硫酸软骨素酶ABC和环磷酸腺苷缓释组织工程 支架的构建

目的:制备一种可生物降解有效安全的硫酸软骨素酶ABC(ChABC)和环磷酸腺苷(cAMP)缓释组织工程支架,使药物缓慢稳定释放,降低局部应用时对神经的刺激,促进中枢神经系统损伤后神经的修复和轴突的再生。方法:应用电纺丝技术制作的含ChABC及cAMP的聚碳酸亚丙酯及壳聚糖缓释组织工程支架,分析支架直径、载药量、包封率等参数,然后以磷酸盐缓冲液为体外释药介质观察组织工程支架的药物释放速度、药物的失活率及支架的降解速度。结果:ChABC和cAMP缓释组织工程支架在聚碳酸亚内酯质量浓度为8%、电压为10～15 kV、距离为15～20 cm时可以纺出纤维直径约3μm的平滑支架,单纯聚碳酸盐内酯纤维光滑,直径均一,壳聚糖微球光滑,聚碳酸亚内酯与壳聚糖混合后电纺丝形成的支架呈串珠样结构,其能缓慢持续释放有活性ChABC和cAMP,12 d后支架降解失重率约7%。结论:应用电纺丝方法成功制备含ChABC及cAMP的聚碳酸盐内酯及壳聚糖组织工程支架,其药物稳定释放,局部应用无神经刺激,可生物降解。     

腹腔镜腹股沟疝修补应用轻质3D Max补片与普通补片的效果比较

文题释义：轻质3D Max补片：是一种大网孔的轻质补片,适用于腹壁疝、腹股沟疝修补及软组织缺损重建当中。相较于传统的聚丙烯补片,轻质3D Max补片更轻,体内异物残留更少,且具有更佳的腹壁顺应性、更少的炎症反应,放置更容易,在减少创面、快速愈合、防止复发、易吸收等方面的优势明显。3D Max补片因其卓越的安全性、高效性、方便性,迅速受到临床医生的青睐。腹腔镜腹股沟疝修补术：是近十几年来发展起来的一种治疗腹股沟疝的新兴技术,较之于传统的开放式无张力修补术,腹腔镜下能将补片放在更深的位置,降低复发率。同时,腹腔镜腹股沟疝修补术还具有外观美观、创伤较小、患者痛苦感更轻、术后并发症少等诸多优点,近年来在临床腹股沟疝治疗中得到了推广应用。 背景：在腹股沟疝修补中基于单个补片特征的补片选择仍然存在争议,需要对疝气复发和补片特异性并发症的长期结局进行评估。 目的：比较腹腔镜腹股沟疝修补术中应用轻质3D Max补片与普通聚丙烯补片对手术结局和患者生活质量影响。方法：选择2013年2月至2016年1月河北省秦皇岛军工医院收治的无并发症腹股沟疝患者142例,其中男131例,女11例,年龄18-60岁,计算机软件随机分为轻质3D Max补片组(n=80)和聚丙烯补片组(n=62)进行腹腔镜腹股沟疝修补。收集患者的手术细节和结局、疝气复发率、并发症和住院费用等信息。分别于术前、术后2周及术后1,6,12和24个月采用卡罗来纳舒适量表评估患者的生活质量。试验已获得河北省秦皇岛军工医院伦理委员会批准,批准号：2013-002-02。结果与结论：①轻质3D Max补片组的手术时间、术后卧床时间和住院费用少于聚丙烯补片组(P < 0.05),术后血清肿发生率低于聚丙烯补片组(7.5%,21.5%,P < 0.001);两组疝气复发率与其他并发症发生率比较差异无显著性意义(P > 0.05);②轻质3D Max补片组术后2周、1个月的疼痛感觉评分少于聚丙烯补片组(P < 0.05),两组术后2周及1,6,12,24个月的总生活质量评分与疝气感觉、运动受限等评分比较差异无显著性意义(P > 0.05);③结果表明与聚丙烯补片相比,轻质3D Max补片可有效缩短疝修补手术时间,降低住院费用和术后短期慢性疼痛的发生率。ORCID: 0000-0001-5676-0824(侯海生) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

New Generation Extracorporeal Membrane Oxygenation With MedTech Mag‐Lev,a Single‐Use,Magnetically Levitated,Centrifugal Blood Pump: Preclinical Evaluation in Calves

We have evaluated the feasibility of a newly developed single‐use, magnetically levitated centrifugal blood pump, MedTech Mag‐Lev, in a 3‐week extracorporeal membrane oxygenation (ECMO) study in calves against a Medtronic Bio‐Pump BPX‐80. A heparin‐ and silicone‐coated polypropylene membrane oxygenator MERA NHP Excelung NSH‐R was employed as an oxygenator. Six healthy male Holstein calves with body weights of about 100 kg were divided into two groups, four in the MedTech group and two in the Bio‐Pump group. Under general anesthesia, the blood pump and oxygenator were inserted extracorporeally between the main pulmonary artery and the descending aorta via a fifth left thoracotomy. Postoperatively, both the pump and oxygen flow rates were controlled at 3 L/min. Heparin was continuously infused to maintain the activated clotting time at 200–240 s. All the MedTech ECMO calves completed the study duration. However, the Bio‐Pump ECMO calves were terminated on postoperative days 7 and 10 because of severe hemolysis and thrombus formation. At the start of the MedTech ECMO, the pressure drop across the oxygenator was about 25 mm Hg with the pump operated at 2800 rpm and delivering 3 L/min flow. The PO₂ of the oxygenator outlet was higher than 400 mm Hg with the PCO₂ below 45 mm Hg. Hemolysis and thrombus were not seen in the MedTech ECMO circuits (plasma‐free hemoglobin [PFH] < 5 mg/dL), while severe hemolysis (PFH > 20 mg/dL) and large thrombus were observed in the Bio‐Pump ECMO circuits. Plasma leakage from the oxygenator did not occur in any ECMO circuits. Three‐week cardiopulmonary support was performed successfully with the MedTech ECMO without circuit exchanges. The MedTech Mag‐Lev could help extend the durability of ECMO circuits by the improved biocompatible performances.     

单丝聚丙烯补片修补老年腹壁巨大切口疝治疗体会

目的 分析应用单丝聚丙烯补片修补老年腹壁巨大切口疝的治疗效果.方法 采集2006年1月至2009年12月我院老年巨大切口疝患者36例,使用单丝聚丙烯补片修补,其中肌鞘前修补(Onlay法)12例,肌肉与肌肉间修补(Inlay法)5例,肌肉后腹膜前修补(Sublay法)19例.结果 无切口感染,皮下积液6例,均为Onlay法,9例有不同程度异物感,但不妨碍日常生活.平均随访24个月,无复发.结论 应用单丝聚丙烯补片无张力修补老年腹壁巨大切口疝,可取得满意疗效,采用妥善的术中、术后处理方法,可减少术后并发症的发生.     

Improvements in overactive bladder syndrome after polypropylene mesh surgery for cystocele

Background: The International Continence Society has defined overactive bladder syndrome (OABS) by the following set of symptoms: 'urgency, with or without urge incontinence, usually with urinary frequency and nocturia'. OABS and cystocele often coexist.
Aim: This study aimed to analyse the changes in the overactive bladder symptom score (OABSS) of women followed up for one year after anterior repair surgery performed using a polypropylene mesh. In this surgery, a tape with four straps designed for optimum tissue holding capacity was fixed to the obturator foramen.
Material and methods: Thirty-four women were operated using the abovementioned mesh. The OABSS, maximal urinary flow rate (Qmax) and postvoid residual (PVR) volume were evaluated pre- and post-surgery.
Results: We observed significant improvements in the OABSS and quality of life scores before and after one year of surgery. The surgery was significantly effective in improving urgency, daytime frequency, incontinence, the Qmax and the PVR volume. No significant change in nocturia was observed post-surgery.
Conclusions: Our study confirmed the efficacy of the propylene mesh introduction surgery for cystocele for the improvement of OABS symptoms.     

直立式聚丙烯输液袋细胞毒性检测

目的评价聚丙烯输液袋的细胞毒性情况.方法本实验选取了3个不同批次的样品,采用琼脂覆盖法来进行直立式聚丙烯输液袋的细胞毒性检测.结果在琼脂覆盖法试验中,使用L-929细胞在直立式聚丙烯输液袋检测过程中未观察到明显的脱色区和细胞溶解现象,细胞毒性评级为0级.结论直立式聚丙烯输液器无细胞毒性作用,值得在静脉输液中推广使用.     

A comparative study of laparoscopic sacrocolpopexy and total vaginal mesh procedure using lightweight polypropylene meshes for prolapse repair

ObjectiveUse of vaginal meshes for treatment of pelvic organ prolapse (POP) remains controversial. A trend toward abdominal approaches and the development of new meshes has been noted. We compared the 1-year results of two different approaches using new lightweight meshes.Materials and methodsSixty-nine (95.8%) of 72 women with POP Stage ≥ 2, who underwent laparoscopic sacrocolpopexy (LSC) (n = 39) or a total vaginal mesh (TVM) procedure (n = 30) using lightweight polypropylene meshes, were studied. Baseline and follow-up assessments included a pelvic examination and a composite condition-specific questionnaire. A detailed comparison of 1-year outcomes was made. Data were analyzed using appropriate statistical methods.ResultsCompared to the TVM group, the LSC group was characterized by a younger age (53.7 years vs. 64.1 years, p < 0.001) and a longer operating time (264 minutes vs. 177.6 minutes, p < 0.001). Objective anatomic success (POP Stage ≤ 1) rates were similar between groups after statistical adjustment, i.e., 84.6% (33/39) and 86.7% (26/30) after LSC and TVM (p = 0.94), respectively. However, the dominant recurrence sites were different with anterior (n = 6) most frequent after LSC and apical (n = 4) most frequent after TVM. Reoperations were needed for the four (13.3%) apical recurrences in the TVM group. No serious complications were noted. We found “cystocele as the dominant prolapse” (p = 0.016; odds ratio = 6.94) and “suspension of prolapsed (POP Stage ≥ 2) uterus” (p = 0.025; odds ratio = 7.00) significantly affected recurrence after LSC and TVM, respectively.ConclusionPOP repair by LSC or TVM using the new lightweight polypropylene meshes seems to be safe and has comparable outcomes, but limitations may vary.     

轻量型网片可以提高腹腔镜全腹膜外腹股沟疝修补术后的功能结局

前瞻性研究旨在比较腹腔镜全腹膜外腹股沟疝修补术（TEP）中,采用新型轻量型网片和传统重量型网片的差异,所有手术均在同一疝中心完成。方法 自2004年11月到2005年7月,共有250例病人接受了腹腔镜TEP,采用轻量型（Ultrapro,30 g/m2）或重量型网片（Prolene, 100 g/m2）。通过病历资料回顾及电话问卷调查获得随访数据。术后早期及远期均对病人进行随访,以评估术后结局的变化。结果 250例中有188例（75%）获得随访。在术后平均4个月及15个月进行的随访中发现,轻量型网片组和重量型网片组在疼痛或不适感的发生率及程度上没有差别。轻量型网片组在术后早期及远期对体力活动的影响显著小于重量型网片组,尤其是举重（9% vs.21% ,平均随访4个月, Mann-Whitney U, P = 0.024）、行走（1% vs. 11%,平均随访5个月, Mann-Whitney U, P = 0.006）及剧烈运动（7% vs. 19%,平均随访15个月, Mann-Whitney-U, P = 0.012）。腹股沟区的网片感或不适感两组差异无统计学意义。结论 采用轻量型网片行腹腔镜TEP可以改善术后早期及远期的功能结局。轻量型网片可以显著减少对所有体力活动的影响。两者的疼痛都较轻微,表明腹腔镜手术的优势。     

Mechanical Properties,Curing Mechanism,and Microscopic Experimental Study of Polypropylene Fiber Coordinated Fly Ash Modified Cement–Silty Soil

Silty soil has the characteristics of low natural moisture content and poor viscosity, and the strength and deformation required for foundation engineering can be satisfied by reinforcing and improving the silt. In order to study the reinforcement and improvement effects of polypropylene (PP) fiber and fly ash (FA) on cement–silty soil, an unconfined compressive strength (UCS) test, scanning electron microscope (SEM) test, and X-ray diffraction (XRD) analysis test were carried out. Cement (mixed amounts are 4%, 8%, 12%, and 16% of dry soil mass) was used as the basic modifier, and PP fiber (mixed amounts are 0%, 0.15%, 0.3%, and 0.45% of dry soil mass) compounded with FA (adding amounts of 0%, 5%, 10%, and 15% of dry soil mass) were used as an external admixture of cement–silty soil to study the mechanical properties, curing mechanism, and microstructure of the modified soil in different ages of 7 d, 14 d, 28 d, and 60 d. The test results show that with the increase in cement and curing age, the UCS of the modified soil increases, and with the increase in the PP fiber and FA, the UCS of the modified soil first increases and then decreases; there is an optimal content of FA and PP fiber, which are 10 and 0.15%, respectively. A large amount of C-S-H and AFt substances are produced inside the modified soil to cover the surface of soil particles or fill in the pores between soil particles, forming a tight spatial network structure and improving the mechanical properties of the cement–soil. The intensity of the diffraction peaks of the mineral components within the modified soils is more influenced by the cement and age, and the effect of FA is weaker. The stress–strain curve of the modified soil is divided into elastic stage, plastic deformation stage, and strain-softening stage, and the specimens in each stage have corresponding deformation characteristics. By analyzing the behavioral characteristics and curing improvement mechanism of modified soil from the duo perspective of macro-mechanical properties and microstructural composition, it can provide some basis for the engineering application of silty soil.