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    18 January 2017, Volume 21 Issue 2 Previous Issue    Next Issue
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    Growth factor composite scaffolds for bone defect repair via immediate implantation of bone defects
    Yang Yu-peng1, Yang Sheng-jun2, Cheng Feng-xia1, Gu Jian-qi1, Zheng Yao1, Li Juan1, Hao Wei1, Wu Yong-sheng1
    2017, 21 (2):  165-170.  doi: 10.3969/j.issn.2095-4344.2017.02.001
    Abstract ( 314 )   PDF (1102KB) ( 301 )   Save

    BACKGROUND: Nerve growth factor has been shown to play an important role in bone healing, but little is reported on the effect of growth factor composite scaffolds via the immediate implantation in the repair of canine bone defects.
    OBJECTIVE: To analyze the effect of nerve growth factor composite scaffolds via the immediate implantation for the repair of canine bone defects.
    METHODS: Nerve growth factor composited strontium apatite scaffolds were prepared. Canine mandibular defect models were established and divided into three groups, followed by implanted with composite scaffold (experimental group), strontium apatite (positive control group), or nothing (blank control group). The three-dimensional CT reconstruction and hematoxylin-eosin staining of canine mandibular bone defects were observed.
    RESULTS AND CONCLUSION: In the blank control group, there were few new bones surrounding bone defect. Trabecular bones spread from the defect center to the surrounding tissues in the experimental and positive control groups. The bone density, volume, thickness, and implant-bone contact were significantly increased, while the trabecular separation was significantly decreased in the experimental group compared with the positive control and blank control groups (P < 0.05), and all above indicators in the positive contro group were significantly higher than those in the blank control group (P < 0.05). Hematoxylin-eosin staining showed that in the experimental group, there were a large number of new bones that contacted with the surrounding bones closely, and trabecular bones arranged regularly. In the positive control group, newborn osteoid, trabeculare, and a small amount of debris were found. In the blank control group, few new bones were connected with the surrounding bones untightly and trabecular bone arranged irregularly. These results indicate that the nerve growth factor composite scaffold can promote the bone regeneration in the canine bone defects after immediate implantation. 

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    Disinfection efficiency of different disinfectants on dental impressions and the dimensional stability of impressions after disinfection
    Wu Hong-mei, Li Chang-chun, Jiang Hao, Feng He-qiang
    2017, 21 (2):  171-176.  doi: 10.3969/j.issn.2095-4344.2017.02.002
    Abstract ( 380 )   PDF (1175KB) ( 312 )   Save

    BACKGROUND: The surface of dental impression is inevitable to carry various bacteria caused by direct contact with the patient saliva, mucosa and blood during preparation; therefore, disinfection of the dental impression is necessary.
    OBJECTIVE: To evaluate the disinfection efficiency of glutaraldehyde, chlorine dioxide and electrolyzed oxiding water on dental impressions and to investigate the dimensional stability of impressions after disinfection, thus providing basis for establishing a standard and reasonable disinfection method.
    METHODS: Alginate impression materials were contaminated in vitro, and then immersed in glutaraldehyde, chlorine dioxide and electrolyzed-oxiding water for 5, 10 and 15 minutes, respectively. The colonies were counted after germiculture to compare the disinfection efficiency of three disinfectants. The impressions were poured in die stone after immersion, the dental models were structured-light scanned and three-dimensional digital dental models were reconstructed. All the data were globally registered, and linear dimensions were measured on the digital models to deduce the influence of disinfection on surface accuracy and dimensional stability of the impressions.
    RESULTS AND CONCLUSION: The disinfecting rate reached 100% through immersion in 2% alkaline glutaraldehyde for 5 minutes, and the disinfection of killing the hepatitis B virus was effective after 10-minute immersion. The disinfecting rate of 600 ppm chlorine dioxide for 15 minutes killing experimental bacteria reached 99% and effective for killing the hepatitis B virus. While the disinfecting rate of killing experimental bacteria was less than 99% through immersion in electrolyzed oxiding water for 15 minutes, and was not effective for hepatitis B virus. The three-dimensional digital dental models did not differ significantly. These results suggest that immersion in 2% alkaline glutaraldehyde for 10 minutes or 600 ppm chlorine dioxide for 15 minutes can effectively disinfect alginate impressions and make no significant effect on the dimensional stability.

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    Hollow hydroxyapatite combined with human bone morphogenetic protein-2 microspheres for bone defect repair
    Tang Zhi-ming, Xiong Long, Zeng Jian-hua, Liao Xin-gen, Li Jing-tang, Yao Ai-hua, Hua Fu-zhou
    2017, 21 (2):  177-181.  doi: 10.3969/j.issn.2095-4344.2017.02.003
    Abstract ( 301 )   PDF (4405KB) ( 296 )   Save

    BACKGROUND: Hydroxyapatite (HA) is a good scaffold material, and recombinant human bone morphogenetic protein-2 (rhBMP-2) possesses a strong osteogenic ability, therefore, by which preparing a novel composite material will be helpful for bone repair.
    OBJECTIVE: To explore the effects of the hollow HA/rhBMP-2 microspheres on the osteogenesis and biomechanics of rabbit bone defects.
    METHODS: Forty-eight male healthy adult New Zealand white rabbits were randomly divided into three groups (n=16 per group), including composite, single and control groups. Radical defect models were prepared, and the hollow HA/rhBMP-2 and hollow HA scaffolds were implanted into the composite and single groups, respectively. The control group received no treatment. At the 1st day of 4, 8, 12, and 16 weeks after implantation, the level of serum alkaline phosphatase was detected, and the bone healing was assessed through X-ray, three-dimensional CT, radionuclide bone scan and biomechanics testing, respectively.
    RESULTS AND CONCLUSION: The level of serum alkaline phosphatase, X-ray scale scores, osteogetic effect, region of interest volume, three-dimensional CT and biomechanical strength in the composite group were superior to those in the single group. In the meanwhile, the bone healing was unsatisfactory in the control group. Our findings indicate that the hollow HA/rhBMP-2 artificial bone exhibits a good osteogenic ability and mechanical strength, contributing to bone healing.

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    Bone biomaterial composited with human bone marrow mesenchymal stem cells for large costal defects
    Wang Jun-gang1, Li Cong-cong2, Mao Guang-xian3, Zhang Jie1, Yang Cui1
    2017, 21 (2):  182-186.  doi: 10.3969/j.issn.2095-4344.2017.02.004
    Abstract ( 362 )   PDF (4823KB) ( 313 )   Save

    BACKGROUND: Tissue-engineered biomaterials have the similar structure and function with autologous tissues.
    OBJECTIVE: To explore the osteoinduction of the bone biomaterial composited with rat bone marrow mesenchymal stem cells in the treatment of large costal defects.
    METHODS: Forty Wistar rats were enrolled used for the preparation of right large costal defect models, and then randomized into two groups, followed by the implantation of calcium chloride-sodium alginate gel (control group) or chloride-sodium alginate-bone marrow mesenchymal stem cells (experimental group). At 2, 4 and 8 weeks after implantation, chest X-ray radiograph and histological examination of the defect region were conducted.
    RESULTS AND CONCLUSION: X-ray showed that in the experimental group, the defect area had no significant changes at the 2nd week after implantation until the formation of few bones at the 4th week; and at the 8th week, both ends of the defect region gradually connected, and newly formed bones were full of the defect. In contrast, the defect region in the control group showed no obvious bone healing, and both ends of the defect closed and osteosclerosis occurred. In the experimental group, there were a small amount of fibrous tissues and numerous inflammatory cells infiltratied in the material compartment, and no connection occured between the material and broken ends; there were numerous inflammatory cells but no bone tissues in the control group at the 2nd week. At the 4th week, the scaffold degraded gradually and abundant bone tissues were seen in the experimental group; the scaffold degraded little, and bone tissues aggregatied at the both defect ends in the control group. Up to the 8th week, the two kinds of scaffolds degraded mostly. A large number of bone tissues and trabeculae formed and the both defect ends were connected with the newly formed bones in the experimental groups, while in the control group, osteosclerosis appeared at both ends of the defect. To conclude, the bone biomaterial composited with rat bone marrow mesenchymal stem cells promotes the repair of large costal defects.

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    In vitro toxic effect of polymethylmethacrylate bone cement on lung cancer cells
    Pan Yuan-xing, Mi Chuan, Shi Xue-dong, Wang Bing, Cui Yun-peng, Lin Yun-fei
    2017, 21 (2):  187-191.  doi: 10.3969/j.issn.2095-4344.2017.02.005
    Abstract ( 408 )   PDF (4315KB) ( 277 )   Save

    BACKGROUND: Percutaneous vertebroplasty is a minimally invasive treatment for spinal metastasis tumor, but the mechanism of the injected polymethylmethacrylate (PMMA) bone cement in the treatment of tumor is not fully understood.
    OBJECTIVE: To explore the cytotoxicity of PMMA bone cement and its monomers on tumor cells.
    METHODS: PMMA extracts in the wire drawing and curing periods and different mass concentrations of monomer dilutions were co-cultured with human lung cancer cells spc-A1. The cell morphology was observed using inverted microscope, the absorbance (A) values were detected by cell counting kit- 8 assay, the relative growth rate was calculated, and the toxicity of PMAA bone cement and its monomers was evaluated at 1 and 3 days of culture, respectively.
    RESULTS AND CONCLUSION: At 1 day of culture, the absorbance values in the 1 and 10 g/L groups were significantly lower than that in the negative control group (P < 0.01). The absorbance values in the 1 g/L, 10 g/L, 100 mg/L and wire drawing extract groups were significantly lower than those in the negative control group at 3 days of culture (P < 0.05). The relative growth rate in the 1 and 10 g/L groups was 26%-29%, and the level of toxicity was grade 4 after 1-day culture; at 3 days, the relative growth rate was decreased to 12%-16%, and the level of toxicity was grades 4-5. After 3-day culture, the level of toxicity reached to grade 2 in the 100 mg/L and wire drawing extract groups. These results indicate that PMMA bone cement in wiredrawing period and its monomers exert toxic effects on tumor cells.

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    Preparation and application of layered osteochondral composite scaffold in the repair of articular cartilage defects
    Wei Rong, Wu Jun-long, Wu Fei-xiang, Wang Chao, Liu Juan-juan, Wu Qing-yuan
    2017, 21 (2):  197-201.  doi: 10.3969/j.issn.2095-4344.2017.02.007
    Abstract ( 407 )   PDF (2390KB) ( 252 )   Save

    BACKGROUND: Ideal osteochondral tissue-engineered scaffolds should be able to mimic the normal structure of human articular cartilage.
    OBJECTIVE: To prepare a layered osteochondral composite scaffold based on the anatomical and physiological functions of osteochondral articular cartilage and to observe its repair effect on osteochondral defects in rabbits.
    METHODS: The poly (lactide-glycolide acid)/β-tricalcium phosphate organic solution was sprayed on the surface of cartilage scaffold using rapid prototyping technology. The layered osteochondral composite scaffold was formed by the “dissolving-adhesion” process. Sixty rabbits were enrolled, modeled into left knee articular cartilage defects, and then randomly divided into three groups. The layered osteochondral composite scaffold and cartilage scaffold were implanted into experimental and control groups, respectively. Those without any treatment served as controls. Gross and histological observations of the defect region were performed at 12 and 24 weeks after implantation.
    RESULTS AND CONCLUSION: Gross observation: At 12 weeks after implantation, the defects in the control group were obvious and not repaired at all; the 24-week defect area was decreased, covered by newly formed tissues, but with rough surface. In the experimental group, the defect surface was flat after 12 weeks of implantation, the texture was soft, and the boundary with the surrounding tissues was unclear; at 24 weeks, the defect was covered with transparent cartilaginous tissues and the surface was smooth. Histological observation: At 12 weeks after implantation, the irregular callus appeared in the control group, but the trabeculae were not formed; in the experimental group, the thickness of the new cartilage was similar with that of the normal cartilage and there was irregular trabecular bone under the cartilage. After 24 weeks of implantation, there were new tissues in the control group, but the thickness was irregular and uneven and the trabecular structure was irregular; while the cartilage surface was smooth and repaired well in the experimental group. In contrast, repair effect in the control group was poor as assessed by gross and histological observations. These results show that the layered composite scaffold holds a similar structure with human articular cartilage and can promote the repair of articular cartilage defects.

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    Palygorskite/hydroxyapatite/polycaprolactone/collagen composite scaffold for bone repair
    Li Zhen-jun, Qi She-ning, Zhao Hong-bin, Wang Wei, Li Gen, Zhang Xiao-min, Song Xue-wen
    2017, 21 (2):  202-208.  doi: 10.3969/j.issn.2095-4344.2017.02.008
    Abstract ( 314 )   PDF (2655KB) ( 286 )   Save

    BACKGROUND: Bone transplantation is the only method for the repair of bone defects. However, traditional bone transplantation has some disadvantages. Bone tissue engineering, as a new treatment strategy, can achieve the desire therapeutic outcomes.
    OBJECTIVE: To fabricate a new tissue-engineered scaffold for improving bone repair effectively.
    METHODS: Hydroxyapatites (HA) with different Ca/P (1.50/1.67) ratios were synthesized by chemical precipitation method and microwave radiation method. Composite scaffolds of palygorskite (APC)/HA/polycaprolactone (PCL)/ collagen (COL), APC/calcium deficiency HA (CDHA)/PCL/COL, and APC/PCL/COL (control group) were prepared by solution perfusion-solvent evaporation and ion leaching method. The material characterization, active ingredients, hydrophilic property, and mechanical properties were evaluated by scanning electron microscope, infrared spectrometer, surface contact measuring instrument and universal mechanics, respectively. The histocompatibility of the implant with the host was assessed through animal experiments.
    RESULTS AND CONCLUSION: By precise control of pH range, HA with different Ca/P ratios could be synthesized. The mechanical properties, air permeability, hydrophilic property of the APC/HA/PCL/COL and APC/CDHA/PCL/COL composite materials were significantly increased compared with the APC/PCL/COL composite material (P < 0.05), while the porosity, water absorption expansion rate were significantly decreased (P < 0.05). Results from our animal experiments showed that no immune inflammatory reaction was observed suggesting that the composite materials hold good histocompatibility. To conclude, the APC/HA (1.50/1.67)/PCL/COL composite materials are promising bone substitutes in bone tissue repair.

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    Directional cartilage scaffold for the repair of articular cartilage injury caused by exercise
    Zhao Xia1, Guo Qiu-lin2
    2017, 21 (2):  209-214.  doi: 10.3969/j.issn.2095-4344.2017.02.009
    Abstract ( 465 )   PDF (4817KB) ( 280 )   Save

    BACKGROUND: Cartilage scaffold plays an important role in articular cartilage injury, but it is still restricted in practice, leading to the repair failure using tissue-engineered cartilage.
    OBJECTIVE: To explore the preparation method of cartilage scaffold with directional structure and its repairing effect in cartilage injury of rabbits.
    METHODS: Directional cartilage scaffolds were prepared by temperature gradient induced phase separation technique. The cross-linking of cartilage scaffold was completed with genipin. The physical and mechanical properties of scaffolds were determined. Forty-eight white rabbits were modeled into exercised-induced articular cartilage injury and equivalently randomized into two groups, followed by implantation of non-directional or directional scaffolds. Samples were collected at postoperative 6, 12 and 24 weeks to compare the repair effect of two scaffolds on rabbit joint injury.
    RESULTS AND CONCLUSION: Scanning electron microscope showed that the regular microstructures on the longitudinal section of directional scaffolds were aligned in the same direction, while the longitudinal and transverse planes of the non-directional scaffolds showed porous honeycomb structures. The elastic modulus of the directional scaffold was significantly higher than that of the non-directional scaffold (P < 0.05). O’Driscoll histological scores in the directional scaffold group were significantly higher than those in the non-directional scaffold group at 6, 12 and 24 weeks postoperatively (P < 0.05). At postoperative 24 weeks, in the directional scaffold group, the three-dimensional reconstruction of the rabbit defect region was flat and smooth, and coronal two-dimensional scanning showed the cartilage thickness of the newborn cartilage was very close to that of the normal bone; the cartilage surface in the non-directional rabbits was flat under three-dimensional CT, and coronal two-dimensional scanning showed that the repaired cartilage was almost the same as the normal cartilage. Hematoxylin-eosin staining showed that at 24 weeks postoperatively, the defect site disappeared and the cartilage cells arranged in the vertical direction in the directional scaffold group. There were typical cartilage lacunae at the defect site in the non-directional scaffold group at 24 weeks postoperatively. Our findings suggest that the directional cartilage scaffold prepared using temperature gradient induced phase separation technique holds good physical and mechanical properties, and its implantation into the rabbit articular cartilage injury induced by exercise can promote the injury repair to obtain ideal mechanical properties.

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    Preparation of polyvinyl alcohol/lota-carrageenan scaffolds and its biocompatibility
    Cui Jing, Zhang Ya-bin, Ma Si-qi, Xiong Yan-jie, Cui Man, Li Shuo-feng, Che Peng-cheng, Yao Fang-lian,Sun Hong
    2017, 21 (2):  215-220.  doi: 10.3969/j.issn.2095-4344.2017.02.010
    Abstract ( 450 )   PDF (1357KB) ( 469 )   Save

    BACKGROUND: Polyvinyl alcohol (PVA) hydrogel with similar porous structure and mechanical properties to the natural cartilage is very suitable for the repair of articular cartilage. However, the pure PVA hydrogel after lyophilization will be accompanied by the shrinkage of the polymer network and the collapse of the pores, leading to the inhomogeneous performance of the material even in the state of re-swelling. Addition of the active polymer will increase the cell adhesion ability of PVA hydrogel.
    OBJECTIVE: To construct PVA/ lota-carrageenan (l-CA) composite materials with different mass fractions of l-CA and evaluate the biocompatibility with vascular endothelial cells.
    METHODS: PVA/l-CA composite films with different contents of l-CA were fabricated and then co-cultured with vascular endothelial cells. Attachment, proliferation and morphological changes of vascular endothelial cells on the composite were observed by scanning electron microscope and MTT assay to evaluate its biocompatibility. PVA/l-CA three-dimensional scaffold with different contents of l-CA were constructed, and hemolysis experiment was conducted according to the biological evaluation standards of medical devices, and the porosity and pore size were observed using scanning electron microscope.
    RESULTS AND CONCLUSION: In vitro experimental results showed that the addition of l-CA could significantly increase the biological activity of PVA hydrogel, and promote the cell attachment and proliferation on the scaffold. The hemolysis rate of each experimental group was less than 5% (the accepted safety standard), suggesting that the composite materials were in accordance with the standard of medical devices for hemolysis experiment. These findings indicate that the composite scaffolds with 20%-30% l-CA possess the pore size suitable for cell growth and proliferation and the porosity beneficial for transportation of nutrients and metabolites, which can serve as an excellent scaffold for tissue engineering.

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    Treatment outcomes of human epidermal stem cells/porcine acellular dermal tissue-engineered skin in the repair of full-thickness skin defects
    Qian Li-ke, Qian Ming-yuan
    2017, 21 (2):  227-231.  doi: 10.3969/j.issn.2095-4344.2017.02.012
    Abstract ( 411 )   PDF (2172KB) ( 242 )   Save

    BACKGROUND: Biological artificial skin made by fibroin, connective tissues, biopolymer materials, synthetic polymeric material, nano materials as well as sensor and non-biological artificial skin both have achieved satisfactory effects in clinical trials, but there is still a significant difference from the natural skin.
    OBJECTIVE: To investigate the treatment outcomes of epidermal stem cells/porcine acellular dermal tissue-engineered skin for full-thickness skin defects in rats.
    METHODS: Twenty Sprague-Dawley rats were selected to make the skin defect model on the rat back, and then randomly divided into experimental and control groups, followed by subjected to the implantation of human epidermal stem cells/porcine acellular dermal tissue-engineered skin and porcine acellular dermal matrix, respectively. Gross, histological and immunohistochemical observations were performed at 4 weeks after implantation.
    RESULTS AND CONCLUSION: Gross observation: the wound in the experimental group healed well, and the skin had good elasticity; the control group showed scar formation in the implanted site and the texture was hard. Histological observation: there were good epidermal and dermal structures under microscope in both groups, and the basal layer, stratum corneum and stratum corneum of the epidermis could be distinguished clearly. Compared with the experimental group, more fibrous connective tissue could be found in the control group. Immunohistochemical observation: the wound surface in the experimental group was positive for the anti-HLA class I antigen, while the wound surface in the control group negative for the anti-HLA class I antigen. These findings suggest that the human epidermal stem cells/porcine acellular dermal tissue-engineered skin can effectively inhibit the scar formation and contracture in the repair of full-thickness skin defects.

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    Chitin hybrid membrane carrying cells repairs corneal epithelial injury
    Lu Jing, Wu Shi-ke, Chen Guang, Zhao Yue, Li Dan
    2017, 21 (2):  232-237.  doi: 10.3969/j.issn.2095-4344.2017.02.013
    Abstract ( 439 )   PDF (4225KB) ( 257 )   Save

    BACKGROUND: Chitin has been found to be a good biomaterial, but research on chitin carrying corneal epithelial cells for rabbit corneal epithelial injury is little reported.
    OBJECTIVE: To investigate the repair outcomes of chitin hybrid membrane carrying corneal epithelial cells in the rabbit corneal epithelial injury.
    METHODS: Eighteen New Zealand white rabbits were enrolled and made into left corneal epithelial injury models, and then randomized into two groups and treated with chitin hybrid membrane carrying corneal epithelial cells (experimental group) and chitin hybrid membrane (control group), respectively. The damage area, histological changes and ultrastructure of the cornea were observed at 1, 3, and 7 days after implantation.
    RESULTS AND CONCLUSION: Damage area of the cornea in the experimental group was significantly less than that in the control group at 1 and 3 days after implantation (P < 0.05), and the cornea in both two groups healed well at 7 days after implantation. At 7 days after implantation, in both two groups, the corneal epithelium with six layers adhered to the corneal stroma closely, which was repaired completely and regularly. Comparatively speaking, the cornea in the experimental group possessed smooth outer layer. Besides, in the experimental group, the hexagonal corneal epithelial cells arranged closely with flat surface; while the hexagonal corneal epithelial cells in the control group showed no smooth surface and gaps between cells. These results indicate that chitin hybrid membrane carrying corneal epithelial cells promotes the repair of rabbit corneal epithelial injury.

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    Vitreous cryopreservation of tenocytes co-cultured with porous polydimethylsiloxane scaffolds
    Wang Zhi, Tan Mei-yun, Qing Quan, Chen Xi, Liu Cheng-jun, Qin Ting-wu
    2017, 21 (2):  238-243.  doi: 10.3969/j.issn.2095-4344.2017.02.014
    Abstract ( 313 )   PDF (4587KB) ( 251 )   Save

    BACKGROUND: Accumulative evidence supports that vitreous cryopreservation can improve the cell survival rate.
    OBJECTIVE: To investigate the effect of vitreous cryopreservation on the tenocytes co-cultured with the porous polydimethylsiloxane (PDMS) scaffold.
    METHODS: Tenocytes were co-cultured with the porous PDMS scaffold for 9-14 days, and then preserved and resuscitated in the 10% dimethyl sulfoxide (DMSO), 21% DMSO and VS55, respectively. One hour later, the survival rate of post-resuscitated tenocytes versus pre-resusciated tenocytes was analyzed by live/dead double color fluorescent staining and flow cytometry.
    RESULTS AND CONCLUSION: Live/dead double color fluorescent staining revealed that tenocytes in the 10% DMSO group appeared to be irregular and double stained, and a large number of cells shedding from the scaffold. The VS55 and 21% DMSO groups showed some spindle and hemispherical cells single stained for green fluorescence and few double stained irregular cells. Additionally, the cell density in the two groups was significantly lower than that in the control group. Flow cytometry results found that there were homogenous cells in the control group; the number of cells in the 10% DMSO group was too low to undergo flow cytometry; small cell particles were visible in the VS55 group; in the 21% DMSO group, the cell volume was similar with the control group, and small particles also existed. The survival rate in the VS55 group (64.9%) was significantly lower than that in the 21% DMSO group (76.2%; P < 0.05). Conversely, the survived cells were rare in the 10% DMSO group. To conclude, 21% DMSO vitreous cryopreservation improves the cell survival rate and is beneficial for tenocyte adherence to the scaffold.

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    Chitosan/hydroxyapatite composite scaffolds for articular cartilage injury
    Liu Hong-ya
    2017, 21 (2):  244-248.  doi: 10.3969/j.issn.2095-4344.2017.02.015
    Abstract ( 395 )   PDF (997KB) ( 249 )   Save

    BACKGROUND: Studies have shown that the chitosan/hydroxyapatite composite scaffold with good biological performance is very similar to natural bone in structure, and plays the performance of different materials.
    OBJECTIVE: To observe the repairing effect of chitosan/hydroxyapatite composite scaffold on articular cartilage injury.
    METHODS: Thirty New Zealand white rabbits were selected to make articular cartilage injury on the left knee, and then model rabbits were randomly divided into sodium hyaluronate gel group (control group, n=15) and chitosan/hydroxyapatite composite scaffold group (experimental group, n=15). At 4, 8, 12 weeks after scaffold implantation, cartilage tissues were taken out and observed histologically.
    RESULTS AND CONCLUSION: Compared with the control group, the experimental group showed higher Wakitani scores at 4, 8, 12 weeks, but lower Mankin scores at 4 and 12 weeks after implantation (both P < 0.05). Safranin-O staining results showed that at 4 weeks after implantation, chondrocytes arranged relatively in disorder with overt pleated small projections in the control group, while chondrocytes were well aligned with slightly pleated small projections and slightly large nuclei in the experimental group; at 8 weeks, chondrocytes arranged irregularly with pleated small projections in the control group, while in the experimental group, the chondrocytes arranged orderly with pleated small projections and large nuclei; at 12 weeks, the chondrocytes in the control group exhibited a substantially ordered arrangement with pleated small projections and large nuclei, while in the experimental group, the chondrocytes arranged in order with no pleated small projections but with large nuclei. All these findings indicate that chitosan/hydroxyapatite composite scaffold can promote articular cartilage repair.

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    Effect of enamel matrix proteins on the growth of apatite coating on dual thermo-etching modified titanium
    Zhu Xi-hua1, Wu Qian-wen2, Huang Hui3
    2017, 21 (2):  249-253.  doi: 10.3969/j.issn.2095-4344.2017.02.016
    Abstract ( 323 )   PDF (2740KB) ( 287 )   Save

    BACKGROUND: Various surface modification techniques have been used to improve the bioactivity of titanium
    implant in vivo.
    OBJECTIVE: To investigate the effects of enamel matrix proteins (EMPs) on the growth of apatite coatings on dual thermo-etching treated pure titanium.
    METHODS: EMPs were extracted from porcine tooth germs and then were identified. Dual thermo-etching was applied to treat titanium samples following polished, and then immersed in a blank simulated body fluid supersaturated calcification solution (control group) or supersaturated calcification solution containing different concentrations of EMPs for 7 days. The morphology of samples was observed using scanning electron microscope, and element components and crystal structures of the apatite coatings were analyzed by energy dispersive spectrometer and X-ray diffraction.
    RESULTS AND METHODS: After double-etching, a pit-like rough surface was observed on the titanium plate. After 7-day mineralization, in the control group, no overt calcium-phosphate deposits were found on the titanium surface; however, in the experimental groups, there were calcium-phosphate deposits, whose quantity and morphology changed with increasing concentrations. Energy dispersive spectrometer showed that the main element components of the mineralized coating included calcium, phosphorus, oxygen and carbon, and the calcium-phosphate ratio ranged from 1.32 to 1.41. The apatite coatings were proved to be carbonate hydroxyapatite by X-ray diffraction. To conclude, EMPs promote apatited deposition on pure titanium surfaces in a concentration-dependent manner.

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    ffect of ultrasonic cleaning of post space on the apical microleakage following treatment with two kinds of root canal sealers
    Feng Xin-yan, Gao Cheng-zhi
    2017, 21 (2):  254-259.  doi: 10.3969/j.issn.2095-4344.2017.02.017
    Abstract ( 405 )   PDF (1006KB) ( 306 )   Save

    BACKGROUND: The post space cleaning using ultrasonic file can improve the bonding strength of fiber posts
    cemented with the self-adhesive resin cement, but the effect on apical sealing ability is still unclear.
    OBJECTIVE: To evaluate the effect of the post space cleaning using ultrasonic file on apical microleakage following treatment with two kinds of root canal sealers at two different residual lengths of root canal filling.
    METHODS: Eighty extracted human maxillary anterior teeth with single-rooted canal were selected, and equivalently randomized into groups A and B (n=40 per group), followed by filled with Cortisomol or AH-plus, respectively. Groups A and B were randomly subdivided into four groups according to the residual length of root canal filling and with or without ultrasonic cleaning (n=10 per group): A1, B1 groups: residual 5 mm, no ultrasonic cleaning; A2, B2 groups: residual 5 mm, ultrasonic cleaning; A3, B3 groups: residual 3 mm, no ultrasonic cleaning; A4, B4 groups: residual 3 mm, ultrasonic cleaning. Subsequently, the apical microleakage was measured using dye method and transparent specimen technique under stereomicroscope.
    RESULTS AND CONCLUSION: The apical microleakage of each group was as follows: A1 (0.73±0.21) mm, A2 (1.37±0.55) mm, A3 (1.18±0.36) mm, A4 (2.05±0.62) mm, B1 (0.34±0.18) mm, B2 (0.47±0.14) mm, B3 (0.59±0.23) mm, B4 (1.39±0.50) mm. The three-factor analysis of variance revealed that the ultrasonic cleaning, root canal sealers and residual length of root canal filling all had a significant effects on the apical microleakage (P < 0.05), and there were significant differences in the apical microleakage between groups A1 and A2, groups A3 and A4, groups B3 and B4, groups A2 and A4, groups B2 and B4 (P < 0.05). These results indicate that the ultrasonic cleaning increases the apical microleakage following the use of Cortisomol at 5 and 3 mm residual length, as well as the use of AH-Plus at 3 mm residual length. Moreover, for the same root canal sealer, the longer residual length of root canal filling indicates, the less microleakage after ultrasonic cleaning.

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    Preparation of span-poly(ethylene glycol) ultrasound contrast agent microbubbles combined with folate-carbon nano tube-paclitaxel
    Liu Jun-xi, Zhang Jie, Zhang Yu, Zhao Yue, Wan Guo-jing, Li Guo-zhong
    2017, 21 (2):  260-267.  doi: 10.3969/j.issn.2095-4344.2017.02.018
    Abstract ( 374 )   PDF (3601KB) ( 337 )   Save

    BACKGROUND: As the sensitivity, clarity and accuracy of traditional ultrasound contrast agents are easy to be affected by objective factors, it is difficult to achieve diagnose and therapy simultaneously. Carbon nano tubes (CNTs) possess a specific reticular, hollow and tubular structure and the potential to enhance the ultrasound imaging. The functional CNTs obtained through non-covalent adsorption, covalent bonding and internal embedding hold a good biocompatibility and high drug loading efficiency. So the drug loaded CNTs are added into the microbubble to synthesize a multi-functional ultrasound contrast agent.
    OBJECTIVE: To prepare the span-poly(ethylene glycol) (span-PEG) ultrasound contrast agent microbubble combined with folate-CNTs-paclitaxel (FA-CNTs-PTX) and to investigate its appearance, particle size as well as loading efficiency of CNTs and PTX.
    METHODS: Firstly, the span-PEG microbubble was prepared using the acoustic cavitation method and its preparation process was optimized through the orthogonal experiment. Then the FA-CNTs-PTX compound was synthesized by the electrostatic self-assembly and π-π adsorption principle. In the end, the span-PEG ultrasound contrast agent microbubble combined with FA-CNTs-PTX was obtained by loading the FA-CNTs-PTX into the span-PEG microbubble. The appearance of the composite microbubble were observed using scanning and transmission electron microscopes, the distribution and average particle size were detected by laser particle size analyzer, and the loading efficiency of CNTs and PTX was measured through ultraviolet spectroscopy.
    RESULTS AND CONCLUSION: The composite microbubble had a smooth surface and the average particle size was 442 nm. The loading efficiency of CNTs and PTX in the composite microbubble was 1.69% and 47.9%, respectively. To conclude, the FA-CNTs-PTX targeting drug delivery system is successfully loaded into the span-PEG microbubble. The composite microbubble is a hollow sphere that has uniform nanoscaled particle size distributions, which is expected to become an ideal ultrasound contrast agent involved in angiography and targeting therapy.  

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    Preparation, transfer property and biocompatibility of the hollow fiber dialysis membrane
    Wang Shi-ying, Zhao Xin-xin, Shi Jun, Yang Su-xia, Sun Zhi-qiang
    2017, 21 (2):  268-272.  doi: 10.3969/j.issn.2095-4344.2017.02.019
    Abstract ( 575 )   PDF (1011KB) ( 313 )   Save

    BACKGROUND: Polysulfone membrane holds good anti-biodegradation ability, but how to use it to prepare hollow fiber dialysis membrane and its blood compatibility have not been fully understood.
    OBJECTIVE: To study the preparation, transfer property and biocompatibility of hollow fiber dialysis membrane.
    METHODS: With polysulfone as the film material, diethylene glycol as the porogen, polyvinyl pyrrolidone as the modifier, N, N-dimethylacetamide as the solvent, and the hollow fiber dialysis membrane was prepared using nonsolvent-induced phase separation. The performance was measured using scanning electron microscopy, ultra-depth three-dimensional microscope imaging and porosity test; the transfer parameters including reject rate and water flux were detected by ultrafiltration device; the blood compatibility was determined through hemolysis test, dynamic clotting time test and platelet adhesion test. Type II medical polyurethane material served as negative control.
    RESULTS AND CONCLUSION: The section of hollow fiber dialysis membrane was asymmetric. 17% dialysis membrane showed a porous middle layer, while 19%, 21% and 23% membrane showed a sponge-like middle layer. Under the same membrane area, the density of fiber dialysis membrane was significantly lower than that of the negative control material, and the porosity of fiber dialysis membrane was significantly higher than that of the negative control material (P < 0.05). The water volume and water flux of the hollow fiber dialysis membrane were significantly higher than those of the negative control material (P < 0.05). Results from three hemolytic tests showed that the average absorbance values and hemolysis rate of the hollow fiber dialysis membrane were significantly higher than those of the negative control material (P < 0.05). The dynamic clotting time test and the platelet adhesion test revealed that the dynamic clotting time of hollow fiber dialysis membrane at 20, 40 and 70 minutes was significantly shorter than that of the negative control material (P < 0.05). These results suggest that polysiloxane can be used as the membrane material to prepare hollow fiber dialysis membrane using nonsolvent-induced phase separation, and holds a good biocompatibility, blood compatibility and transfer efficiency.

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    Controlled release of porous calcium phosphate nanoparticles loaded with vitamin C
    Kong Jun, Zhu Yong-qiang
    2017, 21 (2):  273-279.  doi: 10.3969/j.issn.2095-4344.2017.02.020
    Abstract ( 467 )   PDF (1332KB) ( 404 )   Save

    BACKGROUND: It is reported that vitamin C can induce bone marrow mesenchymal stem cells differentiating into osteoblasts, and promote bone repair and regeneration. However, vitamin C solution is unstable, so a carrier is necessary. 
    OBJECTIVE: To observe the loading and controlled-release abilities of calcium phosphate used as the carrier of vitamin C.
    METHODS: Calcium phosphate particles loaded with vitamin C were fabricated using chemical precipitation method, and the final concentration of vitamin C was 0, 0.1, 2 and 4 mmol/L, respectively. The drug-loaded capacity was detected. The release of vitamin from calcium phosphate nanoparticles in the simulate body fluid and ultrasonic environment was respectively evaluated. MC3T3-E1 cells were co-cultured with calcium phosphate nanoparticles loaded with 2 mmol/L vitamin C, or calcium phosphate nanoparticles only. The cell proliferation was detected at 1, 3, 5 and 7 days of culture, and the alkaline phasphatase activity was detected at 1, 5, 10 and 15 days of culture.
    RESULTS AND CONCLUSION: The drug-loaded contents of calcium phosphate nanoparticles loading 0, 0.1, 2 and   4 mmol/L vitamin C were (59.9±5.4)%, (87.2±1.2)% and (28.4±26.3)%, respectively. Under normal environment, all samples could release vitamin C persistently, but the initial release speed of the particles carrying 0.1 and 2 mmol/L vitamin C was lower than that of particles carrying 4 mmd/L vitamin. Under ultrasonic environment, 2 mmol/L vitamin C-loaded calcium phosphate particles exhibited a quick release speed firstly that reached 5-15%, followed by a slow release speed. When ultrasonic powers kept at 75, 105 and 150 W, the release duration of vitamin C was 220, 340 and 260 minutes, respectively. MC3T3-E1 cell proliferation did not change after co-cultured with 2 mmol/L vitamin C-loaded calcium phosphate particles but the alkaline phosphatase activity was improved. These results suggest that calcium phosphate particles can be used as the carrier of vitamin C.

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    Three-dimensional printed silk fibroin/collagen scaffold and its performance
    Sun Kai, Li Rui-xin, Fan Meng, Li Yi-jin, Dong Bao-kang, Li Hui
    2017, 21 (2):  280-285.  doi: 10.3969/j.issn.2095-4344.2017.02.021
    Abstract ( 478 )   PDF (2098KB) ( 442 )   Save

    BACKGROUND: Searching for a porous three-dimensional (3D) scaffold holding good porosity, mechanical property and biocompatibility has become a hot spot, in which, 3D printing technology also plays apart.
    OBJECTIVE: To prepare silk fibroin/collagen scaffolds using 3D printing technology and detect its performance.
    METHODS: Silk fibroin/collagen scaffolds were constructed using 3D printing technology, and the silk fibroin/collagen mass ratio was 4:2 (group A) and 4:4 (group B), respectively. The porosity, water absorption expansion rate, mechanical properties and pore size of the composite scaffolds were detected. The passage 3 rat bone marrow mesenchymal stem cells were seeded onto the two scaffolds. The cell proliferation was detected using MTT assay at 13 days of culture, and the cell morphology was observed by hematoxylin-eosin staining and scanning electron microscope at 14 days of culture.
    RESULTS AND CONCLUSION: The porosity, pore size, and water absorption expansion rate of group A were significantly larger than those of group B (P < 0.05), while the elasticity modulus showed no significant difference between groups. Bone marrow mesenchymal stem cells on the two scaffolds increased gradually with time, especially in the group A (P < 0.05). Abundant cells distributed evenly in the group A, while few cells distributed unevenly in the group B. These results suggest that the 3D printed scaffolds composed by silk fibroin/collagen mass ratio of 4:2 holds good physicochemical performance and cytocompatibility.

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    Collagen-gelatin scaffolds for the repair of peripheral nerve defects
    Liu Tian-dan, Zhang Bao-chao, Hao Ming-liang
    2017, 21 (2):  286-290. 
    Abstract ( 275 )   PDF (1107KB) ( 308 )   Save

    BACKGROUND: Collagen-gelatin composite scaffolds have been reported to be able to promote the early recovery of peripheral nerve defects. However, this conclusion has not been further confirmed.
    OBJECTIVE: To investigate the biocompatibility of the collagen-gelatin scaffold and its treatment outcomes in the repair of peripheral nerve defects.
    METHODS: The collagen-gelatin scaffold was co-cultured with bone marrow mesenchymal stem cells (BMSCs) of Sprague-Dawley rats for 5 days, and then the cell growth was observed. Twenty Sprague-Dawley rats were enrolled, modeled into a left 30-mm peroneal nerve defect and randomized into experimental and control groups. The collagen-gelatin scaffold composited with BMSCs was implanted into the experimental group, and autograft
    nerve implanted into the control group. Morphology of the middle bridge was observed, and electrophysiology was conducted at 16 weeks after implantation.
    RESULTS AND CONCLUSION: BMSCs grew and adhered well onto the scaffold. The myelinated nerve fiber density did not significantly differ between groups (P > 0.05). The myelinated nerve fiber diameter, myelin sheath thickness and percentage of nerve tissues in the experimental group were significantly lower than those in the control group (P < 0.05). There were no significant differences in the conduction velocity, latency of motor nerves and the conduction velocity and amplitude of sensory nerves between groups (P > 0.05). The amplitude of motor nerves and the latency of sensory nerves in the experimental group were significantly lower than those in the control group (P < 0.05). To conclude, the collagen-gelatin scaffold holds a good cytocompatibity and is ideal for the repair of peripheral nerve defects.

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    Simultaneous determination of three main bioactive constituents in the in vitro fertilization medium by UHPLC-MSMS
    Huang Yuan-li, Ke Lin-nan, Wang Chun-ren, Yang Zhao-peng
    2017, 21 (2):  291-295.  doi: 10.3969/j.issn.2095-4344.2017.02.023
    Abstract ( 373 )   PDF (981KB) ( 286 )   Save

    BACKGROUND: In the present quality control file or technique standards of in vitro fertilization medium, the indicators of the component contents and detection methods have not been clearly defined. To ensure the safety and effectiveness of these products, we should establish the quality standards as early as possible.
    OBJECTIVE: To establish a method for determining the three main bioactive constituents of in vitro fertilization
    medium including glucose, lactic acid sodium salt, pyruvic acid sodium salt by ultra-high performance liquid chromatography tandem mass spectrometric method (UHPLC-MSMS), and to analyze the content of each constituent.
    METHODS: The UHPLC-MSMS was used, and UHPLC separation was performed on a SUPELCO Discovery HS F5-3 column (15 cm × 2.1 mm, 3 μm) in a gradient elute mode with acetonitrile and water (both containing 0.1% formic acid) as the mobile phase at a flow rate of 0.35 mL/min. The column temperature was 40℃. Mass spectrometry detection was performed with multi-reaction monitoring mode using negative electro spray ionization.
    RESULTS AND CONCLUSION: The linearity was achieved in the range of 0.1-10 μg/mL (r=0.999 8) for glucose, 0.05-5 μg/mL (r=0.999 4) for lactic acid sodium salt, and 0.1-10 μg/mL (r=0.999 4) for pyruvic acid sodium salt. The recoveries were 96.4%-98.1% with relative standard deviation less than 2.8%. To conclude, the UHPLC-MSMS method is sensitive, rapid, accurate and specific, thus providing a basis for the quality standard study of in vitro fertilization medium.

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    Application of silicon in biomaterials: an increase in bioactivity but with no change in mechanical performance
    Zhang Shai-lin, Cheng Xiang-yu, Ji Bin
    2017, 21 (2):  296-301.  doi: 10.3969/j.issn.2095-4344.2017.02.024
    Abstract ( 536 )   PDF (1132KB) ( 309 )   Save

    BACKGROUND: Silicon plays an essential role in bone development and bioactive silicate glasses pioneered the current era of bioactive materials. Various biomaterials have been developed based on the biological function of silicon.
    OBJECTIVE: To explore the biological function of silicon and research process of silicon in biomaterials.
    METHODS: A computer-based retrieval of CNKI, PubMed, SpringerLink and Elsevier ScienceDirect databases was performed to search the relevant literatures concerning the biological function of silicon and its application in biomaterials. All data were primarily screened to exclude repeated and irrelevant articles. Literatures about the application of silicon in biomaterials were included.
    RESULTS AND CONCLUSION: A total of 68 eligible English articles are enrolled. Silicon plays important chemical and biological roles in bone. Silicon in the extracellular matrix interacts with glycosaminoglycans and proteoglycans during their synthesis and form ionic substitutions in the crystal lattice structure of hydroxyapatite. In addition, the dissolution products of bioactive glass (mainly silicic acid) expose significant influence on the molecular biology of osteoblasts in vitro, and can regulate the expressions of several genes including osteoblastic markers, cell cycle regulators and extracellular matrix proteins. Silicon has been proved to improve the bioactivity of numerous materials and do no harm to their mechanical properties and without cytotoxicity.  

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    Electrospun materials applied in drug delivery system
    Zhao Zhi-feng, Yang Zhi-xun, Li Feng, Musha Hamushan, Shi Yi-fan, Fei Jian, Zhang Jun, Cui Wen-guo
    2017, 21 (2):  303-308.  doi: 10.3969/j.issn.2095-4344.2017.02.025
    Abstract ( 414 )   PDF (980KB) ( 304 )   Save

    BACKGROUND: Recently, electrospun materials have been extensively applied in the drug delivery system.
    OBJECTIVE: To overview the application prospect of electrospun materials in drug delivery systems.
    METHODS: A computer-based search of PubMed and NCBI databases was performed for literatures about the research progress of electrospinning in tissue engineering and chemotherapy published within the past 10 years using the keywords of “electrospinning, drug delivery system, nanofibers, electrospun materials”.
    RESULTS AND CONCLUSION: Compared with traditional materials, electrospun stents hold good versatility and controllable parameters, thus granting its unique advantage under various physiological conditions. Current drug-loaded materials composed of natural products, synthetic polymers and blended materials; as to drugs, there are antibiotics, chemotherapy medication, DNA and protein. Electrospun materials have been used in tissue engineering, cancer chemotherapy and wound healing. We focus on not only the application progress of electrospun materials in traditional treatments, but also its usage, condition-controlled drug release and living-cell carrying. Electrospun materials combined with various drug-loaded present a broad prospect.

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    Research progress of strontium-doped biomedical titanium alloys
    Li Rui-yan, Liu Guan-cong, Liang Hao-jun, Qin Yan-guo
    2017, 21 (2):  309-314.  doi: 10.3969/j.issn.2095-4344.2017.02.026
    Abstract ( 349 )   PDF (1047KB) ( 633 )   Save

    BACKGROUND: Surface modification of titanium surface to improve its biological activity is the research hotspot. Strontium-doped coating is considered to be an effective approach to promote the implant osseointegration.
    OBJECTIVE: To introduce the research progress of strontium-modified biomedical titanium alloys.
    METHODS: Articles related to the medical titanium alloys modified with strontium published from January 2000 to April 2016 were retrieved from CNKI and PubMed databases. The keywords were “titanium (Ti), strontium (Sr), bone, osteogenic” in Chinese and English, respectively.
    RESULTS AND CONCLUSION: Titanium alloys have been widely used in bone implantation because of their good biocompatibility and similar elasticity modulus with human bones. However, pure titanium alloys have poor bioactivity which leads to weak bone-implant contact. Surface modification is a good approach to enhance implant osseointegration. Sr-doped surface treatment can promote new bone formation and osseointegration. Most of the studies about Sr-doped modification are ongoing at the extracorporeal and animal experiment stage; therefore, further investigation is required to seek rapid, stable, available, safe and effective methods. 

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    Research progress of interbody fusion cage and its materials
    Zhao Bo-ran, Zheng Xiu-jun, Ma Jin-rong
    2017, 21 (2):  315-321.  doi: 10.3969/j.issn.2095-4344.2017.02.027
    Abstract ( 598 )   PDF (1050KB) ( 552 )   Save

    BACKGROUND: With the rapid development of technology, most interbody fusion cages have been applied in clinic, but some are still in experimental stage. All fusion cages hold their own distinct characteristics as well as advantages and shortcomings.
    OBJECTIVE: To clarify the development course of interbody fusion cages and analyze their types in detail, thereby paving ways for its improvement.
    METHODS: A computer-based search for literatures in CNKI and PubMed databases published from January 1989 to March 2016 was performed using the keywords of “interbody fusion cage, PEEK, TMC” in English and Chinese, respectively. A total of 106 articles were retrieved and 38 articles were in accordance with the inclusion criteria.
    RESULTS AND CONCLUSION: Intervertebral fusion is a major method to treat spinal degenerative diseases. There are a variety of fusion cages in clinic, such as pyramesh, polyetheretherketone and absobable fusion cages. Implants used for fusion cages include autogenous, allogenic and artificial bones as well as bone morphogenetic protein. We introduce the development process of fusion cages in detail, emphasize the commonly used fusion cages and analyze its development in future. In the end, we give our opinions about the development of intervertebral fusion cages.

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    High viscosity versus common viscosity bone cement systems in the treatment of osteoporotic vertebral compressive fractures: a Meta-analysis
    Mu Xiao-ping, Yi Wei-lin, Wei Jian-xun, Ou Yu-fu, Li Zhu-hai
    2017, 21 (2):  322-328.  doi: 10.3969/j.issn.2095-4344.2017.02.028
    Abstract ( 370 )   PDF (1399KB) ( 231 )   Save

    BACKGROUND: Vertebroplasty system has been proved to be effective for osteoporotic vertebral compressive fracture (OVCF); however, bone cement leakage-related complications occur frequently. Thereafter, high-viscosity bone cement system with high safety and efficacy is developed, but there is still a lack of large-scale and high quality research.
    OBJECTIVE: To systematically review the efficacy and safety of high viscosity versus common bone cement systems for OVCF.
    METHODS: PubMed, Embase, Cochrane Library, CNKI, CqVip and WanFang databases were searched to collect the literatures about randomized controlled trials (RCTs) or clinical controlled trials (CCTs) of high viscosity versus common bone cement systems for OVCF published before January 2016. The quality assessment of included literatures and data extraction were performed by two researchers independently according to the Cochrane system. Data analysis was conducted using RevMan 5. 2 software.
    RESULTS AND CONCLUSION: Four RCTs and six CCTs were enrolled. The results of Meta-analysis indicate that there were no significant differences in the volume of bone cement [MD=0.17, 95% CI(-0.04, 0.38)], visual analogue scale scores [RCT: MD=-0.30, 95%CI(-0.72, 0.11); CCT: MD=-0.05, 95%CI(-0.43, 0.32)] and incidence of second fractures [OR=1.77, 95%CI(0.24, 12.86)] between two bone cements. However, patients undergoing high viscosity bone cement system have significantly lower Oswestry disability index scores [MD=-2.99, 95%CI(-5.85, -0.13)], greater recovery of Cobb angle [MD=-3.19, 95%CI(-5.27, -1.10)] and lower incidence of cement leakage [OR=0.35, 95%CI(0.24, 0.51)]. High viscosity bone cement system in the treatment of OVCF shows good results at recovery of spinal structure and function and reducing leakage. Due to the limited quantity of included literature sand high heterogeneity, more large scale and high quality RCTs are still needed for further verification.

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