3D printed polyetheretherketone material for skull defect repair北大核心

BACKGROUND: During cranioplasty, the postoperative effects of different cranial repair materials are different, and the occurrence of postoperative complications is also quite different. OBJECTIVE: To study the clinical effect of 3D printed polyetheretherketone material in cranioplasty. METHODS: 112 patients with skull defect admitted to The First Affiliated Hospital of Bengbu Medical College from February 2016 to August 2020, including 67 males and 45 females, were selected and subjected to cranioplasty. The patients were divided into polyetheretherketone group (n=36) and titanium mesh group (n=76). Postoperative follow up was conducted to observe the occurrence of complications in the two groups, including subcutaneous effusion, hydrocephalus, epidural or subdural hematoma, poor wound healing, implant leakage, or infection. RESULTS AND CONCLUSION: (1) The patients in the polyetheretherketone group and titanium mesh group were followed up for (14.64±2.39) and (15.49±2.17) months after surgery, respectively, and there was no significant difference between the groups (P > 0.05). There were no patients with implant failure due to implant material in either group. (2) Complications occurred in 33 patients in the titanium mesh group, including 1 case of hydrocephalus, 9 cases of subcutaneous fluid, 3 cases of epidural/subhematoma, 13 cases of poor wound healing, and 3 cases of implant exposure, and 4 cases of intracranial infection. The complication rate was 43.4%. Totally 10 patients in the polyetheretherketone group had complications, including 6 cases of subcutaneous effusion, 1 case of epidural/subhematoma, and 2 cases of poor wound healing, and 1 case of intracranial infection; the complication rate was 27.8%. There was no significant difference in the total postoperative complication rate between the two groups (P > 0.05), but the incidence of poor wound healing/implant exposure was significantly different (P < 0.05). (3) It is concluded that 3D printed polyetheretherketone repair material has good biocompatibility, safety and accuracy in the application of skull defect repair. Compared with titanium mesh repair material, polyetheretherketone has a better advantage in wound healing. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

降钙素增强双膦酸盐对绝经后骨质疏松患者慢性腰背痛缓解及生活质量改善的作用

BACKGROUND: Salmon calcitonin or elcatonin has been reported to alleviate acute and severe back pain caused by osteoportic fracture. OBJECTIVE: To evaluate the effects of the combined use of elcatonin and risedronate in the treatment of chronic back pain and the improvement of quality of life in postmenopausal women with osteoporosis. METHODS: Forty-five postmenopausal women with osteoporosis accompanied by chronic back pain persisting for more than 3 months, after excluding women with fresh vertebral fractures within the last 6 months, were randomly assigned to a risedronate group (administration of risedronate alone, n=22) and a combined drug group (combined administration of risedronate and elcatonin, n=23). Pain was evaluated using a visual analogue scale (VAS) and the Roland-Morris questionnaire. Bone mineral density was determined by dual-energy X-ray. Quality of life was assessed using the Medical Outcomes Study 36-Item Short-Form (SF-36) at 6 months after treatment. RESULTS AND CONCLUSION: There were 20 and 19 cases in the risedronate and combined drug groups, respectively included in the final analysis. Significant improvements were found in the combined drug group for VAS and mental health status section scores in the SF-36 at final follow-up compared with baseline and 3-month follow-up, while no change was found in the risedronate group. Bone mineral density was increased significantly in both groups, while no significant difference was found between groups. These findings suggest that the use of elcatonin in addition to risedronate for more than 3 months may reduce chronic back pain in osteoporosis patients. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

富血小板血浆修复膝关节骨关节炎

BACKGROUND: Platelet-rich plasma (PRP) containing high levels of platelet-derived growth factor for knee osteoarthritis has achieved good clinical results; however, the effects of RPR on the repair of damaged articular cartilage are still controversial. OBJECTIVE: To study the effects of RPR on the repair of damaged articular cartilage in a rabbit model of knee osteoarthritis. METHODS:The model of osteoarthritis in the rabbit right knee was established by Hulth’s method. Autologous PRP (0.5 mL) (PRP group), sodium hyaluronate (0.5 mL) (sodium hyaluronate group), and normal saline (model group) were injected into the right knee joint cavity, respectively. The morphology of articular surface and nitric oxide contents in knee joint fluid were observed and determined at 8 weeks after surgery. RESULTS AND CONCLUSION: The morphology of articular cartilage in the PRP group was better than that in the other three groups. Mankin scores of articular cartilage and nitric oxide contents of knee joint fluid in the PRP group were significantly decreased compared with the model and sodium hyaluronate groups that in (P < 0.05), while increased compared with the sham-operation group (P < 0.05). Our results suggest that repair effects of PRP on the damaged articular cartilage are superior to sodium hyaluronate treatment. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Surgical approaches for stage Ⅰ and Ⅱ thymoma-associated myasthenia gravis:feasibility of complete video-assisted thoracoscopic surgery (VATS) thymectomy in comparison with trans-sternal resection

Complete resection could be achieved in virtually all myasthenic patients with Masaoka stage Ⅰ and Ⅱ thymoma using the trans-sternal technique.Whether this is appropriate for minimally invasive approach is not yet clear.We evaluated the feasibility of complete video-assisted thoracoscopic surgery (VATS) thymectomy for the treatment of Masaoka stage Ⅰ and Ⅱ thymoma-associated myasthenia gravis,compared to conventional trans-sternal thymectomy.We summarized 33 patients with Masaoka stage Ⅰ and Ⅱ thymoma-associated myasthenia gravis between April 2006 and September 2011.Of these,15 patients underwent right-sided complete VATS (the VATS group) by using adjuvant pneuomomediastinum,comparing with 18 patients using the trans-sternal approach (the T3b group).No intraoperative death was found and no VATS case required conversion to median sternotomy.Significant differences between the two groups regarding duration of surgery and volume of intraoperative blood loss (P=0.001 and P < 0.001,respectively) were observed.Postoperative morbidities were 26.7% and 33.3% for the VATS and T3b groups,respectively.All 33 patients were followed up for 12 to 61 months in the study.The cumulative probabilities of reaching complete stable remission and effective rate were 26.7% (4/15) and 93.3% (14/15) in the VATS group,which had a significantly higher complete stable remission and effective rate than those in the T3b group (P=0.026 and P=0.000,respectively).We conclude that VATS thymectomy utilizing adjuvant pneuomomediastinum for the treatment of stage Ⅰ and Ⅱ thymoma-associated myasthenia gravis is technically feasible but deserves further investigation in a large series with long-term follow-up.     

Renal arterioles in patients with type I diabetes and microalbuminuria before and after treatment with antihypertensive drugs

 Antihypertensive drugs can slow or even reverse the progression of diabetic nephropathy at the microalbuminuric stage. This study was performed to obtain quantitative data on changes in the renal arterioles in a follow-up study. Twelve patients with type I diabetes and with microalbuminuria were allocated to treatment for 3 years with either an ACE inhibitor (group I, 6 patients) or a beta blocker (group II, 6 patients). Baseline and follow-up renal needle biopsy specimens were taken and serially sectioned at 1 μm for light microscopy, enabling identification of arterioles as afferent or efferent. Thin sections for electron microscopy were made at 50-μm intervals, and micrographs were taken of arteriolar profiles. Matrix volume fraction of the media and a calculated matrix thickness were obtained. At baseline, structural parameters were higher than normal values. At follow-up all patients were normoalbuminuric. Both groups showed only minor changes in arteriolar structures over 3 years. In the afferent arterioles in group II there was a significant increase in the matrix volume fraction of the media, and there was a tendency to an increase in matrix thickness in both groups. In the efferent arterioles there were no significant changes in parameters. There were no differences between the two groups in arteriolar structural changes from baseline to follow-up. Thus, this study shows a slight but significant matrix accumulation in the afferent arterioles during treatment with antihypertensive drugs. This may have implications for the progression to overt nephropathy, which indicates a need for more long-term studies of treatment with antihypertensive drugs in incipient nephropathy in type I diabetes. Received: 29 September / Accepted: 19 January 1999     

羟基磷灰石-骨形态发生蛋白复合人工听小骨与同种异体软骨听骨赝复物修复听骨链损伤的比较

BACKGROUND:There is a great dispute on the choice of repair materials for ossicular chain damage. OBJECTIVE: To explore the effects of new hydroxyapatite-bone morphogenetic protein ossicular prosthesis versus allogeneic cartilage ossicular prosthesis in patients with ossicular chain damage. METHODS: Sixty patients with chronic otitis media were equally assigned into a control group and a test group. Two groups of patients underwent tympanoplasty and ossicular chain reconstruction with allogeneic cartilage ossicular prosthesis or hydroxyapatite-bone morphogenetic protein ossicular prosthesis, respectively. Twelve months after surgery, follow-up results were compared between two groups. RESULTS AND CONCLUSION: Air conduction value and air-bone gap value were both improved significantly in the two groups after surgery (P < 0.05), and especially, the postoperative air conduction value was better in the test group than the control group (P < 0.05). Implant detachment was found in three cases of the control group, whereas did not occur in the test group. Improved hearing was found in 28 cases in the test group with an improvement rate of 93% and 25 cases in the control group with an improvement rate of 83%. There was a significant difference in the hearing improvement between the two groups (P < 0.05). Overall, two kinds of prostheses can share similar effects on the ossicular chain repair. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Diffuse distribution of bone cement in percutaneous vertebroplasty reduces the incidence of refracture of adjacent vertebral bodies北大核心

BACKGROUND: Percutaneous vertebroplasty is one of the effective treatments for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will influence the clinical efficacy. OBJECTIVE: To investigate the influence of the distribution of bone cement in percutaneous vertebroplasty on the early postoperative outcomes after osteoporotic vertebral compression fractures. METHODS: A total of 132 patients, including 52 males and 80 females, with a mean age of (76.3±8.2) years who diagnosed as osteoporotic vertebral compression fractures in First Hospital of Shanxi Medical University from January 2017 to June 2019 were enrolled. All patients were divided into underdispersion group (n=54) and diffuse distribution group (n=78) according to the pattern of cement distribution on postoperative X-rays. Visual analogue scale scores postoperatively, the height of anterior edge and midline of injured vertebrae, Cobb angle of local kyphosis and the incidence of complications after 1-year follow-up were compared between the two groups. The trial was performed in accordance with the relevant ethical requirements for research in the First Hospital of Shanxi Medical University. RESULTS AND CONCLUSION: (1) The visual analogue scale scores were lower at 2 days, 1 and 6 months after operation than those before operation in the two groups (P < 0.05). The visual analogue scale scores at 1 month after operation in the underdispersion group were higher than those in the diffuse distribution group (P < 0.05), and there was no significant difference between the two groups at 2 days and 6 months after operation (P > 0.05). (2) Cobb angle and vertebral body height improved in both groups postoperatively compared to preoperatively (P < 0.05). The difference in Cobb angle and vertebral body height was not statistically significant between the two groups (P > 0.05). (3) The rate of bone cement infiltration was not significantly different between the two groups (P > 0.05). Incidence of recurrent fractures in adjacent vertebrae was lower in the diffuse distribution group than that in the underdispersion group (P < 0.05). (4) These findings confirm that percutaneous vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will affect the surgical results. The bone cement is diffusely distributed, which may reduce the incidence of recurrent fractures in adjacent vertebrae. © 2022, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

颈项透明层增厚胎儿的临床结局分析

Objective To study the clinical outcome of fetus with thickened nuchal translucency,and to explore the clinical value of ultrasonography in testing nuchal translucency (NT) thickness for evaluating fetal prognosis. Methods NT test was routinely performed in 4081 fetuses between 11- 13+6 weeks of gestation and with head-buttock length between 45-84 mm. Fetuses would be taken with thickened NT if NT thickness≥2.5 mm. The clinical outcome of fetuses with NT thickness was followed up. The NT thickness was classified into four groups (Group A: 2.5-3.4 mm, Group B: 3.5-4.4 mm, Group C: 4.5-5.4 mm and Group D: 5.5-6.4 mm). Ridit analysis was used for comparing the clinical outcomes of fetuses with various NT thickness, and rank correlation analysis was applied for analyzing correlation of NT thickness with fetuses survival rate. Results Thickened NT was observed in 58 fetuses by ultrasound, of whom, NT≥6.5 mm appeared in 6, and these 6 cases were aborted during early pregnancy. The other 52 cases had NT ＜6.5 mm, 4 of whom had chromosomal abnormalities, 10 cases were with normal chromosomes but accompanied by malformation or genetic syndrome, 1 case ceased development in the first trimester, no abnormity to birth was observed in other 33 cases and 4 cases lost follow up. The clinical outcomes in fetus with various NT thickness had significant differences (P＜0.05). Survival rate of fetuses decreased as NT thickened [Group A: 81.8% (27/33), Group B: 62.5%(5/8), Group C: 25% (1/4), Group D: 0% (0/3),r=-0.993, P＜0.05 ]. Conclusion Ultrasonography for testing NT thickness is an important reference value for making early evaluation on prognosis of fetuses in clinical.     

Comparison of two kinds of tendon fixation in arthroscopy for treating proximal lesions of long head of biceps tendons北大核心

BACKGROUND: For young patients with proximal lesions of long head of biceps tendons with high requirements for upper limb movement, the commonly tendon fixation includes interface extrusion screw fixation and suture anchor ligation fixation. At present, there are few clinical reports and no conclusion on the comparison of the clinical efficacy of the two. OBJECTIVE: To compare the clinical efficacy of proximal lesions of long head of biceps tendons by interface extrusion screw fixation and suture anchor ligation fixation in arthroscopy. METHODS: Totally 52 patients with proximal lesions of long head of biceps tendons treated in Nanchang Hongdu Hospital of TCM from January 2019 to December 2020 were enrolled and randomly divided into interface extrusion screw group (n=29) and suture screw group (n=23). The patients in both groups were subjected to interface extrusion screw fixation and suture anchor ligation fixation in arthroscopy, respectively. Before, 1, 3, 6, and 12 months after operation, and during last follow-up, shoulder visual analog scale score, the American shoulder and elbow surgeons score, and range of motion in anterior flexion of shoulder and internal and external rotation at elbow flexion 90° were compared between the two groups. Elbow flexion muscle strength, reoperation rate and complication rate (Popeye sign) were compared between the two groups at the last follow-up. RESULTS AND CONCLUSION: The visual analog scale scores, the American shoulder and elbow surgeons score and shoulder range of motion in anterior flexion of shoulder and internal and external rotation at elbow flexion 90° were significantly improved after operation compared with those before operation in both groups (P < 0.05). There were no significant differences in visual analog scale scores, the American shoulder and elbow surgeons score and shoulder range of motion in anterior flexion of shoulder and internal and external rotation at elbow flexion 90° between the two groups before and at various time points after operation (P > 0.05). At the last follow-up, the elbow flexion muscle strength of the two groups reached above grade IV, and the results showed no significant difference. Popeye syndrome occurred in the interface extrusion screw group (14%) and reoperation was performed (7%). In the suture screw group, the incidence of Popeye sign was 4.3% and the reoperation rate was 0%. The incidence of Popeye sign and the reoperation rate were not significantly different between the two groups (P > 0.05). For the proximal lesion of long head of biceps tendons, both the interface extrusion screw fixation and the suture anchor ligation fixation in the arthroscopy can effectively relieve shoulder pain and improve shoulder function within one year and the clinical effects of the two methods are equivalent. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

急性脊髓损伤动物模型的建立与评估

BACKGROUND: There are a variety of methods for modeling spinal cord injury at home and abroad, showing their own advantages and disadvantages, but not yet a kind of objective and standardized model meeting the clinical research. OBJECTIVE:To design a simple impactor used for establishing the spinal cord injury model, then to evaluate the parameters and stability of the Allen’s spinal cord injury model through comparing with the New York University (NYU) impactor established model. METHODS: Female rats were equivalently allotted into five groups: sham-operation group (group A), self-made impactor 5 and 10 cm groups (group B1 and B2) and NYU 1.25 and 2.5 cm groups (group C1 and C2). All groups except group A were subjected to striking at different heights. Behavioral scores were detected at 1, 3, 5 and 7 days after modeling. Nissl staining was used to observe the morphological changes after freezing section and semiquantitative analysis. RESULTS AND CONCLUSION:(1) At the same time point, the behavioral scores, damaged area ratio of spinal cord and semiquantitative analysis of dorsal horn neurons showed significant differences in the group A compared with the other groups, also between groups B1 and B2, and groups C1 and C2 (P < 0.05), but no significant differences were found between groups B1 and C1, as well as groups B2 and C2 (P > 0.05). (2) In the group A, there was a clear boundary between the grey and white matter in a butterfly shape, numerous neurons with large nucleus and obvious nucleolus, and plaques or tabby of Nissl body appeared in the cytoplasm. In contrast, in the other four groups, there were few neurons, different degrees of Gore focal, swelling, demyelinating, and vacuole of cellula could be found, and Nissl body was fuzzy or disappeared. These results administrate that the self-made impactor can establish different damage degrees of spinal cord inury models, which are close to the NYU-made models. Moreover, it can be helpful for study on spinal cord injury for reasons of good stability, low cost, and operated easily. 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程