This study was to develop a feasible and safe animal model for minimally invasive injectable lumbar interbody fusion using a novel biomaterial, mineralized collagen-polymethylmethacrylate bone cement (MC-PMMA), with unilateral pedicle screw fixation in an in vivo goat model. Eight goats ( Capra aegagrus hircus) were divided into three groups: MC-PMMA, unmodified commercial-polymethylmethacrylate bone cement (UC-PMMA), and a control group (titanium cage filled with autogenous bone, TC-AB). Each group of goats was treated with minimally invasive lumbar interbody fusion at the L3/L4 and L5/L6 disc spaces (injected for MC-PMMA and UC-PMMA, implanted for TC-AB). The pedicle screws were inserted at the L3, L4, L5, and L6 vertebrae, respectively, and fixed on the left side. The characteristics of osteogenesis and bone growth were assessed at the third and the sixth month, respectively. The methods of evaluation included the survival of each animal, X-ray imaging, and 256-layer spiral computed tomography (256-CT) scanning, imaged with three-dimensional microfocus computed tomography (micro-CT), and histological analysis. The results showed that PMMA bone cement can be extruded smoothly after doping MC, the MC-PMMA integrates better with bone than the UC-PMMA, and all goats recovered after surgery without nerve damage. After 3 and 6 months, the implants were stable. New trabecular bone was observed in the TC-AB group. In the UC-PMMA group a thick fibrous capsule had formed around the implants. The MC-PMMA was observed to have perfect osteogenesis and bone ingrowth to adjacent bone surface. Minimally invasive injectable lumbar interbody fusion using MC-PMMA bone cement was shown to have profound clinical value, and the MC-PMMA showed potential application prospects.

The aim of this study was to forecast the risk factors of poor outcomes and postoperative loss of lordosis or recurrence of kyphosis. In this retrospective study, 101 patients with cervical spondylosis and preoperative kyphosis who underwent anterior cervical discectomy and fusion (ACDF) were enrolled, between June 2015 and June 2019. Patients were grouped according to the recovery rate of Japanese Orthopaedic Association (JOA) score whether more than 50%, and the change of postoperative cervical Cobb angle. There were 22 cases with less than 50% of recovery rate and 35 cases with the worsening of postoperative sagittal alignment (WPSA). Multivariate linear-regression analysis was conducted with the data. Advanced age (p = 0.019), longer duration of symptoms (p = 0.003) and loss of local Cobb angle (LCA) after surgery (p = 0.031) was significantly associated with a poor clinical outcome. A whole kyphosis (p = 0.009), aggravated neck pain after surgery (p = 0.012), preoperative lower thoracic 1 (T1) (p < 0.001), bigger change of C2-7 sagittal vertical axis (SVA) (p = 0.008) and adjacent segment degeneration (ASD) (p = 0.024) was significantly associated with the WPSA. Preoperative health education, nutritional support and early postoperative rehabilitation intervention, in perioperative period, were recommended for patients with advance age, longer duration of symptoms, whole cervical kyphosis and lower T1. Postoperative sagittal malalignment was related to neck pain and ASD after surgery.

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Anti-Müllerian Hormone (AMH) is a hormone produced by the granulosa cells in ovarian follicles. It indicates the presence of a woman's eggs. The more eggs a woman has the more granulosa cells she has and the higher her AMH. Lower AMH shows low egg supplying which is associated with infertility. According to the American College of Obstetricians and Gynecologists (ACOG) [3], the production of AMH is reflective of the ovarian reserve. A low AMH level (< 0.5-1.1 ng/ml, Bologna criteria) points to a diminished ovarian reserve (DOR) or low egg count, which is linked to fertility. Consequently, low AMH can predict poor response in controlled ovarian stimulation [4]. According to traditional Chinese medicine (TCM), DOR is caused by four factors: the imbalance of qi, blood and body fluid; the dysfunction of the channels Chong and Ren; and the dysfunction of Zangfu/viscera such as kidney, spleen and stomach qi deficiency; and liver qi stagnation. TCM Etiology and PathogenesisIn traditional Chinese medicine, the book "The Inner Classic of the Yellow Emperor: Simple Question; The Universal Truth" mentioned a physiological law called "Seven Women and Eight Men". It means that the rhythm of life of women is related to seven, while the rhythm of life of men is related to eight. "In general, the reproductive physiology of woman is such that at seven years of age, her kidneys' energy is strong. At fourteen years, Tian Gui, or fertility essence is mature, the Ren/conception and Chong/vital channels are flourishing, menstruation begins, and conception is possible.At twenty-one years, the kidney energy is strong and healthy, the wisdom teeth appear, and the body is vital and flourishing. At twenty-eight years, the bones and tendons are well-developed and the hair and secondary sex characteristics are complete. This is the height of female development. At thirty-five years the Yangming/ stomach and large intestine channels that govern the major facial muscles begin to deplete, the muscles begin to atrophy, facial wrinkles appear, and the hair begins to thin. At forty-two all three yang channels-Taiyang, Shaoyang and Yangming are exhausted, the face is wrinkled, and the hair begins to turn gray. At forty-nine years the Ren and Chong channel are completely empty, and the Tian Gui has dried up. Hence, the flow of the menses ceases and the woman is no longer able to conceive."