聚磷酸钙纤维和左旋聚乳酸软骨支架复合自体骨髓间充质干细胞构建组织工程化人工关节软骨

目的应用组织工程学技术，体外初步构建组织工程化人工关节软骨。方法制备三维多孔软骨支架材料CPP／PLLA，体外诱导兔MSCs向软骨细胞表型分化，免疫组织化学染色检测软骨特异性Ⅱ型胶原表达，将诱导细胞与软骨支架材料CPP／PLLA复合，体外培养构建人工关节软骨，1周后终止培养，扫描电镜观察组织工程化人工软骨的微观结构；同时将构建人工软骨移植于兔大腿皮下，3周后处死动物，甲苯胺蓝染色观察。结果扫描电镜观察可见该复合材料CPP／PLLA为高孔隙率的网状、连通、微孔结构，微孔分布均匀，孔径大小为300～400Ⅳn之间；兔MSCs经体外软骨表型定向诱导后，Ⅱ型胶原免疫组化染色阳性。诱导后的MSCs可在支架材料内良好贴附生长，细胞被分泌的胶原基质包裹；从体内获取的培养物组织切片观察可见大量的软骨细胞生成，甲苯胺蓝染色阳性。结论经软骨起源诱导后的MSCs与CPP／PLLA复合培养可以构建自体软骨移植的替代物，为应用软骨组织工程方法修复关节软骨缺损和功能重建提供一种新材料，具有较大的潜在应用价值。     

Usefulness of interposition arthroplasty in the Sauvé–Kapandji procedure for rheumatoid wrist

Abstract

The aim of synovectomy combined with the Sauvé–Kapandji (S–K) procedure for the treatment of a rheumatoid wrist is to obtain a stable painless wrist that retains sufficient mobility for function. However, loss of motion occurs postoperatively in most cases. In our study of 59 rheumatoid patients, the results of the transposition of distal strips of retinaculum into the radiocarpal and ulnocarpal joints for interposition arthroplasty to maintain wrist motion (interposition group), and transposition below the extensors to provide a gliding surface (SK group) were evaluated. The distal end of the ulna was fixed to the radius with poly-L-lactic acid screws, and a proximal strip of retinaculum was placed above the extensors after synovectomy of the rheumatoid wrist. Clinical symptoms, radiographic changes, and postoperative complications were assessed 3–9 years (mean 5.9 years) postoperatively. Patients in the interposition group showed better postoperative results, including wrist motion, than those of patients in the SK group. Both procedures resulted in only minor complications such as superficial skin necrosis, hematoma, and superficial infection. We concluded that interpostion arthroplasty combined with the S–K procedure using a distal strip of retinaculum might be a safe and appropriate method for wrist reconstruction following synovectomy of a rheumatoid wrist.     

先天性心脏病儿童与正常儿童圆顶尖角型T波的比较

摘要： 目的 比较先天性心脏病患儿与超声心动图正常儿童的圆顶尖角型T波在形态及高度上的区别。方法 回顾性分析本院2015年12月—2016年12月间心电图检查出圆顶尖角T波的儿童心电图114例， 根据超声心动图结果分成先天性心脏病组 （先心病组） 71例和超声心动图正常组 （正常组） 43例， 通过测量2组圆顶尖角型T波的高度比较2组圆顶尖角型T波在形态上的区别； 先心病组患者根据先天性心脏病种类不同分组， 比较各组间圆顶尖角型T波的高度。结果 与正常组相比， 先心病组的圆顶尖角型T波的第二峰大于第一峰的比例更高 （52.11% vs. 18.60%）， 且第二峰尖角波高度更高。不同先天性心脏病病种之间圆顶尖角型T波在高度及形态上差异无统计学意义 （P＞ 0.05）。结论 圆顶尖角型T波可出现在先天性心脏病患儿心电图中， 亦可出现在超声心动图正常儿童心电图中， 但先天性心脏病患儿有着更高的尖角T波， 且第二峰高于第一峰。     

三维多孔支架材料PLLA/n-HA的体外生物相容性研究

目的：研究三维多孔支架材料聚乳酸/纳米羟基磷灰石(PLLA/n-HA)的体外生物相容性,探讨其作为细胞培养材料和骨组织工程支架的可行性。方法将大鼠成骨细胞接种于PLLA/n-HA复合支架上,体外共同培养后,CCK-8法检测大鼠成骨细胞增殖活性,荧光倒置显微镜、扫描电子显微镜下观察PLLA/n-HA复合支架材料表面和孔隙内细胞粘附情况。结果 CCK-8法检测显示实验组复合支架材料上细胞的增殖与空白对照组的差异无统计学意义（P>0.05）;电镜观察到细胞在复合支架材料表面和孔隙内大量黏附、生长,并且随着共培养时间的增加,材料表面的细胞数量呈几何级增长。结论三维多孔支架材料PLLA/n-HA的生物相容性较好,可望成为一种性能良好的骨组织工程支架材料。     

Effects of Glycine‐Based Ionic Liquid on Spherulite Morphology of Poly(l‐Lactide)

Crystalline morphology, lamellar assembly, spherulitic growth rate, and physical properties of poly(l ‐lactide acid) (PLLA) modified by a room‐temperature ionic liquid (IL), N‐alkyl‐substituted‐glycine ester [N,N‐dimethyl‐N‐propyl glycine ethyl ester (DMPGlyET)⁺] bis(fluoromethanesufonyl)imide [TFSI^?], are investigated by using polarized optical microscopy, optical microscopy, differential scanning calorimetric, and atomic‐force microscopy. Thermal analyses and in situ microscopy characterization reveal the PLLA/IL mixture with upper‐critical‐solution‐temperature behavior. Crystalline morphology of PLLA is significantly changed by the addition of IL to display massive diversification of spherulites morphology which has never been reported before in neat PLLA or PLLA blends with polymers. The morphological change and diversifications in PLLA/IL mixture are associated with strong interactions between PLLA and IL, which impede the melt crystallization of PLLA and tend to form PLLA nuclei of various geometry shapes. In addition, neat PLLA is generally brittle with extensive crack formation during postcrystallization cooling process; however, with the addition of IL, cracks are reduced or diminished entirely, potentially to enhance the performance and properties of PLLA.

     

Star-shaped PCL/PLLA blended fiber membrane via electrospinning

Electrospun fiber mesh has been a candidate for guided bone regeneration membrane. However, its poor mechanics property has been limited in clinical application. In this study, various star-shaped poly(ε-caprolactones) (PCLs) are successfully synthesized by ring-opening polymerization and mixed with poly(l-lactide) (PLLA) to be made into blended membranes through electrospinning. Their corresponding properties are evaluated including morphology, thermodynamics, mechanics, and cytotoxicity. The blended fibers show smooth surface and well-distributed structure, which have slight differences in morphology with the change of arm number of star-shaped PCL. Crystallization of the fibrous membrane is influenced by star-shaped PCLs. Glass temperature drops from 64.23 °C for pure PLLA membrane to 53.62–49 °C for the blended membranes. The membranous tensile strength is depended strongly on star-shaped PCLs. The tensile strength goes up with arm number increasing; on the contrary, at the same arm number, the mechanics strength decreases with molecular weight increasing. And the fibrous membrane containing 20 wt.% star-shaped PCL shows better mechanics property compared to the other membranes. The star-shaped PCL/PLLA fiber membrane is not cytotoxicity.     

Fabrication of Nano-fibrous PLLA Scaffold Reinforced with Chitosan Fibers

In this study, a nano-fibrous PLLA scaffold reinforced by micro-scale chitosan fibers was fabricated using thermally-induced phase separation (TIPS). The morphology, porosity, mechanical performance and pH changes in in vitro degradation of the scaffold were also investigated. Results showed that the mechanical properties of the scaffold increased with the amount of chitosan fibers embedded, and the pH in in vitro degradation of the scaffold changed more slowly than that of the pure nano-fibrous PLLA scaffold without chitosan fibers. The new composite scaffold might be a very promising scaffold for tissue engineering.     

Preparation and properties of poly(L-lactide)/hydroxyapatite composites

In this study, two different viscosity-average molecular weight (η = 4.0 and 7.8) poly(L-lactide) (PLLA) were synthesized by ring-opening polymerization and the poly(L-lactide)/hydroxyapatite composites (PLLA/HA) were prepared by blending HA particles (size range: 25-45 μm and Ca/P = 1.69) with a content of 10, 30, and 50 wt% in PLLA solution with further evaporation of the solvent. The plain PLLA polymers and PLLA/HA composites were compressionmolded and machined to yield 25×3×2 mm3 specimens. The molar mass of resulting specimens was decreased drastically due to the hydrolytic and thermal degradation of ester bonds. Scanning electron microscopy and thermal gravimetric results indicated that the compositions of HA in PLLA were well dispersed. With increasing HA content, the crystallinity of PLLA/HA composites are slightly increased due to the effect of HA as a nucleating agent. The dynamic mechanical analysis is useful in studying the viscoelastic behaviour of the PLLA/HA composites and no secondary relaxation was observed below the glass-to-rubber transition (60°C). The mechanical properties of the PLLA/HA composites were found to vary with HA content. Increased levels of HA resulted in increased bending modulus and strength.     

Effect of gamma,ethylene oxide,electron beam,and plasma sterilization on the behaviour of SR-PLLA fibres in vitro

- The aim of this study was to evaluate the effect of various sterilization processes on the physical and mechanical properties of self-reinforced bioabsorbable fibres made out of polylactide (PLLA). The samples were sterilized using plasma, ethylene oxide (one and two cycles), gamma (25 kGy at room temperature, 25 kGy in dry ice, and 2 × 25 kGy at room temperature), and electron beam (15, 25, and 55 kGy) sterilization. The intrinsic viscosity, crystallinity, and mechanical properties (modulus of elasticity, yield strength, and ultimate tensile strength) were tested before and immediately after each sterilization treatment, as well as up to 30 weeks in vitro. Compared with unsterilized fibres, the intrinsic viscosity was markedly decreased after radiation sterilization (gamma and electron beam) and the loss in mechanical properties was accelerated during in vitro degradation. Plasma and ethylene oxide (one and two cycles) did not markedly alter the properties of the samples after sterilization or during in vitrodegradation. These data are important for determining the effect of various sterilization processes on the physical and mechanical properties of polylactidebased materials and can be used to predict how fast degradation of the mechanical properties of the self-reinforced PLLA will occur. They can also be used to tailor the degradation kinetics to optimize implant design.