In Situ PL Probes the Effect of 2D SnSe Nanosheets on the Crystallization Process of CsPbI2Br Perovskite Solar Cells.

Reducing defects in the active layer is important for improving the crystalline quality of all-inorganic perovskite solar cells (PSCs). Exploring novel additives is one of the most promising approaches to minimize active layer defects. In this work, two-dimensional (2D) SnSe nanosheets with excellent optoelectronic properties are prepared using an ultrasonic exfoliation method. The prepared 2D SnSe nanosheets are introduced into a CsPbI2Br precursor, which reduces the defect formation at grain boundaries and enhances the crystallinity of CsPbI2Br perovskites. We use the in situ photoluminescence (PL) technique to investigate the role of 2D materials in the crystallization process. The results show that SnSe nanosheets primarily shorten the grain boundary merging time and reduce the defect generation during the grain boundary merging stage, thereby regulating the crystallization of perovskite. In addition, SnSe nanosheets passivate uncoordinated Pb atoms at grain boundaries by Se atoms, further reducing the defect density in perovskite. As a result, PSCs exhibit a higher power conversion efficiency (PCE) of 14.24% and a Voc of 1.22 V. This study highlights the role of 2D materials in enhancing the crystalline quality and PCE of PSCs.

Probe into a novel surfactant-free microemulsion system of ethylene glycol monobutyl ether + water + diesel for crude oil removal and recovery from oily sludge.

A novel surfactant-free microemulsion (SFME) system was proposed in this study, and applied in the crude oil removal and recovery from oily sludge (OS). Based on an investigation of the SFME phase behavior and solution properties, a complete ternary phase diagram was constructed. The SFME with three-liquid phase equilibrium (Winsor III type) was selected for the treatment of OS to achieve simultaneous efficient removal (up to 95.1 %) and recovery (up to 83.2 %) of crude oil. The SFME could be reused continuously for OS treatment without purification. The removal efficiency could still keep >75.9 % after 5 times of reuse, showing high reusability. The detached crude oil could be automatically recovered based on the phase equilibrium principle without additional separation. In the washing experiments, single-factor and multi-factor orthogonal tests were applied to investigate the effects of different experimental conditions on oil removal efficiency and determine the optimal experimental scheme. The treated OS was sufficiently decontaminated according to the morphology, composition, and properties analysis by scanning electron microscopy, Fourier transform infrared spectroscopy, thermogravimetric analysis and contact angle. The composition of the recovered crude oil was identical to that of commercial crude oil according to gas chromatography-mass spectrometry analysis, showing a high recovery value. The kinetic analysis revealed that crude oil desorption experienced three main stages: membrane diffusion, intra-particle diffusion and surface desorption, and identified the chemisorption was the main interaction between the oil-soil. Finally, the mechanism of SFME action was assessed for dissolution and activation based on ultra-low IFT.

Biomaterial Improves the Stability of Perovskite Solar Cells by Passivating Defects and Inhibiting Ion Migration.

With the rapid improvement of power conversion efficiency (PCE), perovskite solar cells (PSCs) have broad application prospects and their industrialization will be the next step. Nevertheless, the performance and long-term stability of the devices are limited by the defect-induced nonradiative recombination centers and ions' migration inside the perovskite films. Here, usnic acid (UA), an easy-to-obtain and efficient natural biomaterial with a hydroxyl functional group (-OH) and four carbonyl groups (-C═O) was added to MAPbI3 perovskite precursor to regulate the crystallization process by slowing the crystallization rate, thereby expanding the crystal size and preparing perovskite films with low defect density. In addition, UA anchors the uncoordinated Pb2+ and suppresses the migration of I-ions, which enhances the stability of the perovskite film. Consequently, an impressive PCE exceeding 20% was achieved for inverted structure MAPbI3-based PSCs. More impressively, the optimized PSCs maintained 78% of the initial PCE under air with high humidity (RH ≈ 65%, 25-30 °C) for 1000 h. UA can be extracted from the plant, usnea, making it inexpensive and easy to obtain. Our work demonstrates the application of the plant material in PSCs and their industrialization, which is significant nowadays.

p-Toluenesulfonic Acid Modified Two-Dimensional ZrSe2 as a Hole Transport Layer for High-Performance Organic Solar Cells.

Two-dimensional (2D) materials have attracted attention due to their excellent optoelectronic properties, but their applications are limited by their defects and vacancies. Surface modification is an effective method to restore their performance. Here, ZrSe2 is modified with conductive polymer p-toluenesulfonic acid (PTSA). It is found that PTSA can obtain electrons of ZrSe2 through the combination of -SO3H and ZrSe2, thus forming interfacial dipoles, which improve the work function of ZrSe2. In addition, -OH in PTSA can effectively fill the Se vacancy in ZrSe2 to form P-type doping, thereby improving its conductivity. ZrSe2 modified by the PTSA material is first used as a hole transport layer (HTL) in organic solar cells (OSCs). The efficiency of OSCs based on the PBDB-T:ITIC and PM6:L8-BO binary active layer with ZrSe2:PTSA as the novel HTL reaches 10.66 and 18.14%, which are obviously higher than the efficiency of OSCs with pure ZrSe2 as the HTL (8.48 and 15.64%). More interestingly, the stability of the device with ZrSe2:PTSA as HTL is significantly better than that of PEDOT:PSS. This study shows that the modification of the organic material can effectively improve the photoelectric performance of ZrSe2 and explores the physical mechanism of the interaction between the organic modifier and 2D materials.

An MBene Modulating the Buried SnO2/Perovskite Interface in Perovskite Solar Cells.

The interface of perovskite solar cells (PSCs) plays an important role in transferring and collecting charges. Interface defects are important factors affecting the efficiency and stability of PSCs. Here, the buried interface between SnO2 and the perovskite layer is bridged by two-dimensional (2D) MBene, which improves charge transfer. MBene can deposit additional electrons on the surface of SnO2, passivate its surface defects and facilitate the charge collection. Moreover, the dipole moment formed at the interface increases the electron transfer ability in the PSCs. MBene also regulates the growth of perovskite crystals, improves the quality of perovskite films, and reduces its grain boundary defects. As a result, PSCs based on FA0.2MA0.8PbI3 and (FAPbI3)0.95(MAPbBr3)0.05 get the enhanced efficiencies of 22.34 % and 24.32 % with negligible hysteresis. Furthermore, the optimized device exhibits better stability. This work opens up the application of MBene materials in PSCs, reveals a deeper understanding of the mechanism behind using 2D materials as an interface modification layer, and shows opportunities for using MBene as potential material in photoelectric devices.

Efficacy of lumbar decompression under large-channel spinal endoscope in elderly patients with segmental lumbar spinal stenosis.

OBJECTIVE: The present study was conducted with an attempt to explore the overall efficacy of large-channel spinal endoscopy technology in elderly patients with segmental lumbar spinal stenosis. METHODS: We included a total of 68 elderly patients with segmental lumbar spinal stenosis in our hospital from February 2021 to March 2023. The participants were randomly and equally distributed into the study group and the control group using a random number table method. The control group received the open lumbar decompression surgery, and the study group received the lumbar decompression under large-channel spinal endoscopy technology. We compared the surgical conditions of the two groups, including pain level, Oswestry Disability Index (ODI) score, and Japanese Orthopedic Association (JOA) score before surgery, 1 week after surgery, 3 months after surgery, and 1 year after surgery. In addition, we compared the efficacy and adverse reactions 1 year after surgery between the two groups. RESULTS: Our findings revealed that the operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were significantly lower than those in the control group (p < 0.05). There was no statistically significant difference in the degree of pain between the two groups before surgery (p > 0.05), and the pain intensity of the study group was significantly lower than that of the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). Similarly, preoperative ODI and JOA scores were not significantly different between the two groups (p > 0.05), while they were significantly lower in the study group than those in the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). Before surgery, no significant difference was seen in therapeutic efficacy between the two groups (p > 0.05), whereas the efficacy was remarkably improved in the study group comparing to the control group at 1 week, 3 months, and 1 year after surgery (p < 0.05). All patients in this study were followed up for 10 to 16 months, with an average of 13.29 ± 1.28 months. The incidence of adverse reactions in the study group was significantly lower than that in the control group (p < 0.05). CONCLUSIONS: Large-channel spinal endoscopy technology exerted promising results in elderly patients with segmental lumbar spinal stenosis, in terms of reducing the surgical time, intraoperative bleeding, postoperative drainage volume, and hospital stay. The approach also alleviated pain, reduced ODI and JOA scores, and restored lumbar function, with decreased incidence of adverse reactions, thereby promoting patient recovery. It is considered valid for wide clinical application.

Synergetic Regulation of Interface Defects and Carriers Dynamics for High-Performance Lead-Free Perovskite Solar Cells.

Severe nonradiative recombination and open-circuit voltage loss triggered by high-density interface defects greatly restrict the continuous improvement of Sn-based perovskite solar cells (Sn-PVSCs). Herein, a novel amphoteric semiconductor, O-pivaloylhydroxylammonium trifluoromethanesulfonate (PHAAT), is developed to manage interface defects and carrier dynamics of Sn-PVSCs. The amphiphilic ionic modulators containing multiple Lewis-base functional groups can synergistically passivate anionic and cationic defects while coordinating with uncoordinated Sn2+ to compensate for surface charge and alleviate the Sn2+ oxidation. Especially, the sulfonate anions raise the energy barrier of surface oxidation, relieve lattice distortion, and inhibit nonradiative recombination by passivating Sn-related and I-related deep-level defects. Furthermore, the strong coupling between PHAAT and Sn perovskite induces the transition of the surface electronic state from p-type to n-type, thus creating an extra back-surface field to accelerate electron extraction. Consequently, the PHAAT-treated device exhibits a champion efficiency of 13.94% with negligible hysteresis. The device without any encapsulation maintains 94.7% of its initial PCE after 2000 h of storage and 91.6% of its initial PCE after 1000 h of continuous illumination. This work provides a reliable strategy to passivate interface defects and construct p-n homojunction to realize efficient and stable Sn-based perovskite photovoltaic devices.

The Relationship Between Endplate Defect Scores and Lumbar Sagittal Translation Stability in Lumbar Spondylolisthesis Patients.

BACKGROUND: Lumbar instability and endplate defects are commonly seen in patients with spondylolisthesis. However, little is known about associations between segmental stability and endplate defects. The present study explored associations between stability-related radiographic parameters and endplate defect scores and assessed whether endplate defect scores can predict lumbar stability in lumbar spondylolisthesis. METHODS: Neutral, flexion, and extension radiographs of 159 patients with monosegmental lumbar spondylolisthesis were analyzed. Radiographic parameters included average intervertebral disc height (IDH), slip distance, sagittal translation (ST) and sagittal angulation (SA). Correlation analysis and linear regression analysis were used to explore associations between endplate defect scores and radiographic parameters. Logistic regression analysis was used to assess associations between endplate defect scores and ST stability. Receiver-operating characteristic curve (ROC) analysis was used to evaluate the value of the endplate defect score in predicting ST stability. RESULTS: A total of 11.9% of patients had ST ≥ 4 mm, and 30% of patients had SA ≥ 10°. Endplate defect scores were negatively correlated with ST and IDH and positively correlated with slip distance in isthmic spondylolisthesis but not in degenerative spondylolisthesis. In multiple regression analysis, endplate defect scores were significantly associated with ST, slip distance, IDH, and disc degeneration. ST instability was associated with endplate defect scores in isthmic spondylolisthesis (OR=0.460, P = 0.010). The AUCs for using the endplate defect score to evaluate ST stability in overall patients and isthmic spondylolisthesis patients were 0.672 and 0.774, respectively. The optimal threshold of the endplate defect score constructed by the Youden index was 7.5 for predicting ST stability. CONCLUSIONS: Endplate defect scores increase with a reduction in IDH, progression of slippage and a decrease in ST in isthmic spondylolisthesis but not in degenerative spondylolisthesis. ST instability was associated with endplate defect scores in isthmic spondylolisthesis, and endplate defect scores could be used to reflect lumbar stability at the slippage segment.

Novel "on-off" fluorescence sensing for rapid and accurate determination of Cr3+ based on g-CNQDs.

Cr3+ is one of the most essential trace elements in living organisms and plays a vital role in human metabolism. However, both deficiency and excess intake of Cr3+ can be harmful to the human body. Therefore, the quantitative determination of Cr3+ is of great significance in the field of life science. Based on this, in this study, a g-CNQDs@p-acetaminophenol fluorescence sensing system was developed for the quantitative detection of Cr3+ in actual complex samples. G-CNQDs were synthesized with sodium citrate and urea as precursors. The fluorescence signal was enhanced by the synergistic effect between p-acetaminophenol (APAP) and g-CNQDs. The fluorescence quenching phenomenon can be produced when Cr3+ is introduced into the fluorescence-enhanced g-CNQDs@p-acetaminophenol system. An "on-off" fluorescence sensing system was constructed based on g-CNQDs@p-acetaminophenol for the quantitative detection of Cr3+. The experimental data showed a wide linear region in the concentration range of 0.64-63.0 µM, and the detection limit was as low as 0.23 µM. The construction of the sensor system broadens the research field for the practical application of Cr3+.

A Clinical Comparative Study on Percutaneous and Open Approaches for Screw Internal Fixation in Treating Thoracolumbar Fractures.

OBJECTIVE: Conventional open internal fixation surgery for thoracolumbar fractures has many complications and long recovery time. There are few clinical studies on the minimally invasive percutaneous injured vertebrae screw internal fixation. The purpose of this paper is to evaluate the application value of minimally invasive percutaneous injured vertebrae screw internal fixation in the treatment of thoracolumbar fractures (TF). METHODS: A total of 98 patients with TF admitted to our hospital from January 2019 to December 2021 were retrospectively enrolled. According to the surgical method, the patients were divided into the study group (n = 49, treated with minimally invasive percutaneous injured vertebrae screw internal fixation) and the control group (n = 49, treated with traditional open internal fixation surgery). The two groups were compared in the perioperative period, the degree of pain at different periods, the percentage of the height of the anterior edge of the injured vertebra, the Cobb angle of the injured vertebra body and the wedge angle of the injured vertebra body at the first week and the last follow-up, and the postoperative complications and the occurrence of the cone shell after the operation were recorded. Then, statistical analysis such as Student's t test or Chi-Square test was performed. RESULTS: The operation time (p = 0.002), intraoperative blood loss (p < 0.001), postoperative drainage volume (p = 0.011), and length of hospital stay (p = 0.003) in the study group were significantly lower than that in the control group. The VAS in the study group (3.38 ± 1.02) was significantly lower than that in the control group (4.56 ± 1.04) on the 7th day after the operation, with a significant difference (p < 0.001). The correction values of the percentage of leading edge height (LEH), Cobb angle, wedge angle in the study group were significantly lower than that in the control group at 1 week after surgery (all ps < 0.001). The incidence of postoperative complications in the study group (one case, 2.04%) was significantly lower than that in the control group (seven cases, 14.29%) (p = 0.031). At 1 month, 6 months, 10 months, and the last follow-up, the incidence of "empty shell" on CT scan in the study group were lower than that in the control group with a significant difference (all ps < 0.05). CONCLUSION: Applying minimally invasive percutaneous injured vertebrae screw internal fixation is more beneficial to shorten the operation time and hospital stay, with fewer postoperative complications.

Posterior endoscopic decompression combined with anterior cervical discectomy and fusion versus posterior laminectomy and fusion for multilevel cervical spondylotic myelopathy: a retrospective case-control study.

OBJECTIVE: To compare the clinical efficacy of surgical treatment for multilevel cervical spondylotic myelopathy (MCSM) between the hybrid procedure, posterior endoscopic decompression (PED) combined with anterior cervical discectomy fusion (ACDF), and posterior cervical laminectomy and fusion (PCLF). METHODS: A retrospective analysis was performed on 38 patients who received surgical treatment for MCSM from January 2018 to December 2021, including 19 cases in hybrid procedure group (13 males and 6 females), followed up for 10 to 22 (12.8 ± 10.3) months, and 19 cases in PCLF group (15 males and 4 females), followed up for 10 to 21 (11.7 ± 8.9) months. Perioperative information, including operation time, intraoperative blood loss, length of hospitalization, and complications, were compared between two groups. Visual analogue scale (VAS) of pain, neck disability index (NDI) and Japanese Orthopaedic Association (JOA) score were recorded to evaluate clinical efficacy. Cervical lordosis was calculated by radiographic examination. RESULTS: Intraoperative blood loss, length of hospital stay were less in hybrid group than PCLF group, while operation time is longer in hybrid group, with a statistically significant difference (p < 0.05). Increased lordosis was better in hybrid group. There was no significant difference in preoperative VAS, JOA and NDI at pre-operation and final follow-up between two groups. But at post-operation and final follow-up, VAS was less in hybrid group than PCLF group (p < 0.05). There were 2 cases of neurostimulation symptoms in hybrid group, 2 cases of C5 nerve root palsy, 2 cases of subcutaneous fat necrosis and 1 case of dural tear in PCLF group, and all patients relieved with symptomatic treatment. CONCLUSION: The hybrid procedure of PED combined with ACDF showed satisfied clinical outcome, with less intraoperative blood loss, shorter length of hospitalization and lower post-operative neck pain than PCLF. It is an effective surgical treatment for MCSM.

Modified Bone-Disc-Bone Osteotomy for Spinal Kyphosis: A Retrospective Clinical Study with 2-Year Follow-Up.

OBJECTIVE: To determine the efficacy of modified bone-disc-bone osteotomy to treat spinal kyphosis. METHODS: Between January 2018 and December 2022, 20 patients underwent modified bone-disc-bone osteotomy surgery for spinal kyphosis. Radiologic parameters pelvic incidence, pelvic tilt, sagittal vertical axis, and kyphotic Cobb angle were measured and compared. Oswestry Disability Index, visual analog scale, and general complications were recorded to evaluate clinical outcomes. RESULTS: All 20 patients completed 24 months of postoperative follow-up. Mean kyphotic Cobb angle correction was from 40.2 ± 6.8° to 8.9 ± 4.1° immediately after surgery to 9.8 ± 4.8° at 24 months postoperatively. Average surgical time was 277 minutes (range, 180-490 minutes). Mean intraoperative blood loss was 1215 mL (range, 800-2500 mL). Sagittal vertical axis was improved from 4.2 cm (range, 1-5.8 cm) preoperatively to 1.1 cm (range, 0-2 cm) at final follow-up (P < 0.05). Pelvic tilt was reduced from 27.6 ± 4.1 preoperatively to 14.9 ± 4.4 postoperatively (P < 0.05). Visual analog scale decreased from 5.8 ± 1.1 preoperatively to 1 ± 0.6 at final follow-up (P < 0.05). Oswestry Disability Index changed from 28.7 ± 2.7% preoperatively to 9.4 ± 1.8% at final follow-up. Bony fusion was achieved at 12 months postoperatively in all patients. All patients experienced significant improvement in clinical symptoms and neurological function at final follow-up. CONCLUSIONS: Modified bone-disc-bone osteotomy surgery is an effective and safe method for treatment of spinal kyphosis.

The Study of Crystallization Behavior, Microcellular Structure and Thermal Properties of Glass-Fiber/Polycarbonate Composites.

Polycarbonate (PC) foam is a versatile material with excellent properties, but its low thermal stability limits its application in high-temperature environments. The aim of this study was to improve the thermal stability of PC foam by adding glass fibers (GF) and to investigate the effect of GF on PC crystallization behavior and PC foam cell morphology. This study was motivated by the need to improve the performance of PC foams in various industries, such as construction, automotive, and medical. To achieve this goal, PC/GF composites were prepared by extrusion, and PC/GF composite foams were produced using a batch foaming process with supercritical carbon dioxide (SC-CO2) as the blowing agent. The results showed that the addition of GF accelerated the SC-CO2-induced crystallization stability of PC and significantly increased the cell density to 4.6 cells/cm3. In addition, the thermal stability of PC/GF foam was improved, with a significant increase in the residual carbon rate at 700 °C and a lower weight loss rate than PC matrix. Overall, this study highlights the potential of GF as a PC foam reinforcement and its effect on thermal and structural properties, providing guidance for industrial production and applications.

Study of single-level lumbar degenerative diseases treated by unilateral wiltse access with unilateral nail rod fixation assisted by a new automatic retraction device.

OBJECTIVE: To evaluate the clinical efficacy of unilateral wiltse transforaminal lumbar interbody fusion (TLIF) combined with unilateral nail bar system fixation for single-level lumbar degenerative diseases with the assistance of a new automatic retraction device in a retrospective comparative study. METHODS: A total of 46 patients with single-level lumbar degenerative diseases from September 2019 to December 2021 were retrospectively analyzed. Bilateral nail bar fixation with bullet-type fusion cage (ctrl group, 24 patients) and unilateral nail bar fixation on the affected side with kidney-like fusion cage (study group, 22 patients) were performed in TLIF via wiltse intermuscular approach assisted by a new automatic retraction device. The differences in intraoperative blood loss, operative time, intraoperative fluoroscopy time, postoperative drainage, bed rest, VAS score, ODI score, JOA score, serological creatine kinase (CK), the proportion of multifidus atrophy, modified Pfirrmann classification and intervertebral space height of the upper intervertebral disc were compared between the two groups based on clinical and imaging data. RESULTS: Intraoperative bleeding, operative time, and postoperative drainage were significantly lower in study group than ctrl group, and there were no significant differences in bed rest time and intraoperative fluoroscopy time between them. In addition, there was no statistical difference in CK between the study group and the ctrl group at 24 and 48 h postoperatively. Moreover, no statistically significant difference was found in VAS score of low back pain, VAS score of lower limb pain, ODI index, modified Pfirrmann classification of the upper intervertebral disc and intervertebral space height of the upper intervertebral disc between two groups. The atrophy ratio of multifidus muscle was significantly lower in the study group. CONCLUSION: The new automatic retraction device assisted unilateral TLIF surgery with wiltse approach combined with unilateral nail bar fixation is a simple, effective and easy to master surgical method for single-level lumbar degenerative diseases.

Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis.

OBJECTIVE: Nowadays, with the increasing proportion of osteoporosis in patients with lumbar degenerative diseases, doctors are facing the choice of intraoperative internal fixation methods. The purpose of this study was to compare and assess the clinical results of posterior bilateral pedicle screw fixation and lateral fixation in the extreme lateral interbody fusion (XLIF) in patients with osteopenia or osteoporosis. METHODS: The retrospective review was performed on 67 degenerative lumbar diseases patients with osteopenia or osteoporosis who underwent XLIF in our hospital from January 2018 to July 2021. Patients in this study were classified into lateral screw (LS) group, lateral self-locking plate (LP) group, and bilateral pedicle screw (BPS) group. The functional evaluation factors containing Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) of leg pain, and VAS of low back pain, radiological factors such as disc height (DH), lumbar lordotic (LL) angle, segmental lordotic (SL) angle, cage subsidence degree and interbody fusion degree were compared. RESULTS: Primary outcomes: no differences were observed with regards to the incidence of complications among LS, LP and BS group (P < 0.05). The JOA and leg pain VAS were significantly improved after operation (P < 0.05) and all groups demonstrated similar improvements in the leg pain VAS and JOA score (P > 0.05). When comparing VAS of leg pain and JOA scores, no differences were identified among LS, LP and BPS groups (P > 0.05). There are four thigh sensory complaint, one hip flexor weakness and one thigh pain occurred and no death was observed. There were significantly better DH, LL angle, SL angle, cage subsidence degree and interbody fusion degree in the BPS group than in LS and LP groups 1 year after surgery (P < 0.05). The DH loss ratio, LL angle loss ratio, SL angle loss ratio in the BPS group was significantly lower than in the LP and LS groups (P < 0.05). The 12-month SL angle improvement rate in the BPS group was significantly higher than in the LP and LS groups (20.20 ± 14.69, 0.73 ± 4.68, 6.20 ± 12.31, P < 0.05). SECONDARY OUTCOMES: the BPS patients had significantly worse intraoperative blood loss and operation time than LS and LP patients (P < 0.05). CONCLUSION: In lumbar diseases patients with osteopenia or osteoporosis, the bilateral pedicle screw fixation has better orthopedic effect than lateral internal fixation, and can better maintain the stability of the spine in the long-term follow-up, which is a better choice in XLIF surgery.

Comparison of multifidus degeneration between scoliosis and lumbar disc herniation.

OBJECTIVE: To assess and compare the pathological and radiological outcomes of multifidus degeneration in scoliosis and lumbar disc herniation patients. METHODS: We performed a retrospective review on 24 patients with scoliosis and 26 patients with lumbar disc herniation (LDH) in the Third Hospital of Hebei Medical University from January 2017 to March2021. The patients were divided into scoliosis group and LDH group according to the treatment. The MRI fatty infiltration rate (FIR) of multifidus and strength of back muscle were calculated to evaluate muscle condition. Multifidus biopsy samples were obtained during surgery in the affected side at L4 or L5 segment in LDH group and on the concavity side of apical vertebrae in scoliosis group. The biopsy fatty infiltration degree (FID) and FIR in two groups, the FIR of affected and unaffected side in LDH group, and the FIR of concavity and convexity side in scoliosis group were compared. The correlation between concavity-convexity FIR difference and cobb angle in scoliosis group, back muscle strength and FIR in LDH group, FID and FIR in both groups was calculated respectively. RESULTS: The FIR was higher in scoliosis group than in LDH group, higher in concavity side than convexity side in scoliosis group (both P < 0.05). The FID was higher in scoliosis group than in LDH group (P < 0.05). No significant difference was found between affected and unaffected side in LDH group (P > 0.05). There was a positive correlation between concavity-convexity FIR difference and cobb angle, FIR and FID (both P < 0.01). There was a negative correlation between back muscle strength and FIR (P < 0.01). The biopsy staining results showed that both two groups were found the existence of rimmed vacuoles, nuclear aggregation, and abnormal enzyme activity, indicating that the scoliosis and LDH may be associated with myogenic diseases. CONCLUSION: The scoliosis patients showed more serious fatty infiltration than LDH patients and rare pathological findings were found in both diseases.

A Comparative Study of a New Retractor-Assisted WILTSE TLIF, MIS-TLIF, and Traditional PLIF for Treatment of Single-Level Lumbar Degenerative Diseases.

OBJECTIVES: To compare the clinical efficacy of a new retractor-assisted Wiltse transforaminal lumbar interbody fusion (TLIF), minimally invasive TLIF (MIS-TLIF), and traditional posterior lumbar interbody fusion (PLIF) in treating single-level lumbar degenerative diseases. METHODS: A retrospective study was conducted by analyzing the clinical and imaging data of consecutive patients with single-level lumbar degenerative diseases who underwent the new retractor-assisted Wiltse TLIF, MIS-TLIF, or traditional PLIF. This study enrolled 87 concurrent patients between June 2016 and December 2019 (Wiltse TLIF 29 cases; MIS-TLIF 28 cases; PLIF 30 cases). The three groups were compared for perioperative indicators (including intraoperative blood loss, postoperative drainage volume, operation time, intraoperative fluoroscopy time, bedridden time), creatine kinase (CK), visual analog score (VAS), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, intervertebral fusion rate, muscle atrophy, and fatty infiltration (including ratio of multifidus atrophy and ratio of lean-to-total cross-sectional area [CSA]). RESULTS: Intraoperative blood loss (F = 62.628, p < 0.001), postoperative drainage volume (F = 72.048, p < 0.001), and bedridden time (χ2  = 62.289, p < 0.001) were significantly lower in the MIS-TLIF and Wiltse groups than in the PLIF group. The operative and intraoperative radiation times of the MIS-TLIF group were significantly longer than those of the Wiltse and PLIF groups. The CK concentration in the Wiltse and MIS-TLIF groups were significantly lower than those in the PLIF group 1 day (F = 9.331, p < 0.001) and 3 days after surgery (F = 15.967, p < 0.001). The PLIF group's back pain VAS score was higher than those of the Wiltse and MIS-TLIF groups. The PLIF group had a higher ODI 6 months (F = 3.282, p = 0.042) and 12 months (F = 5.316, p = 0.007) after surgery and a lower JOA score than the Wiltse and MIS-TLIF groups 6 months (F = 3.234, p = 0.044) and 12 months (F = 3.874, p = 0.025) after surgery. The ratio of multifidus atrophy in the PLIF group (41.70 ± 8.84%) was significantly higher than those of the Wiltse group (24.13 ± 6.82%) and the MIS-TLIF group (22.35 ± 5.03%). The ratio of lean-to-total CSA in the PLIF group was lower than those of the Wiltse and MIS-TLIF groups after surgery (F = 8.852, p < 0.001). MIS-TLIF group showed longer operation time (169.11 ± 29.38 min) and intraoperative fluoroscopy time (87.61 ± 3.13 s) than the Wiltse group. CONCLUSION: Wiltse TLIF assisted by the new retractor is a more convenient and minimally invasive surgical method than the traditional PLIF and MIS-TLIF methods, which are linked to a long learning curve and long operation and fluoroscopy time.

Efficacy and safety of a modified lateral lumbar interbody fusion in L4-5 lumbar degenerative diseases compared with traditional XLIF and OLIF: a retrospective cohort study of 156 cases.

BACKGROUND: The authors designed a modified lateral lumbar interbody fusion (LLIF) procedure named as XOLIF and compared the efficacy and safety with traditional LLIF procedures. METHODS: Patients were divided into XLIF, OLIF, and XOLIF group according to the surgical approach. Cases of psoas major and vascular space stenosis, psoas major muscle elevation, psoas major muscle hypertrophy, and high iliac crest were recorded. Basic information, composition ratio of specific cases, Visual analog scale (VAS), Oswestry Disability Index (ODI), interbody fusion rate and complications were compared between the 3 groups. RESULTS: The study included 156 cases of L4-5 LLIF. There was no statistical difference in age, gender, BMI among the three groups. Cases with stenosis between psoas muscle and artery accounted for 11.8 and 18.4% of the XLIF and XOLIF group, respectively, while no case of this type had undergone OLIF surgery, the difference was statistically significant (P < 0.05). The proportions of high iliac crest cases in the OLIF and XOLIF group were 12.5 and 18.4%, respectively, while the XLIF group with vertical approach is not suitable for cases with high iliac crest. The postoperative VAS and ODI of the three groups were significantly improved compared with those before operation. There were 51 cases (32.7%) of complications including 21cases in XLIF group, 20 cases in OLIF Group and 10 cases in XOLIF group. XOLIF group has more advantages in reducing lumbar plexus injury and the risk of vascular injury. CONCLUSIONS: XOLIF showed good clinical efficacy and technical advantages with a low incidence of intraoperative and postoperative complications, especially in the specific cases.

Several Triazine-Based Small Molecules Assisted in the Preparation of High-Performance and Stable Perovskite Solar Cells by Trap Passivation and Heterojunction Engineering.

The functional group is the main body in modifying the perovskite film, and different functional groups lead to different modification effects. Here, several conjugated triazine-based small molecules such as melamine (Cy-NH2), cyanuric acid (Cy-OH), cyanuric fluoride (Cy-F), cyanuric chloride (Cy-Cl), and thiocyanuric acid (Cy-SH) are used to modify perovskite films by mixing in antisolvent. The crystallizations of perovskites are optimized by these molecules, and the perovskite films with low trap density are obtained by forming Lewis adducts with these molecules (Pb2+ and electron-donating groups including -NH2, C═N-, and C═O; I- and electron-withdrawing groups including F, Cl, N-H, and O-H). Especially for the Cy-F and Cy-Cl, the heterojunction structure is formed in the perovskite layer by p-type modification, which is conducive to charge transfer and collection in PSCs. Compared with that of control devices, the performance of devices with trap passivation and heterojunction engineering is obviously improved from 18.49 to 20.71% for MAPbI3 and 19.27 to 21.11% for FA0.85Cs0.15PbI3. Notably, the excellent moisture (retaining 67%, RH: 50% for 20 days) and thermal (retaining 64%, 85 °C for 72 h) stability of PSCs are obtained by a kind of second modification (Cy-F/Cy-SH)─spin-coating a few Cy-SH on the Cy-F-modified perovskite film surface. It also reduces Pb pollution because Cy-SH is a highly potent chelating agent. Therefore, this work also provides an effective method to obtain high-performance, stable, and low-lead pollution PSCs, combining trap passivation, heterojunction engineering, and surface treatment.

Comparison of Anterior Cervical Discectomy and Fusion with Cervical Laminectomy and Fusion in the Treatment of 4-Level Cervical Spondylotic Myelopathy.

OBJECTIVE: To assess and compare the therapeutic effects of Anterior Cervical Discectomy and Fusion (ACDF) and Cervical Laminectomy and Fusion (CLF) in the treatment of 4-level cervical. METHODS: We performed a retrospective review on 39 patients with 4-level CSM who underwent ACDF or CLF in the Third Hospital of Hebei Medical University from January 2010 to December 2018. The patients were divided into ACDF group and CLF group according to the treatment. The operative index was evaluated based on intraoperative blood loss and operation time. The functional outcomes including Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS) of axial pain were compared. The Cobb angle, Cobb angle improvement rate, range of motion (ROM) and ROM loss ratio were measured for radiographic evaluation. RESULTS: No major complications or deaths occurred. The average age at baseline was 55 years. There was no significant difference between the ACDF and CLF group in follow-up time (26.29 months, 25.39 months, P > 0.05). The intraoperative blood loss was higher in the CLF group than in the ACDF group (692.67 ± 38.68 vs 392.14 ± 128.06, P < 0.05). The operation time was longer in the CLF group than in the ACDF group (206.60 ± 49.37 vs 172.64 ± 31.96, P < 0.05). Significant improvements in the VAS and JOA scores were observed in both groups (P < 0.05). No significant difference in VAS was found between the ACDF and CLF groups (P < 0.05). There was a significantly larger improvement rate of JOA score in the ACDF group than in the CLF group (60.9% ± 9.57% vs 31.5% ± 15.70%, P < 0.05). There were two (9.6%) cases with complications In the ACDF group, including one (4.8%) case of dysphagia and one (4.8%) case of pharyngodynia. In the CLF group, two patients (11.1%) developed C5 palsy. No significant difference in the incidence of complications, ROM loss ratio and Cobb angle improvement rate was found between group ACDF and group CLF (all P < 0.05). CONCLUSION: Both ACDF and CLF were effective in the treatment of multi-level cervical spondylosis and ACDF is more suitable for patients with 4-level CSM.