血管内支架表面生物涂层材料与血管内再狭窄

背景：心脏病是威胁人类健康的首要病因之一,现在全世界每年大约有1 500万例冠心病患者需要接受经皮穿刺冠状动脉(冠脉)成形治疗,但是大约10%发生急性或亚急性冠脉阻塞,6个月后再狭窄发生率高达20%~50%,再狭窄已成为制约经皮穿刺冠状动脉(冠脉)成形术发展的最主要因素。 目的：探讨药物洗脱支架治疗支架内再狭窄的长期临床效果。 方法：作者以“药物洗脱支架,阻塞,再狭窄”为检索词,在中国期刊全文数据库中,采用电子检索的方式进行文献检索。排除Meta分析及重复性研究,共检索到25篇文献,从支架置入治疗进展,不同材料及类型支架对开通率、开通时间的影响,以及预防支架狭窄等方面进行探讨。 结果与结论：药物洗脱支架运用先进的支架载药及药物控制释放技术,在支架机械支撑病变血管的同时,具有抑制血管平滑肌细胞增生的药物从支架表面缓慢释放,作用于与支架接触的血管壁,解决了血管弹性回缩、重塑以及内膜的过度增生问题。随着冠状动脉介入治疗设备的改进和创新,药物涂层支架技术也在不断地成熟和发展。目前新出现的药物涂层支架设计理念是建立在药物筛选和可控释放系统基础上的。相信未来的药物涂层支架将能够应用于更多的血管复杂病变(尤其是静脉和多血管损伤)以及其他脏器疾病。     

Influence of surface microroughness by plasma deposition and chemical erosion followed by TiO2 coating upon anticoagulation, hydrophilicity, and corrosion resistance of NiTi alloy stent

Two different surface modification techniques were used to change the surface morphology and roughness of stents at the micrometer level, and eventually improve their surface adhesion properties with respect to endothelial cells. One was chemical erosion followed by sol-gel TiO(2) coating, and the other was low temperature gas plasma deposition. After surface modification, the biocompatibility including the anticoagulation properties, hydrophilicity, and corrosion resistance of these stents was evaluated. It was found that both techniques could change the surface morphology of the stents with microroughness. In comparison with the control, the treated NiTi alloy intravascular stents showed increased surface hydrophilicity and enhanced anticoagulation properties. However, the corrosion properties of the stents were not improved significantly.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

表面磁性膜医用316L不锈钢支架的生物相容性

目的 对表面磁性膜血管内支架进行生物相容性研究,为该支架的临床应用提供实验依据.方法 通过溶血实验、动态凝血时间实验、急性全身毒性实验、皮内刺激实验、细胞毒性实验、热源实验、过敏实验、体内植入实验综合评价表面磁性膜血管内支架的生物相容性.结果 表面磁性膜血管内支架无溶血反应及凝血功能的改变,无急性全身毒性反应,无热源反应,支架材料中不存在致敏性物质;支架材料动物体内植入在初期有轻度的炎性反应,12周后炎性反应基本消失,未见炎性细胞浸润积聚现象.结论 表面磁性膜血管内支架具有良好的生物相容性,其应用于临床具有可行性和安全性.     

Electrochemical studies on the stability and corrosion resistance of titanium-based implant materials

The corrosion susceptibility of Ti, Ti-6A1-4V and Ti-45Ni was studied in a buffered saline solution using anodic polarisation and electrochemical impedance measurements. Pitting potentials as low as + 250 mV(SCE) were recorded for Ti-45Ni and once initiated pits continued to propagate at potentials as low as -150 mV(SCE). It was possible to increase the pitting potential of Ti-45Ni to values greater than +800 mV(SCE) using a H2O2 surface treatment procedure; however, this surface modification process had no beneficial effect on the rate of pit repassivation. Impedance spectra, recorded under open-circuit conditions, were modelled using a dual oxide film model; a porous outer layer and an inner barrier oxide layer. The nature of this porous outer layer was found to depend on the nature of the electrode material and the presence of phosphate anions in the saline-buffered solution. The porous layers formed on Ti-45Ni and Ti-6Al-4V in the presence of phosphate anions had low resistances typically between 10 and 70 ohm cm2. Much higher porous layer resistances were recorded for Ti and also for Ti-45Ni and Ti-6Al-4V in the absence of the phosphate anions.     

Enhancing biocompatibility and corrosion resistance of Mg implants via surface treatments

Oxide coating layers were formed on a pure magnesium (Mg) substrate through anodization and micro-arc oxidation (MAO) in order to enhance the biocompatibility and reduce the degradation rate. A thin, smooth MgO coating layer was formed after the anodization. On the other hand, when the Mg was treated using the MAO process, a relatively thick, rough MgO layer was formed. The corrosion properties were investigated using electrochemical and ion release tests in a simulated body fluid. Both the anodization and the MAO treatment enhanced the corrosion resistance of the Mg specimens. However, the MgO layers that formed on the surface were not stable enough to render favorable environments for cell growth. The anodized and MAO-treated specimens were post-treated in a cell-culturing medium in order to improve the stability of the coating layer. The biocompatibility was evaluated using in vitro cell tests, including cell attachment, DNA measurement, and alkaline phosphatase (ALP) activity tests. The DNA levels of the surface-treated Mg were about 6-10 times higher than the bare Mg. The ALP activity levels were also more than double after either the anodization or the MAO followed by the post-treatments. These results demonstrated that the biocompatibility and the corrosion resistance of Mg were significantly improved by the series of surface treatments.     

Antibacterial properties and corrosion resistance of Cu and Ag/Cu porous materials

The porous materials of Cu and Ag/Cu were successfully prepared by the electrodeposition on a precursor of conventional polyamide foam. The microstructure of the porous materials was observed by scanning electron microscope. Their porosity and specific surface area were measured. The inhibition effect of Cu porous materials against E. coli was also investigated. The broad-spectrum of antibiosis of the Cu and Ag/Cu porous materials were characterized. The corrosion resistance of Cu, Ag/Cu coatings was also compared. The shape and size of pores are uniform in three directions for the porous materials. Their porosity may reach above 95% and specific surface area is beyond 12.8 m(2)/m(3). The antibacterial test results show that the Cu porous materials not only exhibited high antibacterial effect and good broad-spectrum antibacterial properties, but also excellent persistent antibacterial effects; the antibacterial effects, and broad-spectrum of antibiosis were greatly improved through the deposition of a thin Ag coating on the surface of Cu porous material.     

Influence of Nitinol wire surface treatment on oxide thickness and composition and its subsequent effect on corrosion resistance and nickel ion release

Medical implants and devices are now used successfully in surgical procedures on a daily basis. Alloys of nickel and titanium, and in particular Nitinol are of special interest in the medical device industry, because of their shape memory and superelastic properties. The corrosion behavior of nitinol in the body is also of critical importance because of the known toxicological effects of nickel. The stability of a NiTi alloy in the physiological environment is dependant primarily on the properties of the mostly TiO(2) oxide layer that is present on the surface. For the present study, a range of nitinol wires have been prepared using different drawing processes and a range of surface preparation procedures. It is clear from the results obtained that the wire samples with very thick oxides also contain a high nickel content in the oxide layer. The untreated samples with the thicker oxides show the lowest pitting potential values and greater nickel release in both long and short-term experiments. It was also found that after long-term immersion tests breakdown potentials increased for samples that exhibited lower values initially. From these results it would appear that surface treatment is essential for the optimum bioperformance of nitinol.     

Composition of surface oxide film of titanium with culturing murine fibroblasts L929

Changes in the composition of surface oxide film on titanium specimens in the presence of amino acids, serum proteins, and cells were characterized using X-ray photoelectron spectroscopy. The surface oxide film on titanium formed in the air is so protective that the further oxidation of titanium is prevented in various circumstances. During immersion of the specimen in Hanks' solution, Eagle's minimum essential medium (MEM), and MEM with the addition of fetal bovine serum (MEM+FBS), calcium phosphate precipitated, causing the increase in thickness of the surface oxide film. Calcium phosphate was also precipitated with culturing murine fibroblast L929, but the amount of the calcium phosphate was smaller than those in Hanks' solution, MEM, and MEM+FBS. The relative concentration ratio of calcium to phosphorous, [Ca]/[P], increased with proteins charging negatively, while the ratio decreased with the cells whose extracellular matrix charging positively. In addition, sulfur precipitated as S(0) and/or S(2-) only with culturing the cells. Sulfate ions in the MEM+FBS are reduced at the interface between titanium and the solution with the existence of cells.     

Increased expression of surface activation markers on neutrophils following migration into the nasal lumen

BACKGROUND : The sequence of events following the recruitment of a free-flowing neutrophil in the peripheral circulation, via adhesion, migration and release of mediators, to a neutrophil on the surface of the nasal epithelium is a co-ordinated process. Little is known about the state of neutrophil activation following this course of events. OBJECTIVES : To investigate the expression of surface activation markers on neutrophils, reflecting activation during their recruitment to the nose, and to see whether the inflammatory process during allergic rhinitis influences this process. METHOD : Nine healthy controls and 12 patients with grass pollen-induced intermittent allergic rhinitis were investigated during the peak of the pollen season. The expression of CD11b, CD66b and CD63 on the neutrophil cell surface, as a reflection of activation, was analysed using flow cytometry. Neutrophils were derived from peripheral blood and nasal lavage fluid. In addition, eosinophil cationic protein (ECP) and myeloperoxidase (MPO) as well as L-, P- and E-selectins in the nasal lavage fluid were analysed using RIA and ELISA, respectively. RESULTS : A marked increase in the expression of all three CD markers on the neutrophil cell surface was noticed following migration from the bloodstream to the surface of the nasal mucosa. At the peak of the grass pollen season, the MPO levels increased, reflecting an increase in the total number of nasal fluid neutrophils. In parallel, the expression of CD11b was further augmented. The expression of the CDb11b was reduced on neutrophils remaining in the circulation. In addition, the level of L-selectin was reduced on neutrophils derived from the blood during allergic inflammation. CONCLUSION : Neutrophils might become activated during their transfer from the blood to the surface of the nasal mucosa, but these changes may also be due to depletion of activated neutrophils in the blood via activated endothelial/epithelial adhesion and chemoattractant measures. The increased expression of surface activation markers during allergic rhinitis suggests roles for neutrophils in the inflammatory process.     

Rapid determination of intraepithelial resistance barriers by alternating current spectroscopy

The impedance of Necturus gallbladder epithelium was measured with transepithelial and intracellular microelectrodes in different transport states. The data are analysed with five electrical equivalent circuits, which differ with respect to the configuration of the paracellular shunt path (lumped vs distributed model of the lateral space), and of the apical cell membrane (non-ideal capacitance or surface amplification by micro-tubular infoldings). Least square fits indicate: 1. that the lumped model cannot represent the epithelium properly, even under control conditions; 2. that the distributed model, which considers the lateral intracellular space separately as a cable-like structure, describes the data well, both under control conditions and during collapse of the lateral spaces; and 3. that the above indicated variations of the apical membrane configuration improve the fits, but have little effect on the magnitude of the calculated circuit parameters. Quantitatively the analysis of 214 measurements on 25 gallbladders under control conditions yields the following results: The resistances of the tight junctions, of the lateral intercellular space, and of the apical and basal cell membrane areR _j=123,R _lis=35.5,R _a3,500, andR _b=225 (all in cm²), and the capacitances of the cell membranes areC _a=4.95 andC _bl=26.5 (F/cm²). In oxygen deficiency and after cessation of chamber perfusion transport decreased, the spaces collapsed, and R _lis increased to 130 cm². Although the accuracy of the estimatedR _a values is still limited, the analysis shows that it is possible to determineR _j andR _lis separately and to follow their changes in response to experimental maneuvers.This work was in part supported by the Deutsche Forschungsgemeinschaft     

Rapid determination of intraepithelial resistance barriers by alternating current spectroscopy

A method has been developed to determine rapidly and simultaneously the resistance of the tight junctions, the resistance of the lateral intercellular space, and the resistances and capacitances of the apical and basolateral cell membrane in leaky epithelia by alternating current spectroscopy. The present paper describes the experimental procedures. Multi-frequency sine-wave currents are simultaneously applied across the tissue and the transepithelial and intracellular voltage responses are recorded with shielded microelectrodes, digitized, and stored in a computer. Using Fast Fourier Transform techniques the frequency-dependent transepithelial impedance and an apparent basal cell membrane impedance are then calculated from the voltage and current waveform. By fitting appropriate model circuits to the data the above listed individual resistances can be deduced. The model calculations and the fit results are described in the subsequent paper [14]. In the present design the analysis covers the frequency range between 2.5 Hz and 12.5 kHz. The minimal measuring time is in the order of 1-2s.