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    17 December 2015, Volume 19 Issue 52 Previous Issue    Next Issue
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    Relationship of bone cement injection volume with the stress of osteoporotic compression fractured and adjacent vertebrae
    Bao Yong-zheng, Zhu Zhou-xing, Feng Yun-sheng, Wu Qiang, Hu Kong-he, He Xiao-long
    2015, 19 (52):  8365-8372.  doi: 10.3969/j.issn.2095-4344.2015.52.001
    Abstract ( 284 )   PDF (3073KB) ( 282 )   Save

    BACKGROUND: Vertebroplasty and kyphoplasty can effectively repair osteoporotic vertebral compression fractures, but postoperative change of stress in the fractured vertebrae and adjacent vertebrae can lead to new fractures.
    OBJECTIVE: To analyze the stress changes of the fractured and adjacent vertebrae with different bone cement injection volume by three-dimensional finite element method.
    METHODS: One healthy adult male volunteer was selected for lumbar spine CT scan. The acquired images were 
    imported for three-dimensional reconstruction using Mimics. The three-dimensional model was smoothed, polished and denoised by Geomagic software, and then the solid mode was built under Workbench Ansys. The osteoporotic vertebral compression fracture model in L2-L4 segments was established after assignment. Bone cement of 1, 2, 4, 6 mL was injected into the L3 vertebrae respectively and distributed in the middle of the vertebrae as spherical shape. 500 N pre-load was applied on L2 surface with an additional moment of 50 N•m. The lower surface free degree of L4 was restrainted. The L2-L4 forward flexion, extension, right flexion and axial rotation on the right side were stimulated to compare the stress changes of fractured vertebrae and adjacent vertebrae before and after the bone cement injection with different volume.
    RESULTS AND CONCLUSION: The stresses of fractured and adjacent vertebrae after the bone cement injection were significantly increased; meanwhile, the stresses of fractured and adjacent vertebrae increased with the increase of bone cement injection volume, which may be one of the factors leading to the compression fractures of adjacent vertebrae. 

     

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    Cemented artificial femoral head arthroplasty treats elderly unstable intertrochanteric fracture 
    Cheng Shi-gao, Wang Wan-chun, Xiao Yang, Huang Tun-sheng, Xie Zhong
    2015, 19 (52):  8373-8378.  doi: 10.3969/j.issn.2095-4344.2015.52.002
    Abstract ( 243 )   PDF (3614KB) ( 228 )   Save

    BACKGROUND: Many studies have suggested that artificial joint replacement has a greater advantage in the treatment of cases of elderly osteoporosis, comminuted fractures and unable to internal fixation or failure of internal fixation.
    OBJECTIVE: To analyze the curative effect of cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture.
    METHODS: Totally 18 patients with unstable intertrochanteric fracture, aged > 75 years, were enrolled and underwent cemented artificial femoral head arthroplasty. At 3 months after replacement, the curative effect was evaluated according to the Harris hip joint function score method. The early complications after replacement and long-term complications of prosthesis were observed by follow-up.
    RESULTS AND CONCLUSION: All these 18 patients were followed up for 13 to 34 months, and had no infections, pressure sores, femoral shaft fractures and other complications. X-ray films showed that the frauture healed well, without prosthesis infection, dislocation, loosening, sinking and breaking. After 3 months of replacement, all patients returned to pre-injury level of walking function. The curative effect was excellent for eight cases, good for seven cases, fair for two cases, poor for one case. These results demonstrate that cemented artificial femoral head arthroplasty for treatment of elderly unstable intertrochanteric fracture has good biocompatibility and stability, and can restore the limb function of patients. 

     

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    Polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold repairs laryngeal cartilage defect
    Liu Yong-gang, Zhou Xiang-tao
    2015, 19 (52):  8379-8383.  doi: 10.3969/j.issn.2095-4344.2015.52.003
    Abstract ( 261 )   PDF (3907KB) ( 246 )   Save

    BACKGROUND: The traditional repair methods for laryngeal cartilage defect are restricted by donor source, rejection, which are difficult to be popularized.
    OBJECTIVE: To investigate the effect of polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold in repair of laryngeal cartilage defect.
    METHODS: A total of 20 Wistar rats were randomly divided into polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold and polylactic acid-glycolic acid copolymer scaffold groups. Polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold and polylactic acid-glycolic acid copolymer scaffold were respectively used for repair after the establishment of laryngeal cartilage defect models.
    RESULTS AND CONCLUSION: The laryngeal cartilage defect diameter of rats at 3, 5 and 7 days after modeling in the polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold group was significantly smaller than that in the polylactic acid-glycolic acid copolymer scaffold group. The laryngeal cartilage defect of rats in the polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold group was basically repaired and presented with a smooth surface, and there were no clear boundaries with surrounding tissues; however, the laryngeal cartilage defect of rats in the polylactic acid-glycolic acid copolymer scaffold group had indentations with a rough surface, and there were obvious boundaries with surrounding tissues. These results demonstrate that polylactic acid-glycolic acid copolymer/hydroxyapatite composite scaffold can promote the repair of laryngeal cartilage defect part, and its repair effect is more ideal.
     

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    Inhibitory effect of Sema7A siRNA on osteoclast activation induced by titanium particles
    Cong Yu, Ru Jiang-ying, Zhao Yun-long, Yu Lei, Bao Ni-rong, Xu Bin, Zhao Jian-ning
    2015, 19 (52):  8384-8390.  doi: 10.3969/j.issn.2095-4344.2015.52.004
    Abstract ( 186 )   PDF (8760KB) ( 174 )   Save

    BACKGROUND: Sema7A is a kind of cell surface protein, which can promote the fusion of osteoclasts and the migration of osteoblast at the same time, affecting the dynamic balance of bone.
    OBJECTIVE: To investigate whether Sema7A siRNA has ainhibitory effect on the osteoclast activation in the process of osteolysis which induced by titanium particles.
    METHODS:The precursor osteoclasts with the concentration of 4×109/L were seeded on 96-well plates containing glass cover slips, and divided into four groups: blank control, positive control, experiment and negative control groups. The cell culture medium was added into the control group. 20 μL un-transfected siRNA supernatant was added into the positive control group. 20 μL transfected Sema7A siRNA supernatant was added into the experiment group. 20 μL transfected control siRNA supernatant was added into the negative control group. The supernatant was obtained through the co-culture between titanium particles solution and  monocyte-macrophage cell line RAW264.7of mouse for 24 hours. siRNA was transfected into mononuclear  macrophage cell lines RAW264.7 of mice.
    RESULTS AND CONCLUSION: At 7 days of culture, the expression levels of interleukin-1, interleukin-1β, tumor necrosis factor α, matrix metalloproteinase-9 and the receptor activator of nuclear factor-κB in the positive control,
    negative control and experiment groups were higher than those in the control group (P < 0.05). The expression level of each factor in the experiment group was lower than that in the positive control and negative control groups (P < 0.05). At 8 days of culture, the proliferation activity of osteoclasts and the number of positive cells stained by tartrate-resistant acid phosphatase in the positive control, negative control and experiment groups were higher than those in the control group (P < 0.05). The proliferation activity of osteoclasts and the number of positive cells stained by tartrate-resistant acid phosphatase in the experiment group were lower than those in the control and negative groups (P < 0.05). These results demonstrate that Sema7A siRNA has a certain inhibitory effect on the osteoclast activation induced by titanium particles.
     

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    Relationship between bone cement dispersion within pathologic vertebrae and fracture time in vertebroplasty
    Zhu Min, Li Yu-qian, Wang Xiao-dong, Li Hong-bin, Zhang Jian-hua
    2015, 19 (52):  8391-8395.  doi: 10.3969/j.issn.2095-4344.2015.52.005
    Abstract ( 234 )   PDF (947KB) ( 252 )   Save

    BACKGROUND: Vertebroplasty with bone cement injection in treatment of osteoporotic vertebral compression fractures has a positive clinical outcome, but there is a big controversy on the optimal timing of surgery.
    OBJECTIVE: To analyze the effect of fracture time on bone cement dispersion within pathologic vertebrae in vertebroplasty treatment.
    METHODS: Totally 160 elderly patients with osteoporotic vertebral compression fracture were included, and all were treated with vertebroplasty with high viscosity bone cement injection. According to the duration from fracture to surgery, patients were divided into three groups: fresh fracture group (< 3 weeks), subacute group (3-6 weeks) and old group (> 6 weeks). The bone cement distribution features, diffusion and leakage within the pathologic vertebrae were analyzed by three-dimensional CT image and X-rays.
    RESULTS AND CONCLUSION: The bone cement dispersion volume was ranked as fresh group > subacute group > old group, and there was significant difference between groups (P < 0.05). Bone cement dispersion characteristics of each group were uniform distribution with cement-based lumpy shape. The vast majority of bone cement all can disperse to exceed vertebral midline, reaching the upper and lower lamina to a greater degree. Bone cement dispersion coefficient within the pathologic vertebrae of patients in each group was
     
    ranked as fresh group > subacute group > old group, and there was significant difference between groups (P < 0.05). The bone cement leakage rate in the fresh fracture group was significantly lower than that in the subacute and old groups (P < 0.05). These results demonstrate that patients undergoing vertebroplasty within 3 weeks can obtain better bone cement dispersion effect. 

     

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    Bone cement and nano bone putty strengthen pedicle screw implantation in the fixation of osteoporotic vertebral body: biomechanical characteristics
    Lu Xiao-bing, Meng Xiang-xiang
    2015, 19 (52):  8396-8400.  doi: 10.3969/j.issn.2095-4344.2015.52.006
    Abstract ( 219 )   PDF (953KB) ( 254 )   Save

    BACKGROUND: Nano bone putty and bone cement injection are two common methods to strengthen the fixation of pedicle screws, but there are relatively few reports on the comparison of their strengthening effects.
    OBJECTIVE: To compare the biomechanical characteristics of bone cement and nano bone putty strengthening pedicle screw implantation in the fixation of osteoporotic vertebral body.
    METHODS: Totally 24 human cadaveric pedicles were obtained, which were all in line with osteoporosis standards, and randomly divided into 3 groups: control group (only implanted pedicle screws), bone cement group (first injected bone cement in the nail channel, and then implanted pedicle screws) and nano bone putty group (first injected nano bone putty in the nail channel, and then implanted pedicle screws). After 2 hours of implantation, the maximum axial pullout strength and the maximum rotation torque of specimens in each group were determined.
    RESULTS AND CONCLUSION: The maximum axial pullout strength and maximum rotation torque of the bone cement and the nano bone putty groups were greater than those of the control group (P < 0.05), and the      maximum axial pullout strength and the maximum rotation torque of the bone cement group were greater than those of the nano bone putty group (P < 0.05). These results demonstrate that the maximum axial pullout strength and the maximum rotation torque of pedicle screw implantation in the fixation of osteoporotic vertebral body can be effectively improved by injection of bone cement and nano bone putty, and the strengthening effect of bone cement is more obvious. 

     

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    Borosilicate effect on in vitro biological activity of osteoblasts 
    Cheng Zhong-hua, Xue Wei, Wang Li-qin, Huang Qing-fang, Wu Cheng-huan, Gui Kai-hong, Huang Lin, Cai Ying, Han Yan-fang, Jiang Cai-xia
    2015, 19 (52):  8401-8405.  doi: 10.3969/j.issn.2095-4344.2015.52.007
    Abstract ( 204 )   PDF (1023KB) ( 342 )   Save

    BACKGROUND: Borosilicate cannot only be mineralized to form hydroxy carbonate apatite layer, but also have strong chemical reactivity to promote bone cell regeneration.
    OBJECTIVE: To investigate the effect of the borosilicate bioglass on the growth behavior of rabbit osteoblasts through in vitro culture experiment.
    METHODS: The initial and secondary extracts of borosilicate bioglass were prepared according to the requirement of ISO10993-12: 2007. The bone marrow mesenchymal stem cells of rabbits were isolated and cultured. The second generation bone marrow mesenchymal stem cells were induced to differentiate into osteoblasts. The osteoblasts of the 5th-15th generations were obtained and cultured with the initial and secondary extracts of borosilicate bioglass and α-MEM medium, respectively. The effects of borosilicate bioglass on the osteoblasts proliferation, protein synthesis, alkaline phosphatase activity, cell apoptosis, and cell migration in horizontal and vertical direction were observed.
    RESULTS AND CONCLUSION: The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cell number in Transwell between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in  osteoblast proliferation.
     

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    Internal fixation with different bone grafts via pedicle approach for treatment of thoracic spinal tuberculosis
    Qiu Nan-hai, Wang Li, Yu Ming, Miao Rui-rui, Huang Bi-yu, Zhang Wen-long
    2015, 19 (52):  8406-8411.  doi: 10.3969/j.issn.2095-4344.2015.52.008
    Abstract ( 229 )   PDF (687KB) ( 282 )   Save

    BACKGROUND: Lots of bone graft materials such as autologous iliac bone, autologous rib, titanium mesh plus allograft are available in the treatment of bone defects after spinal tuberculosis debridement.
    OBJECTIVE: To compare the fixation effect of different kinds of bone graft materials via pedicle approach fixation for treatment of thoracic spinal tuberculosis.
    METHODS: Totally 40 patients with thoracic spinal tuberculosis were enrolled, including 18 patients accompanied with paraplegia and 15 patients accompanied with kyphosis deformity. Both of them were subjected to by standard anti-tuberculosis treatment for 2-4 weeks and consequent posterior pedicle screw fixation combined with debridement/bone grafting fusion. They were grouped by the variables of bone graft materials: autologous iliac bone, autologous rib, titanium mesh plus allograft groups. All patients were followed up for 24 months. The lesion healing, bone graft fusion, rehabilitation of paraplegia, correction of kyphosis and incidence of adverse reaction were observed.
    RESULTS AND CONCLUSION: The time of bone graft fusion in the autologous iliac bone group was shorter than that in the autologous rib and titanium mesh plus allograft groups (P < 0.05), and there was no significant difference between autologous rib and titanium mesh plus allograft groups. No adverse phenomenons such as grafts and titanium mesh falling off, fracture and displacement, nonunion and pseudarthrosis, tuberculosis
     
    recurrence were found in these three groups. After the symptomatic therapy for 3-6 months, the muscle strength of patients with paraplegia and spinal kyphosis deformity basically recovered, spinal kyphosis deformity was basically corrected. These results demonstrate that the treatment effect of autologous iliac bone is the best; however, the treatment effect of autologous rib is as good as the titanium mesh plus allograft.   

     

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    Silk fibroins from different sources repair osteochondral defects
    Wang Qian, Ma Yun-sheng, Li De-hua
    2015, 19 (52):  8412-8417.  doi: 10.3969/j.issn.2095-4344.2015.52.009
    Abstract ( 212 )   PDF (926KB) ( 424 )   Save

    BACKGROUND: At present, there are no studies of comparing the effect of silk fibroins from different sources in repair of osteochondral defects.
    OBJECTIVE: To compare the effect of mulberry silk- and tussah-derived silk fibroin scaffold materials in repair of osteochondral defect.
    METHODS: Totally 20 New Zealand white rabbits were obtained to prepare osteochondral defect models on the unilateral knee joint and randomly divided into five groups: control group, experimental group 1, experimental group 2, experimental group 3 and experimental group 4. Rabbits in the control group were not implanted any materials. In the experimental group 1, 3 layers of mulberry silk protein scaffolds stuck together to fill in defects. In the experimental group 2, one mulberry silk protein scaffold coated with transforming growth factor-β3 was stuck with two mulberry silk protein scaffolds coated with bone morphogenetic protein-2 to fill in defects. In the experimental group 3, three layers of tussah protein scaffolds stuck together to fill in defects. In the experimental group 4, one tussah protein scaffold coated with transforming growth factor-β3 stuck together with two tussah protein scaffolds coated with bone morphogenetic protein-2 to fill in defects. At 8 weeks post surgery, 
    articular cartilage repair area was observed histopathologically. Type I and II collagen expressions were determined.
    RESULTS AND CONCLUSION: The collagen fibers in experimental group 1 were widely distributed in the full-thickness defect area. The collagen fibers in the experimental group 2 were parallelly distributed on the surface of repair area, vertically distributed from the middle and bottom to the top direction. Collagen was observed on the surface of repair area in the experimental group 3. The cartilage-like cells presented clumped distribution on the surface and at the bottom of scaffold. The type I collagen expression in the repair area was strongly positive in these four experimental groups. The type II collagen expression in the repair area of experimental 1 and experimental 2 groups was weak. The type II collagen expression in the repair area of experimental 3 and experimental 4 groups was strongly positive. These results demonstrate that these two kinds of silk fibroins can both repair osteochondral defects, in which mulberry silk proteins tend to form bone tissue, and tussah silk proteins tend to form cartilage tissue. 

     

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    Preparation and mechanical properties of polyetheretherketone/odontogenic biphasic bioceramic composites
    Leng Wei-dong, Liu Cai-yun, Huang Cui, Ai Jun, Shi Cong-yu,Yu He-dong
    2015, 19 (52):  8418-8422.  doi: 10.3969/j.issn.2095-4344.2015.52.010
    Abstract ( 300 )   PDF (528KB) ( 464 )   Save
    BACKGROUND: The physical properties and chemical composition of teeth are very similar with human bone tissue, and there are a larger proportion of inorganic components. Therefore, tooth can be considered as a potential repair material for autologous or allogeneic bone defects.
    OBJECTIVE: To prepare polyetheretherketone/odontogenic biphasic bioceramic composite, and to test its mechanical properties.
    METHODS: The human in vitro teeth of clinical waste were collected. The organic components were removed after a preliminary calcination. Another calcination was conducted after soaking in diammonium phosphate solution for 24 hours to prepare the biphasic ceramics with the main components of hydroxyapatite and β-tricalcium phosphate. The biphasic ceramics were ground and sieved using 200-mesh sieve followed by impregnation in organic foam to prepare polyetheretherketone/odontogenic biphasic bioceramics. Phase analysis, scanning electron microscopy, elemental analysis, porosity, compressive strength and bond strength test were conducted.
    RESULTS AND CONCLUSION: Polyetheretherketone/odontogenic biphasic bioceramics presented porous network structure and interconnected holes, with the aperture of 100-800 μm, porosity of 73.65%, compressive strength of (165.260±11.703) N, bond strength of (14.63±6.21) MPa. P element content accounted for 19.8%, and Ca element content accounted for 40.5%. The main phases were β- tricalcium phosphate and hydroxyapatite. These results demonstrate that polyetheretherketone/odontogenic biphasic bioceramics have good mechanical properties. 
     
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    Antibacterial and mechanical properties of ceramic orthodontic brackets with nano silver hydroxyapatite coating
    Zhou Guan-jun, Yang Da-peng, Liu Xin-fang, Hu Bo
    2015, 19 (52):  8423-8427.  doi: 10.3969/j.issn.2095-4344.2015.52.011
    Abstract ( 257 )   PDF (540KB) ( 378 )   Save

    BACKGROUND: In the clinical orthodontics, ceramic brackets have deficiencies in the aspects of antibacterial and mechanical properties, which easily lead to the emergence of a variety of adverse events and influence the orthodontic effect.
    OBJECTIVE: To observe the antibacterial and mechanical properties of nano silver hydroxyapatite coating ceramic brackets.
    METHODS: The nano silver hydroxyapatite coating ceramic brackets were prepared. Scanning electron microscopy was used to observe the coating surface. Coating antibacterial experiment was conducted. Totally 50 in vitro human maxillary premolars were randomly divided into two groups (n=25 per group): experimental and control groups. Premolars in the experimental group were bonded to nano silver coating hydroxyapatite ceramic brackets, and premolars in the control group were bonded to ordinary ceramic brackets. The shear strength was detected in these two groups.
     
    RESULTS AND CONCLUSION: The overall structure of nano silver hydroxyapatite coating was order, uniform and compact. Hydroxyapatite had a porous structure with a micro-nanometer aperture and there were a large number of nano-silver particles uniformly distributed. Quantitative antibacterial experiments showed that nano silver hydroxyapatite coating ceramic brackets had a strong inhibition to Escherichia coli and Staphylococcus albus, with an antibacterial rate of more than 95%. The shear strength in the experimental group was lower than that of the control group (P < 0.05). These results demonstrate that the nano silver hydroxyapatite coating ceramic brackets have good antibacterial and mechanical properties, which meet the requirement of mechanical change in the clinical orthodontics. 

     

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    Tooth correction using self-ligating bracket versus conventional bracket appliance: expression of interleukin 1beta and tumor necrosis factor alpha in gingival crevicular fluid after correction
    Cui Zhan-qin, Li Wen-jing, Yu Huan-bing
    2015, 19 (52):  8428-8432.  doi: 10.3969/j.issn.2095-4344.2015.52.012
    Abstract ( 261 )   PDF (501KB) ( 491 )   Save

    BACKGROUND: During clinical orthodontic correction, the self-ligating bracket is more helpful to maintain the periodontal healthy than the traditional bracket, but previous studies mainly focused on the clinical periodontal index and periodontal pathogens, and whether inflammatory cytokines are involved has not been reported.
    OBJECTIVE: To analyze the changes of the expression levels of interleukin 1β and tumor necrosis factor α in gingival crevicular fluid before and after the correction using self-ligating bracket and conventional bracket appliance.
    METHODS: Totally 38 orthodontic patients without periodontal disease (including 20 males and 18 females; aged 11-25 years) were included in this study. All the patients were randomly divided into control and test groups (n=19/group) and subjected to orthodontic correction using self-ligating bracket and conventional bracket appliance, respectively. The volumes of gingival crevicular fluid and expression levels of interleukin-1β and tumor necrosis factor-α were detected before correction and at 4, 8 and 12 weeks after correction.
    RESULTS AND CONCLUSION: The volume of gingival crevicular fluid and expression levels of interleukin-1β and tumor necrosis factor-α after correction were all higher than those before correction (P < 0.05). The volume of gingival crevicular fluid and expression levels of interleukin-1β and tumor necrosis factor-α after correction in the test group were lower than those in the control group (P < 0.05). These results demonstrate that self-ligating bracket appliance is more conducive to protect the periodontal tissue than the conventional bracket appliance.  

     

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    Preparation and biocompatibility of chitosan-collagen corneal repair materials
    Du Qian
    2015, 19 (52):  8433-8437.  doi: 10.3969/j.issn.2095-4344.2015.52.013
    Abstract ( 304 )   PDF (462KB) ( 318 )   Save

    BACKGROUND: The collagen and chitosan composite membrane made at a certain percentage can reduce the positive charge of chitosan, improve the adsorption force of chitosan, promote the cell adhesion and growth, migration and proliferation, and enhance the biological properties of chitosan, which has become a very excellent biological material.
    OBJECTIVE: To prepare chitosan-collagen composite membrane and observe its histocompatibility with corneal stroma layer.
    METHODS: Chitosan-collagen composite membrane was prepared. Totally 16 New Zealand rabbits were randomly divided into experimental and control groups. The chitosan-collagen composite membrane was implanted into right eye cornea stroma bag in the experimental group, and the chitosan membrane was implanted into right eye cornea stroma bag in the control group. The slit lamp microscope, anterior segment optical coherence tomography and histological observation were conducted after transplantation.
    RESULTS AND CONCLUSION: Slit lamp microscope observation results showed that after 8 weeks of transplantation, degradation infiltration was visible in the center of the diaphragm, crease buckling was not obvious in the experimental group; the diaphragm was infiltrated completely and crease buckling was notable in the control group. The anterior segment optical coherence tomography results showed that at the 6th week after
    transplantation, the composite membrane boundary was fuzzy, its density was very close to the normal corneal tissue, and the corneal shape recovered to normal in the experimental group. The histological findings showed that after 8 weeks of transplantation, in the experimental group, the membrane surface was degraded a little; biodegradable materials were fused with the corneal stroma; there were a small amount of inflammatory cells infiltrated on the corneal stroma around the iris. In the control group, the membrane degradation was greater than that of the experimental group; degradable substances intertwined and fused with corneal stroma; there were more inflammatory cells infiltrated on the corneal stroma around the iris. These results demonstrate that chitosan-collagen composite membrane has degradability and good histocompatibility.  

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    Biocompatibility of double-layer poly(L-lactic acid) electrospun nanofiber scaffold with human periodontal ligament cells
    Sun Wen-juan, Jiang Hao-shun, Huang Nan-nan, Tang Qian, Yang Yu-hong
    2015, 19 (52):  8438-8483.  doi: 10.3969/j.issn.2095-4344.2015.52.014
    Abstract ( 291 )   PDF (670KB) ( 369 )   Save
    BACKGROUND: The morphological structure of nanofiber scaffold which fabricated by electrospinning technique is similar to the natural extracellular matrix, which provides a good microenvironment for cell growth and proliferation, and can also enhance cell adhesion, migration, proliferation and differentiation. 
    OBJECTIVE: To observe the biocompatibility of double-layer poly(L-lactic acid) electrospun nanofiber scaffold and human periodontal ligament cells.
    METHODS: Electrospinning technique was used to prepare double layers poly(L-lactic acid) electrospun nanofiber scaffold. The toxicity of different concentrations of (100%, 75%, 50%, 25%) double-layer poly(L-lactic acid) electrospun nanofiber scaffold extracts to human periodontal ligament cells was evaluated by MTT assay. The double-layer poly(L-lactic acid) electrospun nanofiber scaffold was co-cultured with human periodontal ligament cells. The cell adhesive capacity in early stage was determined by MTT assay. The growth of cells on the scaffold was observed by scanning electron microscopy.
    RESULTS AND CONCLUSION: Different concentrations of double-layer poly(L-lactic acid) electrospun nanofiber scaffold extracts did not create any toxicity to human periodontal ligament cells. After co-culture for 2, 6, 24 hours,
    human periodontal ligament cells were poorly adherent onto the double-layer poly(L-lactic acid) electrospun nanofiber scaffold. After 7 days of co-culture, human periodontal ligament cells adhered well on the loose surface of scaffold, maintained the original shape, stretched well, and interconnected processes were observed; on the dense surface of the scaffold, multi-layer cells were observed. The cells showed fusiform or polygonal appearance and were connected together. These results demonstrate that the double-layer poly(L-lactic acid) electrospun nanofiber scaffold has good biocompatibility with human periodontal ligament cells. 
     
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    In vivo degradation and biological safety of microporous vacuum polysaccharide hemostatic microspheres
    Du Bao-tang, Shi Yue, He Yuan-qing, Yin Wen-jing, Wang Ying
    2015, 19 (52):  8444-8449.  doi: 10.3969/j.issn.2095-4344.2015.52.015
    Abstract ( 492 )   PDF (631KB) ( 476 )   Save

    BACKGROUND: Microporous vacuum polysaccharide hemostatic microspheres are derived from degenerated potato plant starch and prepared through special processing. It is an ideal absorbable polymer styptic material with independent intellectual property rights. OBJECTIVE: To observe the degradation of microporous vacuum polysaccharide hemostatic microspheres and detect the safety indicators of body fluids by implanting microporous vacuum polysaccharide hemostatic microspheres in rats.
    METHODS: 0.1-0.2 g microporous vacuum polysaccharide hemostatic microspheres were implanted  subcutaneously on the left side of the spine in 12 rats. At the 1st, 3rd, 7th and 14th days after implantation, 
    the degradation of microporous vacuum polysaccharide hemostatic microspheres in the tissue was observed. Another 15 rats were selected, of which 5 rats were taken as the control group and fed normally, and 10 rats were subjected to anesthesia. Two incisions were made on both sides of the spine, about 5 cm, deep into the muscular layer of 0.3 cm. The right amount of hemostatic microspheres were sprayed on the incisions and covered the entire wound, then the incisions were sutured. The 10 rats were raised normally for 14 days. The various indicators of body fluids such as appearance features, activities, excretion, feeding were detected. Finally, the rats were dissected, and the gross morphology and color changes of main organs were observed.
    RESULTS AND CONCLUSIONS: The microporous vacuum polysaccharide hemostatic microspheres buried in rats were completely degraded and absorbed within 7 days. After spraying the right amount of microporous vacuum polysaccharide hemostatic microspheres on the incision, the vital signs and biochemical indicators, such as blood and urine tests were all normal. The gross morphology and color of main organs such as liver, spleen, brain and kidney were not found significant anomalies. These results demonstrate that microporous vacuum polysaccharide hemostatic microspheres can be degraded into monosaccharide by amylase and can be completely degraded and absorbed within 7 days, without any side effects to tissues and organs. 

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    Compatibility of osteoblasts with shape memory polyurethane before and after the deformation-complex
    Ye Mao, Luo Meng, Zou Yi, Leng Hua-wei, Zhang Jun-quan
    2015, 19 (52):  8450-8454.  doi: 10.3969/j.issn.2095-4344.2015.52.016
    Abstract ( 268 )   PDF (530KB) ( 416 )   Save
    BACKGROUND: Shape memory polyurethane has good physical and chemical properties and compatibility, but there are relatively few reports on the compatibility of osteoblasts before and after the deformation-complex of the shape memory polyurethane.
    OBJECTIVE: To observe the compatibility of osteoblasts with shape memory polyurethane before and after the deformation-complex.
    METHODS: Shape memory polyurethane membranes were prepared, and its stretching-solid-complex was conducted under the experimental environment, to obtain the membrane materials after the deformation-complex. The Sprague-Dawley neonatal rat osteoblasts were inoculated on the shape memory polyurethane membranes before and after the deformation-complex. After 2 hours of culture, the number of adherent cells was counted, and cell spreading was observed; cell proliferation was determined after 1-11 days of culture.
    RESULTS AND CONCLUSION: The adhesion amount and proliferation activity of osteoblasts on shape memory polyurethane membranes after the deformation-complex were significantly higher than those before the deformation-complex (P < 0.05). The osteoblasts presented fusiform appearance on the shape memory polyurethane membranes after deformation-complex, and cell arrangement showed a clear orientation, but a small spreading area; while the osteoblasts presented polygonal shape on the shape memory polyurethane membranes before deformation-complex, arranged in no particular direction, and spread largely. These findings show the shape memory polyurethane has better osteoblast compatibility after the deformation-complex.
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    Polypropylene patch repairs anterior pelvic organ dysfunction in older women patients
    Zhang Xiao-yue
    2015, 19 (52):  8455-8460.  doi: 10.3969/j.issn.2095-4344.2015.52.017
    Abstract ( 246 )   PDF (552KB) ( 371 )   Save

    BACKGROUND: The patch materials, originally applied in the reconstruction and repair of abdominal hernia, have been successfully applied in the vagina surgery; thus, it has been gradually generalized in gynecological pelvic floor reconstruction.
    OBJECTIVE: To analyze the clinical effect of polypropylene patch in older female patients with anterior pelvic organ reconstruction.
    METHODS: Totally 24 older female patients with stage III, IV anterior pelvic floor dysfunction were enrolled. The individual treatment was formulated according to the wishes of patients, of which 12 patients underwent anterior pelvic organ reconstruction using polypropylene patch (test group), and 12 patients underwent the simply modified vaginal repair treatment (control group). Patients were followed up for 12 months after repair. The clinical symptom remission, wound healing, pelvic organ prolapse staging and subjective disability index scores were observed.
    RESULTS AND CONCLUSIONS: After repair, the clinical symptoms in these two groups were significantly alleviated, and there was no infection, poor wound healing and other adverse reactions. At 12 months of follow-up, the subjective disability index scores in these two groups were all significantly lower than those before repair (P < 0.05); moreover, these scores were significantly lower in the test group than the control group (P < 0.05). There were eight cases of pelvic organ prolapse staging I, four cases of pelvic organ prolapse staging II in the test group; seven cases of pelvic organ prolapse staging I, two cases of pelvic organ prolapse staging II, two cases of pelvic organ prolapse staging III and one case of pelvic organ prolapse staging IV in the control group. The degree of organ prolapse in the test group was lower than that in the control group (P < 0.05). These results demonstrate that polypropylene patch repair used in older female anterior pelvic organ reconstruction is safe and effective, and leads to a low recurrence rate.
     

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    Polyvinyl alcohol hydration algae salt bubble wound dressings with sealing negative pressure drainage repair diabetic foot ulcers
    Zhou Juan, Chen Xiao-yun, Yu Hong-mei
    2015, 19 (52):  8461-8466.  doi: 10.3969/j.issn.2095-4344.2015.52.018
    Abstract ( 380 )   PDF (537KB) ( 456 )   Save

     

    BACKGROUND: Biological dressings with sealing negative pressure drainage can promote the healing of acute and chronic wounds.
    OBJECTIVE: To observe the clinical effects of biological dressings with sealing negative pressure drainage in repair of diabetic foot ulcer.
    METHODS: Totally 40 patients with diabetic foot ulcer were enrolled and all underwent debridement or debridement plus skin grafting treatment. Wound treatment methods were selected according to the willing of patients. Patients in the test group (n=20) underwent polyvinyl alcohol hydration algae salt bubble wound dressings with sealing negative pressure drainage. Patients in the control group (n=20) underwent regular wound dressing treatment. At the 7th day of repair, visual analog scale scores, blood sedimentation, C-reactive protein levels, wound healing time, patient satisfaction and economic costs at the termination of the treatment in these two groups were compared.
    RESULTS AND CONCLUSION: The visual analog scale scores, blood sedimentation, C-reactive protein levels in the test group were lower than those in the control group (P < 0.05). The wound healing time in the test group was shorter than that in the control group (P < 0.05), and the patient satisfaction was higher in the test group than the control group (P < 0.05). There was no significant difference in economic costs between the two groups. There was no local or systemic toxicity, allergy and other adverse reactions in the test group. These results demonstrate that polyvinyl alcohol hydration algae salt bubble wound dressings with sealing negative pressure drainage in repair of diabetic foot ulcer is safe and effective to promote wound healing and reduce local inflammatory response. 
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    Preparation of polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers
    Xiao Rong-dong, Weng Guo-xing
    2015, 19 (52):  8467-8472.  doi: 10.3969/j.issn.2095-4344.2015.52.019
    Abstract ( 278 )   PDF (715KB) ( 387 )   Save

    BACKGROUND: Although polyurethane possesses excellent biocompatibility, its inherent inertness leads to its weak interactions with cells. So, its modification is necessary.
    OBJECTIVE: To prepare the polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers with controllable morphology.
    METHODS: The polyhedral oligomeric silsesquioxane was dispersed in a certain concentration of polyurethane solution to prepare the polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers using electrospinning method. Meanwhile, the effects of mass of polyurethane and oligomeric silsesquioxane, spinning voltage and spinning advance velocity on composite fiber morphology were analyzed. The optimum preparing conditions were filtrated. The stability of oligomeric silsesquioxane in polyurethane was determined. The morphology and composition of fibers were analyzed by scanning electron microscopy, infrared spectroscopy, X-ray photoelectron spectroscopy.
    RESULTS AND CONCLUSION: Oligomeric silsesquioxane stably existed in polyurethane. Polyurethane/polyhedral oligomeric silsesquioxane nanocomposite fibers were the most uniform when the mass fraction of polyurethane in composite fibers accounted for 20%, the mass ratio of polyurethane and oligomeric silsesquioxane was 10: 1, spinning voltage was 15 kV and spinning advance velocity was 0.5 mL/h. Compared with the pure polyurethane, the O/C ratio of polyurethane/polyhedral oligomeric silsesquioxane nanocomposites increased significantly. 
      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

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    The preparation of rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules
    Chen Hong-zhou, Ma Shi-kun,Hu Long-ju, Yang Jian-dong
    2015, 19 (52):  8473-8479.  doi: 10.3969/j.issn.2095-4344.2015.52.020
    Abstract ( 310 )   PDF (586KB) ( 341 )   Save

    BACKGROUND: Microcapsules is one of the main directions of targeted therapeutic dosing system. With a size of several microns to several hundred microns, it can be used for injection, oral, arterial administration and local treatment of targeted organs and other treatment approaches.
    OBJECTIVE: To prepare rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules and optimize the preparation conditions.
    METHODS: The rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules was prepared by ultrasonic emulsification. The effect of the mass concentration (60, 100, 140, 180 g/L), stirring speed (50, 1 000,  2 000, 4 000 r/minutes), colostrum emulsification time (2, 4, 6, 8 minutes), colostrum water oil ratio (1:5, 1:10, 1:15, 1:20) of rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules on gross morphology, particle size distribution width and total flavonoids encapsulation efficiency of microcapsules was univariately analyzed. The rhizoma drynariae total flavonoids/polylactic-co-glycolic acid microcapsules with smaller particle size, uniform dispersion and higher encapsulation efficiency was filtered out.
    RESULTS AND CONCLUSION: The optimum process parameters were as follows: 140 g/L polylactic acid-glycolic acid solution, the stirring speed of 2 000 r/min, the colostrum emulsification time of 6 minutes, and the colostrum water-oil ratio of 1:15. The microcapsules prepared in the optimized process displayed a uniform distribution and its average particle size was (789.8±712.3) nm, which distributed relative narrowly and basically less than 5 μm. Microcapsules presented round, with a regular edge under scanning electron microscope. The average encapsulation efficiency was 47.72%.
     

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    Biodegradable materials combined with osteogenic factor in orthopaedics 
    Liu Da-hai, Li Kai-nan, Wei You-hua
    2015, 19 (52):  8480-8486.  doi: 10.3969/j.issn.2095-4344.2015.52.021
    Abstract ( 193 )   PDF (645KB) ( 417 )   Save
    BACKGROUND: Biodegradable implants cannot only rebuild bone defect site, moreover, with the gradual degradation of the materials, new bone tissue can completely replace the graft materials to fill bone defects.
    OBJECTIVE: To summarize the research progress of biodegradable materials combined with osteogenic factor in orthopedics.
    METHODS: We took the “biodegradable materials, factors, cell active factor, bone tissue engineering” as the search terms in Chinese and English, respectively, to retrieve the related literatures from PubMed, Wanfang and CNKI database during 2000 to 2015 by computer.
    RESULTS AND CONCLUSION: Biodegradable medical polymer materials can be divided into natural polymer materials and synthetic biodegradable materials. Natural polymeric materials have good biocompatibility, but poor mechanical strength. The mechanical strength of synthetic biodegradable materials is higher than that of natural polymer materials, but the synthetic biodegradable materials are likely to cause local accumulation of acidic substances, produce local inflammation. The biodegradable medical polymer materials combined with osteogenic factor can improve the mechanical strength and osteoinductive ability of materials, but as a bone repair material, it still has many problems to be solved. 
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    Bone morphogenetic protein-2 carrier materials in the spinal fusion
    Jiang Jie, Chen Liang, Gu Yong, Peng Zhan
    2015, 19 (52):  8487-8491.  doi: 10.3969/j.issn.2095-4344.2015.52.022
    Abstract ( 167 )   PDF (525KB) ( 296 )   Save
    BACKGROUND: There are some adverse reactions when bone morphogenetic protein-2 is applied independently in clinic; therefore, it is urgent to develop an ideal carrier material to reduce the incidence of adverse reactions induced by bone morphogenetic protein-2.
    OBJECTIVE: To comprehensively understand the performance of different kinds of bone morphogenetic protein-2 carrier materials, and to summarize their research progress in the field of spinal fusion.
    METHODS: The literatures about bone morphogenetic protein-2 scaffolds in spinal fusion were retrieved by the first author from PubMed and Wanfang datebase durings July 1, 1995 to July 1, 2015 with the key words of“tissue engineering, bone morphogenetic protein-2, spinal fusion, scaffold” in English and Chinese, respectively. Repetitive studies were excluded.
    RESULTS AND CONCLUSION: Bone morphogenetic protein-2 carrier materials mainly include four categories: natural biological materials, synthetic organic materials, synthetic inorganic materials and composite materials, each of which has several representative scaffold materials. Each category has their own shortcomings when applied in animal spinal fusion, for instance, the mechanical properties of natural biological materials are generally poor; synthetic organic materials may cause inflammatory reactions; the mechanical strength of synthetic inorganic materials is poor and the production process of composite materials is relatively complicated. Therefore, the selection of bone morphogenetic protein-2 carrier materials still needs further experimental study. 
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    Properties of artificial joint materials and exercise-induced articular cartilage injury 
    Wang Da-peng, Chi Meng, Pei Yan-ming
    2015, 19 (52):  8492-8497.  doi: 10.3969/j.issn.2095-4344.2015.52.023
    Abstract ( 221 )   PDF (626KB) ( 393 )   Save
    BACKGROUND: The artificial joint has gone through nearly a century of history from the beginning of design to the clinical application. The forerunner of artificial joints is artificial hip joint. With the skilled technological application in clinic, the design, application and improvement of wrist, shoulder, knee and other artificial joints have been promoted.
    OBJECTIVE: To summarize the application progress and performance characteristics of artificial joint materials in exercise-induced articular cartilage injury.
    METHODS: PubMed (http://www.ncbi.nlm.nih.gov/PubMed), Wanfang database (http://wanfangdata.com.cn/) and China National Knowledge Infrastructure (http://www.cnki.net/) during 1980 to 2015 were retrieved by the first author. “Sports; Cartilage Injury; Artificial Joint” were taken as the key words in English and Chinese, respectively. Retrieved data were analyzed and summarized. The artificial joint materials commonly used at home and abroad were introduced and analyzed one by one. The clinical advantages and disadvantages of various materials were analyzed from the view of materials science. The surface treatment methods commonly used for artificial joints were described. The direction of the artificial joint research was pointed out from a development perspective.
    RESULTS AND CONCLUSION: The surface modification of titanium alloys can obtain surface ceramic layer with good performance, and can effectively improve the anti-wear properties of titanium alloys. The filling and modification of ultra-high molecular weight polyethylene can obtain joint composites with good anti-wear properties that can effectively reduce the production of ultra-high molecular weight polyethylene wear particles and the biological response induced by ultra-high molecular weight polyethylene wear particles. Further research and improvement of ceramic artificial joints will be the future direction of development of artificial joints. 
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    Artificial bone or autologous bone grafting combined with pedicle screw fixation for repair of spinal tuberculosis
    Jiang Peng-fei, Zhai Wen-bin
    2015, 19 (52):  8498-8502.  doi: 10.3969/j.issn.2095-4344.2015.52.024
    Abstract ( 186 )   PDF (566KB) ( 351 )   Save
    BACKGROUND: With the development of fixation materials and technology, scholars began to use artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis.
    OBJECTIVE: To summarize the characteristics of artificial bone materials combined with pedicle screw fixation in the repair of spinal tuberculosis.
    METHODS: The literatures about artificial bone graft materials in repair of spinal tuberculosis were retrieved from CNKI and PubMed database during 1985 to 2014 by computer. The keywords were “spinal tuberculosis, bone transplantation, internal fixation” in Chinese and English, respectively.
    RESULTS AND CONCLUSION: In the repair of spinal tuberculosis using artificial bone materials combined with pedicle screw fixation, autologous bone is the gold standard for bone grafting, presenting with no immune rejection. To avoid the occurrence of limited bone mass, pain and other complications, however, artificial bone materials have been extensively studied. Currently used artificial materials mainly include titanium and its alloys, hydroxyapatite composites and medical calcium sulfate, which all have good biocompatibility. But there are still certain limitations and shortcomings. 
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    Intrauterine devices, subcutaneous contraceptive implants and tubal contraception devices made of various types of materials
    Gao Kan-xiu, Nie Yao
    2015, 19 (52):  8503-8508.  doi: 10.3969/j.issn.2095-4344.2015.52.025
    Abstract ( 286 )   PDF (669KB) ( 319 )   Save
    BACKGROUND: Aclear understanding on the characteristics of contraceptive materials, techniques and effects on reproductive health is of great significance to reduce unwanted pregnancies and the abortion rate.
    OBJECTIVE: To summarize the progress, current situation and usage of the contraceptive materials, and to comprehensively analyze the characteristics, effects and adverse effects of intrauterine devices, subcutaneous

     

    contraceptive implants and tubal contraception materials, so as to provide the basis for women of childbearing age to choose safe and reliable contraceptive materials.
    METHODS: The related articles were retrieved from China National Knowledge Infrastructure and PubMed database during 1985 to 2015 by taking “intrauterine device, subcutaneous contraceptive implant, tubal contraceptive material, reproduction, health, contraceptive method” as the Chinese key words and taking “intrauterine contraceptive device, subcutaneous contraceptive implants, oviduct contraceptive, materials, reproductive health, influences” as the English key words. Finally 44 articles were included in result analysis.
    RESULTS AND CONCLUSION: Intrauterine devices have a rapid development and wide audience, which are reliable, and mature to have a higher awareness and usage rate among females who have bred children. Subcutaneous contraceptive implants are characterized as strong affinity, constant release, good release effect, simple and convenient operation. Oviduct contraceptive suppository materials have strong biological nature, memory and tolerability, as well as possess non-invasive, reusable, safe, long-term advantages. To seek safe, reliable contraceptive materials and methods with no adverse reactions is of great significance to ensure women’s reproductive health.
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    The clinical application of absorbable internal fixation system in maxillofacial fractures: systematic review and Meta-analysis 
    Liu Hang-hang, Wu Chen-zhou, Pan Wei-yi, Su Zhi-fei, Duan Ze-xi, Shi Long, Li Chun-jie
    2015, 19 (52):  8509-8516.  doi: 10.3969/j.issn.2095-4344.2015.52.026
    Abstract ( 215 )   PDF (760KB) ( 359 )   Save

    BACKGROUND: There are numerous clinical studies on comparing absorbable internal fixation system and titanium metal internal fixation system in maxillofacial fractures; however, the systematic reviews and Meta-analysis in this field are rare.
    OBJECTIVE: To compare the clinical effect of absorbable internal fixation system and titanium internal fixation system in maxillofacial fractures through systematic review and Meta-analysis.
    MATERIALS AND METHODS: The randomized controlled trials and controlled clinical trials regarding the application of absorbable internal fixation system and titanium internal fixation system in maxillofacial fractures were electronically retrieved from Medline, Embase, the Cochrane Central Register of Controlled Trials, China Biology Medicine disc, and China Academic Journal Network Publishing Database using the keywords. Meta-analysis was conducted using Revman 5.3 software.
    RESULTS AND CONCLUSION: Thirteen clinical studies were included, and totally 1 718 patients were involved. The Meta-analysis results showed that the removal rate of implants in the absorbable internal fixation system group was significantly lower than that in the titanium internal fixation group (P=0.000 2); there were no significant differences in the healing rate of fracture I stage, the incidence of insufficient fixation in fracture site and the incidence of long-term complications between these two groups. These results demonstrate that the efficiency and safety of absorbable internal fixation system in maxillofacial fracture is satisfactory, and can reduce the proportion of secondary surgical removal of the implant. More randomized controlled trials should be conducted to confirm this conclusion.
     

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    Efficacy of rapamycin and paclitaxel eluting stent implantation in treatment of coronary artery disease 
    Yang Jun, Chen Dong-lin, Chen Yin-chao, Chen Xin-jing
    2015, 19 (52):  8517-8521.  doi: 10.3969/j.issn.2095-4344.2015.52.027
    Abstract ( 238 )   PDF (470KB) ( 294 )   Save

    BACKGROUND: The clinical effect of drug-eluting stent implantation in treatment of coronary artery disease is good, but there may be some differences in the therapeutic effect between different stents.
    OBJECTIVE: To compare the clinical effect of different stent implantation in treatment of coronary artery disease.
    METHODS: A total of 278 patients with coronary artery disease were enrolled and all underwent coronary artery stent implantation treatment, of which 91 patients underwent implanted rapamycin eluting stent, 92 patients underwent implanted paclitaxel eluting stent, and 95 patients underwent implanted bare metal stents. All the patients were followed up for 12 months after stents implantation. The occurrence of adverse cardiac events such as death, myocardial infarction, and the occurrence of coronary restenosis and host reaction were recorded.
    RESULTS AND CONCLUSION: The rates of coronary artery stenosis, acute myocardial infarction, coronary artery bypass grafting or second-time percutaneous coronary interventional therapy in the paclitaxel eluting stent and rapamycin eluting stent groups were all lower than those in the bare metal stent group (P < 0.05). There were no significant differences in the above indicators between paclitaxel eluting stent and rapamycin eluting stent
    groups (P > 0.05). There was no significant difference in the mortality between these three groups (P > 0.05). There was no stent shift, shedding, breakage, bad implantation position, leukocytosis, thrombocytopenia and hemolysis in these three groups. These results demonstrate that the therapeutic effects of these two kinds of drug-eluting stents are all good enough, and better than those of bare metal stents. 

     

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    Artificial valve ring implantation and Cox Maze III procedure in treatment of degenerative mitral annulus dilatation complicated by atrial fibrillation
    Han Jin-song, Wang Hui-shan, Wang Zeng-wei, Yin Zong-tao, Han Hong-guang, Jin Yan, Liu Yu, Zhao Ke-yan, Yu Yan, Zhao Yang, Chen Zhao-hui
    2015, 19 (52):  8522-8528.  doi: 10.3969/j.issn.2095-4344.2015.52.028
    Abstract ( 320 )   PDF (610KB) ( 454 )   Save

    BACKGROUND: For patients with degenerative mitral annulus dilatation complicated by atrial fibrillation, atrial fibrillation is needed to be treated concomitant with artificial valve ring implantation. Although Cox maze III procedure is the gold standard for treatment of atrial fibrillation, its safety has been questioned.
    OBJECTIVE: To evaluate the safety of artificial valve rings implantation and Cox Maze III procedure for treatment of degenerative mitral annulus dilatation complicated by atrial fibrillation.
    METHODS: A total of 43 patients with degenerative mitral annulus dilatation and atrial fibrillation were enrolled and were randomly divided into test group (n=21) and control group (n=22). Patients in the test group were treated with mitral valvuloplasty and Cox Maze III procedure. Patients in the control group were only treated with mitral valvuloplasty.
    RESULTS AND CONCLUSION: (1) Intraoperative safety indexes: the durations of cardiopulmonary bypass and aortic clamping. and the incidence of hemoglobinuria in the test group were higher than those in the control group (P < 0.001). There was no significant difference in the urine output between these two groups. (2) Postoperative safety indexes: the incidence of atrial dysrhythmia (i.e., any atrial dysrhythmia other than atrial fibrillation), proportion of patients requiring a temporary pacemaker and hospital stays in the test group were higher than those in the control group (P < 0.05). There were no significant differences in the secondary-thoracotomy bleeding rate and incidence of stroke between these two groups. (3) Postoperative outcomes: the rates of cardioversion to achieve sinus rhythm at the day of surgery and at discharge in the test group were significantly higher than those in the control group (P < 0.001). At discharge, patients in both groups were all at NYHA functional class I or II. Echocardiography showed trace to mild mitral regurgitation and complete closure of the tricuspid valve. There were no significant differences in the left atrial diameter, left ventricular diameter, left ventricular volume, and ejection fraction between these two groups. However, the proportions of mitral and tricuspid valve peak A-waves were significantly higher than those in the control group (P < 0.001). These results show that artificial valve ring implantation and Cox Maze III procedure is a safe and effective method for treating degenerative mitral annulus dilatation complicated by atrial fibrillation during operation. 

     

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