The Effect of Fermentation on the Chemical Constituents of Gastrodia Tuber Hallimasch Powder (GTHP) Estimated by UHPLC-Q-Orbitrap HRMS and HPLC.

OBJECTIVE: To compare the effect of fermentation on the chemical constituents of Gastrodia Tuder Halimasch Powder (GTHP), to establish its fingerprinting and multicomponent content determination, and to provide a basis for the processing, handling, and clinical application of this herb. METHODS: Ultra-high-performance liquid chromatography-quadrupole-Orbitrap high-resolution mass spectrometry (UHPLC-Q-Orbitrap HRMS) was used to conduct a preliminary analysis of the chemical constituents in GTHP before and after fermentation. High-performance liquid chromatography (HPLC) was used to determine some major differential components of GTHP and establish fingerprints. Cluster analysis (CA), and principal component analysis (PCA) were employed for comprehensive evaluation. RESULTS: Seventy-nine compounds were identified, including flavonoids, organic acids, nucleosides, terpenoids, and others. The CA and PCA results showed that ten samples were divided into three groups. Through standard control and HPLC analysis, 10 compounds were identified from 22 peaks, namely uracil, guanosine, adenosine, 5-hydroxymethylfurfural (5-HMF), daidzin, genistin, glycitein, daidzein, genistein, and ergosterol. After fermentation, GTHP exhibited significantly higher contents of uracil, guanosine, adenosine, 5-hydroxymethylfurfural, and ergosterol and significantly lower genistein and daidzein contents. CONCLUSIONS: The UHPLC-Q-Orbitrap HRMS and HPLC methods can effectively identify a variety of chemical components before and after the fermentation of GTHP. This study provides a valuable reference for further research on the rational clinical application and quality control improvement of GTHP.

[Difference of lipid-lowering efficacy of "Xinjianqu" before and after fermentation and its mechanism based on LKB1-AMPK pathway and 16S rDNA sequencing technology].

On the basis of establishing the prescription of Xinjianqu and clarifying the increase of the lipid-lowering active ingredients of Xinjianqu by fermentation, this paper further compared the differences in the lipid-lowering effects of Xinjianqu before and after fermentation, and studied the mechanism of Xinjianqu in the treatment of hyperlipidemia. Seventy SD rats were randomly divided into seven groups, including normal group, model group, positive drug simvastatin group(0.02 g·kg~(-1)), and low-dose and high-dose Xinjianqu groups before and after fermentation(1.6 g·kg~(-1) and 8 g·kg~(-1)), with ten rats in each group. Rats in each group were given high-fat diet continuously for six weeks to establish the model of hyperlipidemia(HLP). After successful modeling, the rats were given high-fat diet and gavaged by the corresponding drugs for six weeks, once a day, to compare the effects of Xinjianqu on the body mass, liver coefficient, and small intestine propulsion rate of rats with HLP before and after fermentation. The effects of Xinjianqu before and after fermentation on total cholesterol(TC), triacylglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN), creatinine(Cr), motilin(MTL), gastrin(GAS), and the Na~+-K~+-ATPase levels were determined by enzyme-linked immunosorbent assay(ELISA). The effects of Xinjianqu on liver morphology of rats with HLP were investigated by hematoxylin-eosin(HE) staining and oil red O fat staining. The effects of Xinjianqu on the protein expression of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK), phosphorylated AMPK(p-AMPK), liver kinase B1(LKB1), and 3-hydroxy-3-methylglutarate monoacyl coenzyme A reductase(HMGCR) in liver tissues were investigated by immunohistochemistry. The effects of Xinjianqu on the regulation of intestinal flora structure of rats with HLP were studied based on 16S rDNA high-throughput sequencing technology. The results showed that compared with those in the normal group, rats in the model group had significantly higher body mass and liver coefficient(P<0.01), significantly lower small intestine propulsion rate(P<0.01), significantly higher serum levels of TC, TG, LDL-C, ALT, AST, BUN, Cr, and AQP2(P<0.01), and significantly lower serum levels of HDL-C, MTL, GAS, Na~+-K~+-ATP levels(P<0.01). The protein expression of AMPK, p-AMPK, and LKB1 in the livers of rats in the model group was significantly decreased(P<0.01), and that of HMGCR was significantly increased(P<0.01). In addition, the observed＿otus, Shannon, and Chao1 indices were significantly decreased(P<0.05 or P<0.01) in rat fecal flora in the model group. Besides, in the model group, the relative abundance of Firmicutes was reduced, while that of Verrucomicrobia and Proteobacteria was increased, and the relative abundance of beneficial genera such as Ligilactobacillus and Lachnospiraceae＿NK4A136＿group was reduced. Compared with the model group, all Xinjianqu groups regulated the body mass, liver coefficient, and small intestine index of rats with HLP(P<0.05 or P<0.01), reduced the serum levels of TC, TG, LDL-C, ALT, AST, BUN, Cr, and AQP2, increased the serum levels of HDL-C, MTL, GAS, and Na~+-K~+-ATP, improved the liver morphology, and increased the protein expression gray value of AMPK, p-AMPK, and LKB1 in the liver of rats with HLP and decreased that of LKB1. Xinjianqu groups could regulate the intestinal flora structure of rats with HLP, increased observed＿otus, Shannon, Chao1 indices, and increased the relative abundance of Firmicutes, Ligilactobacillus(genus), Lachnospiraceae＿NK4A136＿group(genus). Besides, the high-dose Xinjianqu-fermented group had significant effects on body mass, liver coefficient, small intestine propulsion rate, and serum index levels of rats with HLP(P<0.01), and the effects were better than those of Xinjianqu groups before fermentation. The above results show that Xinjianqu can improve the blood lipid level, liver and kidney function, and gastrointestinal motility of rats with HLP, and the improvement effect of Xinjianqu on hyperlipidemia is significantly enhanced by fermentation. The mechanism may be related to AMPK, p-AMPK, LKB1, and HMGCR protein in the LKB1-AMPK pathway and the regulation of intestinal flora structure.

Curative effect of capreomycin in adjuvant treatment of multidrug-resistant pulmonary tuberculosis and its effect on quality of life and immune function / 中国热带医学

@#Abstract: Objective To investigate the efficacy of capreomycin adjuvant therapy for multidrug-resistant pulmonary tuberculosis (MDR-TB) and its effect on quality of life and immune function. Methods Eighty-eight elderly pulmonary tuberculosis patients admitted to Affiliated Hospital of Hebei University from October 2019 to October 2020 were selected and divided into two groups according to the random number table method. The control group (n=44) used 4-6Am-Mfx（Lfx）-Pto-Cfz-Z-Hhigh-dose-E/5 Mfx（Lfx）-Cfz-Z-E, the research group (n=44) used capreomycin on the basis of the control group. The 6-Minute Walk Test (6MWT) measured value/predicted value and quality of life [36-Item Short Form Health Survey Questionnaire (SF-36)] scores, safety evaluation results, chest CT cavity and lesion absorption rate and sputum culture turned negative were compared between the two groups, and the serum procalcitonin (PCT) expression levels and immune function were detected before and after treatment. Results The 6MWT measured value/predicted value of the research group and control group before the treatment were (0.48±0.11) and (0.64±0.13), which were significantly higher than corresponding (0.51±0.12) and (0.58±0.14) after treatment (t=6.23, 2.520, P<0.05), the measured/expected value of 6MWT increased in both groups after treatment. Compared with the same group before treatment, the SF-36 scores for each dimension increased in both groups after treatment (P<0.01). The expression levels of serum PCT in the research group and control group before the treatment were (0.37±0.09) ng/mL and (0.12±0.03) ng/mL versus (0.36±0.11) ng/mL and (0.21±0.06) ng/mL after treatment (t=17.480, 7.940, P<0.01). Compared with the same group before treatment, serum PCT expression levels decreased in both groups after treatment. Compared with the same group before treatment, CD3+, CD4+ and CD4+/CD8+ were elevated in both groups after treatment (P<0.05 or P<0.01); after treatment, CD3+, CD4+, and CD4+/CD8+ were significantly higher in research group compared to the control group (t=4.21, 8.02, 2.04, P<0.05). The absorption rate of chest CT cavity and lesions and negative rate of sputum culture in the research group were 88.64% (39/44) and 81.82% (36/44), which were significantly higher than corresponding 63.64% (28/44) and 61.36% (27/44) in the control group (P<0.05). Conclusions　Capreomycin can improve the quality of life of MDR-TB patients, extend the 6-minute walking distance, and regulate serum PCT expression levels and immune function, to promote the absorption of chest CT cavity and lesions, and sputum culture to turn negative, and the security is acceptable.

The diagnostic efficacy and predictive value of combined lipoprotein laboratory indexes for atherosclerosis.

OBJECTIVE: To investigate the diagnostic efficacy and predictive value of combined lipoprotein laboratory indexes for atherosclerosis. METHODS: Clinical data of 250 patients with atherosclerosis admitted to Xianning central hospital, China from January 2015 to December 2018 and 80 healthy subjects on physical examination in the same period were analyzed retrospectively. Serological laboratory indices related to lipid metabolism were measured, and their diagnostic efficacy and predictive value for atherosclerosis were evaluated by univariate and multivariate statistical methods. RESULTS: The levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), small dense low density lipoprotein (sd-LDL), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG) and high-sensitivity C-reactive protein (hs-CRP) of the atherosclerosis group were significantly higher than those of the healthy group (P<0.05). Logistic regression analysis showed that the levels of LP-PLA2, sd-LDL and hs-CRP were independent factors influencing the occurrence of atherosclerosis (P<0.05). Lp-PLA2 combined with sd-LDL had the largest area under ROC curve, and their diagnostic efficiency was higher than that of single serological laboratory indices. There was no significant difference in the levels of Lp-PLA2 and sd-LDL among different types of atherosclerotic diseases (P<0.05). The levels of LP-PLA2 and sd-LDL in triple-vessel or left main coronary artery disease were significantly higher than those of single- or double-vessel disease (P<0.05). The levels of LP-PLA2 and sd-LDL in double-vessel disease were significantly higher than those of single-vessel disease (P<0.05). The level of serum sd-LDL of atherosclerotic patients with alcohol history were significantly higher than those without alcohol history (P<0.05). CONCLUSIONS: When being used to detect atherosclerosis, Lp-PLA2 combined with sd-LDL has better diagnostic efficacy than separate tests. Meanwhile, there is a correlation between their levels and the severity of disease, which can be used to predict the occurrence of atherosclerosis independently of other risk factors.

Development and identification of a fully human single-chain variable fragment 29 against TSLP.

Thymic stromal lymphopoietin is a key initiator for inducing Th2-type inflammation and a potential therapeutic target for allergic disease. In the present study, the naive human antibody library was enriched using human thymic stromal lymphopoietin (hTSLP) as an antigen by phage display. Single clones were randomly picked from the enriched antibody library after three rounds of selection, and these were expressed for enzyme-linked immunosorbent assay (ELISA). The positive single-chain fragment variables (scFvs) determined by ELISA were further identified by Western blot, Biacore, and flow cytometry. After three rounds of phage display, 35% of the scFv clones were positive by ELISA and could bind well with hTSLP. Further identification revealed that scFv29 had satisfactory characteristics. The scFv29 was specific to hTSLP, and had no cross-reaction with hIL-33, hIL-4, and hIL-13. The scFv29 could bind to hTSLP in competition with the TSLP receptor and could also bind to mouse TSLP. Cellular experiments revealed that mTSLP could stimulate myeloid dendritic cell (DC) to mature, and scFv29 blocking could reduce the maturation rate of DC. These findings suggest that scFv29 could be used as a neutralizing antibody to block the signaling of TSLP, and this work provides the foundation for further study of the therapeutic roles of TSLP in allergic inflammation diseases.

Nanoporous diopside modulates biocompatibility, degradability and osteogenesis of bioactive scaffolds of gliadin-based composites for new bone formation.

INTRODUCTION: It is predicted that with increased life expectancy in the whole world, there will be a greater demand for synthetic biomedical materials to repair or regenerate lost, injured or diseased tissues. Natural polymers, as biomedical materials, have been widely applied in the field of regenerative medicine. MATERIALS AND METHODS: By incorporation of nanoporous diopside bioglass (nDPB) into glia-din (GL) matrix, macro-nanoporous scaffolds of nDPB/GL composites (DGC) were fabricated by method of solution compressing and particles leaching. RESULTS: The results revealed that the DGC scaffolds possessed well-interconnected macropores of 200-500 µm and nanopores of 4 nm, and the porosity and degradability of DGC scaffolds remarkably increased with the increase in nDPB content. In addition, in vitro cell experiments revealed that the adhesion and growth of MC3T3-E1 cells on DGC scaffolds were significantly promoted, which depended on nDPB content. Moreover, the results of histological evaluations confirmed that the osteogenic properties and degradability of DGC scaffolds in vivo significantly improved, which were nDPB content dependent. Furthermore, the results of immunohistochemical analysis demonstrated that, with the increase in nDPB content, the type I collagen expression in DGC scaffolds in vivo obviously enhanced, indicating excellent osteogenesis. DISCUSSION AND CONCLUSION: The results demonstrated that the DGC scaffolds containing 30 wt% nDPB (30nDGC) exhibited good biocompatibility and new bone formation ability, which might have a great potential for applications in bone regeneration.

[Status and thinking of quality supervision on imported medicinal materials in shortage].

With the continuous development of traditional Chinese medicine business, the types and amounts of Chinese materia medica resources are increasingly reduced. By reviewing the origins, trading sources, and existing quality standards of the available common Chinese madicinal materials in shortage, it was found that the large amount of imported medicinal materials in domestic market or clinical application were not due to the traditional paths such as envoys presenting tribute, business trade, war conflict, national migration, and tourist travel, but due to the shortage of resources in domestic origins. Meanwhile, the former quality control standard on traditional imported medicinal materials was out of date, and the new imported medicinal materials quality control standard was in absence, resulting in unclear origins, unknown origins and processing methods, as well as more and more prominent problems on mixed use of the different varieties with same name and the same varieties from different origins. On the one hand, this situation once again sounded the alarm for the development of Chinese medicine industry from the resource perspective. On the other hand, the confusion of new varieties in Chinese herbal medicine market has also brought a serious threat to the efficacy of Chinese medicine. It is pointed out that it is an effective way to ensure the drug safety of imported medicinal materials through strengthening quality supervision of shortage of traditional Chinese medicines based on the new pharmacopoeia standards.

Outcome Predictors of the Transforaminal Endoscopic Spine System Technique for Single-level Lumbar Disk Herniation.

BACKGROUND: Endoscopic spine surgery has become increasingly popular. However, no study has researched the predictive factors for different outcomes. This study is the first to evaluate the outcome predictors of the transforaminal endoscopic spine system (TESSYS) technique for lumbar disk herniation (LDH). METHODS: We performed a prospective study of 80 patients meeting the inclusion criteria who underwent TESSYS for LDH. Clinical outcomes were assessed by the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the modified MacNab criteria. Univariate and multivariate analyses were performed to evaluate the outcome predictors. RESULTS: There were 36 men and 44 women with a mean age of 48.76 ± 15.60 years (range: 24-78 years). The mean follow-up time was 25.15 ± 9.76 months (range: 12-48 months). The VAS and ODI scores at the last follow-up were significantly improved (p < 0.001). Based on the modified MacNab criteria, the global outcomes were excellent in 34 patients (42.5%), good in 26 patients (32.5%), fair in 11 patients (13.75%), and poor in 9 patients (11.25%). The percentage of symptomatic improvement was 88.75%, and the success rate (excellent or good) was 75%. In the univariate and multivariate analyses, LDH with older age (odds ratio [OR]: 6.621; 95% confidence interval [CI], 0.632-20.846; p = 0.019), high-intensity zone (HIZ) (OR: 8.152; 95% CI, 0.827-4.380; p = 0.003), and larger disk herniation (OR: 6.819; 95% CI, 0.113-4.825; p = 0.017) were the most significant negative outcome predictors. CONCLUSIONS: TESSYS is an effective method to treat LDH. Older age, the existence of an HIZ, and a large disk herniation were the most important predictors for a worse outcome.

Eccentric technique for foraminoplasty in percutaneous endoscopic transforaminal procedure: A technical note.

OBJECTIVE: To describe a modified technique usied for foraminoplasty in percutaneous endoscopic transforaminal procedure. METHODS: 58 patients (20 males and 38 females, average age 52.5 years) underwent percutaneous endoscopic transforaminal procedure by using our modified technique. Under the guidance of C-arm fluoroscopy, a kirschner wire was inserted into targeted superior articular process. After expanding the soft tissues, a trepan with the largest diameter was located through the kirschner wire and the angle of trepan was flexible enough to adjust to different operative conditions. This technique could help to avoided using step-by-step larger diameters of trepans without slippage during foraminoplasty. RESULTS: With our modified technique, the mean operation time was 65 min (range 50-80 min) and mean estimated blood loss was 12 ml (range 10-30 ml). Fluoroscopy was less (the mean duration of fluoroscopy was 20.4 ± 9.2 s and the mean radiation dose was 0.9 ± 0.2 mSv) and no complications occurred. All foraminoplasties were excellent via CT scans after surgery and all patients were discharged on 2nd day after operation. The results of 58 patients with an average follow-up of 18 (6-36) months demonstrated our eccentric technique to be effective. CONCLUSION: Our eccentric technique could help to avoid step-by-step larger diameters of trepans during foraminoplasty to shorten operation time and reduced the number of fluoroscopy intraoperative.

Percutaneous endoscopical transforaminal approach versus PLF to treat the single-level adjacent segment disease after PLF/PLIF: 1-2 years follow-up.

BACKGROUND: Adjacent segment disease (ASD) is a common complication after lumbar decompression and fusion surgery. Traditional revision-surgery, including posterior lumbar decompression and posterolateral fusion (PLF) or interbody fusion (PLIF) is traumatic. The percutaneous endoscopic transforaminal procedure (PE-TF) has been widely used in patients with lumbar disc disease. However, there are no reports about using PE-TF procedure to treat ASD in the current literature. OBJECTIVE: To compare the clinical outcomes between PE-TF and PLF for single-level ASD after PLF or PLIF. STUDY DESIGN: A retrospective study. SETTING: Department of Spine Surgery. METHODS: There were 64 patients diagnosed with single-level ASD and accepted revision surgery. 33 patients accepted PE-TF (Group A) and 31 underwent PLF (Group B). Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) scores were used to evaluate clinical outcomes. Complications, length of skin incision, hospitalization time and blood loss were investigated according to patient records. RESULTS: All symptoms had improved at the final follow-up. The improvement rate was 82.75% in group A and 86.28% in group B. The satisfactory clinical outcomes were similar in both groups with no recurrence in all cases. PE-TF procedure had significant advantages in the following items: traumatization, cosmetology, hospitalization time and blood loss. CONCLUSIONS: Clinical outcomes of using PE-TF procedure to treat single-level ASD were similar to those of PLF approach, but PE-TF was less invasive and could shorten hospitalization time.

Do the complications increased in the anterolateral right-side approach to treat the cervical degenerative disorders? A retrospective cohort study.

The dysphagia and recurrent laryngeal nerve (RLN) palsy are the most common complications of the patients who underwent anterior cervical surgery in the current literature. These morbidities have led to the study of the impact of sidedness in anterior cervical spine surgery. However, many reports documented the left-side was more effective and safe than right-side based on the anatomy. So the right-side approach is more challenging. We retrospectively study 503 patients with cervical degenerative diseases who underwent cervical spinal surgery using anterolateral right-side approach in our spine center from September 1999 to December 2012 and evaluate the efficient and safety of the anterolateral right-side approach to treat the cervical degenerative diseases. The overall mortality rate in our present report was 3.38% (17 of 503 patients). The most common complication which observed in 2.80% of our cases was dysphagia. Postoperatively, there was only one patient with hematoma and died (0.19%) and symptomatic recurrent laryngeal nerve palsy occurred in 0.39% of the cases. The anterolateral right-side anterior approach didn't increase the incidence of the dysphagia and recurrent laryngeal nerve (RLN) palsy.

Transforaminal endoscopic system technique for discogenic low back pain: A prospective Cohort study.

OBJECTIVE: To investigate the clinical outcomes of transforaminal endoscopic system(TESSYS) for discogenic low back pain(DLBP). METHODS: 62 consecutive patients with one-level DLBP applying to the including criteria underwent TESSYS from January 2010 to December 2013. These patients included 38 males and 24 females with a mean age of 42.7 ± 5.4 years (range, 18-73 yr) and a mean follow-up of 26.8 ± 4.2 months (range, 12-48 months). The visual analog scale (VAS) were used for back pain, the Oswestry Disability Index (ODI) for lumbar function, and the modified MacNab criteria for clinical global outcomes. RESULTS: 24 patients showed only inflammatory granuloma on annulus tear tissues(Group A), 16 patients showed no annulus tear but adhesion and inflammatory granuloma among the intracanal annulus fibrous(AF), posterior longitudinal ligament(PLL) and the abdomen side of the dura sac(Group B) and 22 patients showed both(Group C). Concordant pain could be triggered by touching the inflammation with the bipolar radiofrequency probe. The success rate (excellent and good) of group C was much higher than A and B(P < 0.05). The whole success rate was 75.8%. Of the 4 patients with poor result, 2 refused further surgical treatment and showed either no improvement or worsening. The remaining 2 patients had spinal fusion surgery and achieved better results. VAS and ODI had significantly improved after surgery (P < 0.01). No unexpected complications were seen. CONCLUSION: TEEYS is an effective method in treating DLBP and the complete management of the inflammatory granuloma was the key point in achieving better results.

Comparative analysis of autologous blood transfusion and allogeneic blood transfusion in surgical patients.

OBJECTIVE: To investigate application effects of autologous blood transfusion and allogeneic blood transfusion in surgically treated patients receiving spine surgery, abdomen surgery and ectopic pregnancy surgery. METHODS: 130 patients who would undergo selective operations were divided into autologous transfusion group and allogeneic transfusion group. Both groups received the same anesthesia, and there was no significant difference in transfusion volume or fluid infusion volume. RESULTS: The serum TNF-α level in autologous transfusion group after operation showed a clear upward trend and had significant difference compared with that before operation (P < 0.05). Meanwhile, after operation, the serum TNF-α level in autologous transfusion group was all significantly higher than that allogeneic transfusion group and the comparative difference was statistically significant (P < 0.05). IgG level in treatment group did not significantly fluctuate during perioperative period, but IgG level in allogeneic transfusion group after operation was all significantly lower than that before operation, and there was statistically significant difference between both groups (P < 0.05). At the same time, complement C3 level in treatment group after operation was significantly higher than that before operation (P < 0.05), but complement C3 level in allogeneic transfusion group did not significantly change. After operation, there was statistically significant difference in complement C3 level between both groups (P < 0.05). CONCLUSION: Autologous transfusion is already a widely accepted transfusion method at present, and it can increase TNF-α and complement C3 levels in the body of surgically treated patients to strengthen immune ability against infection.

Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation.

Vertebral hemangiomas are benign lesions and are often asymptomatic. Most vertebral hemangiomas that cause cord compression and neurological symptoms are located in the thoracic spine and involve a single vertebra. The authors report the rare case of lumbar hemangiomas in a 60-year-old woman presenting with severe back pain and rapidly progressive neurological signs attributable to 2 noncontiguous lesions. After embolization of the feeding arteries, no improvement was noted. Thus, the authors performed open surgery using a combination of posterior decompression, intraoperative kyphoplasty, and segmental fixation. The patient experienced relief from back and leg pain immediately after surgery. At 3 months postoperatively, her symptoms and neurological deficits had improved completely. To the authors' knowledge, this is the first description of 2 noncontiguous extensive lumbar hemangiomas presenting with neurological symptoms managed by such combined treatment. The combined management seems to be an effective method for treating symptomatic vertebral hemangiomas.

[Bio-mechanical evaluation of extreme lateral transforaminal lumbar interbody fusion].

OBJECTIVE: To evaluate the feasibility and post-operation stability of extreme lateral transforaminal lumbar interbody fusion (E-TLIF) and other traditional surgical approach via bio-mechanical test. METHODS: There were 24 normal lumbar spine segment of swine were divided into the following four groups: control group, standard group (internal fixed with pedicle screws only), transforaminal lumbar interbody fusion (TLIF) group and E-TLIF group. The specimen in anteflect, hypsokinesis, lateral flexion and rotate movements were tested respectively with bio-mechanical devices to study on the load-straining changes and biomechanics index. RESULTS: After TLIF or E-TLIF, specimen turned out more steady than normal control group (t = 4.17 - 4.53, P < 0.01). Compared with TLIF group [linear displacement (3.98 ± 0.22) mm, angular displacement 3.03° ± 0.18°], specimen after E-TLIF [linear displacement (3.40 ± 0.09) mm, angular displacement 2.57° ± 0.12°] were more stable in biomechanics index on lateral flection movement (t = 2.61, P < 0.05), but no difference on axial or rotational movements (P > 0.05). CONCLUSION: E-TLIF is a safe and more efficient operation approach.