network meta-analysis was performed using R 3.4.3 software. 27 studies with 2241 patients were included. The results of network meta-analysis revealed that no significant differences in Oswestry Disability Index, Visual Analogue Scale, Japanese Orthopedic Association Scores, and posterior disc height were found among posterior lumbar interbody fusion group, Coflex, Wallis, or X-stop. However, compared with posterior lumbar interbody fusion, the three interspinous process devices presented with significantly more range of motion in surgical segment, but no significant difference was found among these three interspinous process devices. Node-splitting analysis showed no significant inconsistency in our network meta-analysis. We concluded that compared with posterior lumbar interbody fusion, Coflex, Wallis and X-stop had the same effectiveness in relieving pain, improving quality of life, recovering disc space height and lumbar function, but may lower incidence of adjacent segment degeneration.

Introducing multifunctional groups and inorganic material imparts xylan-based hydrogels with excellent properties, such as responsiveness to pH, temperature, light, and external magnetic field. In this work, a composite hydrogel was synthesized by introducing acid treated carbon nanotubes (AT-CNTs) into the maleic anhydride modified xylan grafted with poly(N-isopropylacrylamide) (MAX-g-PNIPAM) hydrogels network. It was found that the addition of AT-CNTs affected the MAX-g-PNIPAM hydrogel structure, the swelling ratio and mechanical properties, and imparted the hydrogel with new properties of electrical conductivity and near infrared region (NIR) photothermal conversion. AT-CNTs could reinforce the mechanical properties of MAX-g-PNIPAM hydrogels, being up to 83 kPa for the compressive strength when the amount was 11 wt %, which was eight times than that of PNIPAM hydrogel and four times than that of MAX-g-PNIPAM hydrogel. The electroconductibility was enhanced by the increase of AT-CNTs amounts. Meanwhile, the composite hydrogel also exhibited multiple shape memory and NIR photothermal conversion properties, and water temperature was increased from 26 °C to 56 °C within 8 min under the NIR irradiation. Thus, the AT-CNTs reinforced MAX-g-PNIPAM hydrogel possessed promising multifunctional properties, which offered many potential applications in the fields of biosensors, thermal-arrest technology, and drug-controlled release.