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28 October 2019, Volume 23 Issue 30 Previous Issue    Next Issue

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Effect of icariin on the repair of femoral defects in rabbits by calcium phosphate bone cement/bone marrow mesenchymal stem cell complex Jia Bingshen, Zhang Ximing, Yu Peng, Li Ming, Li Jun, Yun Dake, Wang Sheng, Hu Shuai 2019, 23 (30):  4757-4762.  doi: 10.3969/j.issn.2095-4344.1413 Abstract ( 461 )   PDF (23053KB) ( 330 )   Save BACKGROUND: Previous studies have shown that calcium phosphate bone cement/bone marrow mesenchymal stem cell complex can help repair cartilage defects. Icariin is a kind of flavonoids that can promote cell proliferation and differentiation. OBJECTIVE: To investigate the effect of icariin-treated calcium phosphate cement/bone marrow mesenchymal stem cell complex in the repair of femoral defects in rabbits. METHODS: Thirty New Zealand white rabbits were provided by Laboratory Animal Center, Hainan Medical University, China and prepared into models of right femur end defect. Then these models were randomly divided into three groups. In the blank group, there was no filling material for femoral defect. In the control group, the complex of calcium phosphate bone cement and the bone marrow mesenchymal stem cells which were cultured from osteoblasts was implanted in the femoral defect area. In the experimental group, the complex of calcium phosphate bone cement and the bone marrow mesenchymal stem cells which were cultured from osteoblasts and treated with icariin was implanted in the femoral defect area. Imaging and biomechanical analysis of bone defects were performed at 4, 8 and 12 weeks after surgery. Animal experiments were approved by the Ethics Committee, First Affiliated Hospital of Hainan Medical University, China. RESULTS AND CONCLUSION: At postoperative 4, 8 and 12 weeks, micro-CT scans showed that the osteogenesis rate of the experimental group was significantly faster than that of the blank and control groups. At 12 weeks after surgery, some calcium phosphate bone cement was replaced by new bone, and callus was not completely enclosed in the control group. New bone formed in the femoral defect area, and the implanted calcium phosphate bone cement was completely degraded in the experimental group. At 12 weeks after surgery, trabecular mode factor, bone volume fraction, and the number of trabeculae in the experimental and control groups were significantly greater than those in the blank group (P < 0.05). The indexes in the experimental group were better than those in the control group (P < 0.05). At 4, 8 and 12 weeks after surgery, bone density in the experimental group was significantly higher than that in the control and blank group (P < 0.05). At 12 weeks after surgery, the maximum stress, maximum load and destructive energy in the experimental group were significantly greater than those in control and blank groups (P < 0.05). These results suggest that icariin-treated bone marrow mesenchymal stem cells/calcium phosphate bone cement complex can effectively promote new bone formation and accelerate bone repair. Figures and Tables | References | Related Articles | Metrics

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Mechanical properties of artificial cartilage scaffolds Chen Lei, Ge Weiming, Lü Linwei, Lei Ming, Teresa Zielińska, Xing Enhong 2019, 23 (30):  4763-4768.  doi: 10.3969/j.issn.2095-4344.1412 Abstract ( 401 )   PDF (974KB) ( 254 )   Save BACKGROUND: Cartilage tissue engineering repair is an important method to repair cartilage defects. Silk fibroin/type II collagen scaffolds are viscoelastic materials that have excellent biocompatibility and exhibit solid and liquid characteristics, but the micro-mechanical properties between different layers are still a problem worthy of attention. OBJECTIVE: To obtain the relationship between macro-loading force of scaffold and micro-force between layers, so as to obtain the macro-force under the micro-force of optimal cell proliferation. METHODS: The compression stress relaxation experiment of the blank scaffold was designed, and the finite element model of the scaffold was constructed after fitting viscoelastic constitutive equation with experimental data. The stress relaxation of the model was simulated to obtain the mechanical state between the scaffold layers. RESULTS AND DISCUSSION: The force of each layer of the scaffold was distributed at 1.185-3.305 N, and the stress of each layer gradually decreased with time until it converged. The total displacement of the scaffold increased with the number of layers. The strain values between the layers of the scaffold ranged from 1.82x10-2 to 4.47x10-2. This value indicates that this is the best state for culturing cells. The finite element analysis results show that when 10% strain occurred macroscopically in the scaffold, the strain value of each layer was distributed in the numerical range of 2%-7%. When the macro strain of the stent was 5%, the strain value of each layer was distributed between 1% and 2%. When 20% strain occurred on the scaffold macroscopically, the strain value of each layer was distributed between 8% and 18%. Comparison results revealed the optimal strain value for cell proliferation was 4%-7%. Figures and Tables | References | Related Articles | Metrics

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Autologous chondrocytes combined with collagen I three-dimensional scaffold for treatment of osteochondritis dissecans of the knee Li Zheng, Li Changshu, Lu He, Wang Ping 2019, 23 (30):  4769-4774.  doi: 10.3969/j.issn.2095-4344.1415 Abstract ( 579 )   PDF (612KB) ( 708 )   Save BACKGROUND: Recent studies have shown that autologous chondrocytes combined with collagen I three-dimensional scaffold for treatment of cartilage injury can achieve the clinical efficacy similar to that of normal hyaline cartilage. OBJECTIVE: To analyze the clinical effect of autologous chondrocytes combined with collagen I three-dimensional scaffold in the treatment of large area (greater than 3.0 cm2) of osteochondritis dissecans of the knee joint. METHODS: Seven patients with larger area of knee osteochondritis dissecans who received treatment in Shenzhen Pingle Orthopedic Hospital between March 2014 and January 2017. These patients consisted of 4 males and 3 females, aged 21-39 years. The area of osteochondritis dissecans was 3.62-12.51 cm2. All patients underwent autologous chondrocytes combined with type I collagen three-dimensional scaffold transplantation and strict rehabilitation training after surgery. The therapeutic effect was evaluated by Lysholm subjective knee score, IKDC score of the International Knee Documentation Committee, pain score, patient satisfaction with treatment and MRI examination before treatment and 3, 9, 12 months after treatment as well as at the last follow up. RESULTS AND CONCLUSION: All of the seven patients were followed up for 12-24 months and no complications, such as infection and stiffness of joints were observed. The Lysholm subjective knee score and IKDC score at 12 months after treatment and at the last follow up were significantly higher than those before treatment [Lysholm subjective knee score: (92.1±3.3), (93.4±5.2): (54.8±6.4); IKDC: (91.2±3.2), (92.2±3.7), (52.3±6.3), P < 0.05]. There were no significant differences in the Lysholm subjective knee score and IKDC score between 12 months after treatment and the last follow-up (P > 0.05). At 12 months after treatment and at the last follow-up, pain score in seven patients was significantly lower than that before treatment [(1.2±1.5), (0.8±1.1), (6.7±2.2), P < 0.05]. There was no significant difference in pain score between 12 months after treatment and the last follow up (P > 0.05). Six patients were satisfied or very satisfied with the treatment and one patient was not satisfied with the treatment at 12 months after treatment. MRI revealed that at 12 months after treatment, the transplanted cartilage recovered well, with no shedding or local edema. These results suggest that autologous chondrocytes combined with type I collagen three-dimensional scaffold is a safe and effective treatment for osteochondritis dissecans of the knee joint, which can significantly improve the function of affected limb and relieve pain. Figures and Tables | References | Related Articles | Metrics

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Preparation of nano-demineralized bone matrix by modified low temperature mechanical trituration  Wang Zhiwei, Yuan Bo, Chen Xiongsheng, Zhou Shengyuan, Jia Lianshun 2019, 23 (30):  4775-4779.  doi: 10.3969/j.issn.2095-4344.1403 Abstract ( 384 )   PDF (657KB) ( 236 )   Save BACKGROUND: Previous studies have confirmed that nano-demineralized bone matrix is an alternative to an autograft with non-toxicity, good tissue compatibility, high bioavailability, mild inflammatory reaction, strong osteogenic ability. But its preparation takes long time. Intermittent sampling is required for particle size analysis. OBJECTIVE: To prepare nano-demineralized bone matrix by low temperature mechanical trituration and analyze its structure characteristics and preparation efficacy. METHODS: Allogeneic decalcified bone matrix was prepared by the modified Urist method. The CryoMill automatic freezing grinder was used to initially grind the decalcified bone matrix to the micron-sized particles. Then the E-Max high-energy water-cooled ball mill was used to grind the micro-sized particles into nano-sized particles. Finally, the grinding effect and material appearance were observed by scanning electron microscopy. RESULTS AND CONCLUSION: After two-step grinding, the prepared decalcified bone matrix had nanostructure composed by irregular 20-50 nm-sized nanoparticles through agglomeration. The surface of nano-particles was densely covered with nano-scale grooves. A large number of interconnected micro-pores formed between nanofiber structures, the microstructure of which conformed to the category of nanobiomaterials. Compared with the Micro superfine mill, the new trituration process only took 25 minutes, which increases grinding efficacy. These results suggest that two steps of low temperature mechanical trituration for preparation of nano-demineralized bone matrix produces more uniform particle size distribution. Figures and Tables | References | Related Articles | Metrics

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Biphasic calcium phosphate scaffolds modified with collagen based on three-dimensional printing technology Zhang Haige, Suo Hairui, Wang Ling, Xu Mingen 2019, 23 (30):  4780-4786.  doi: 10.3969/j.issn.2095-4344.1421 Abstract ( 572 )   PDF (878KB) ( 243 )   Save BACKGROUND: Three-dimensional collagen/biphasic calcium phosphate scaffolds with natural bone composition and mechanical strength, good surface activity and porous structure are a difficult point in bone tissue engineering research. OBJECTIVE: To manufacture a three-dimensional porous bone tissue scaffold with high porosity, high mechanical strength and high surface biological activity. METHODS: Biphasic calcium phosphate scaffold was manufactured by three-dimensional printing technology using hydroxyapatite and β-tricalcium phosphate with a mass ratio of 60∶40 as slurry. After high temperature sintering, the biphasic calcium phosphate scaffolds were coated with type I collagen at the concentrations of 0.5, 1.0 and 1.5 g/L. The optimal concentration of type I collagen solution was screened by apparent morphology, porosity, water absorption and mechanical properties to conduct cell experiments. Rat bone marrow mesenchymal stem cells were seeded onto biphasic calcium phosphate scaffolds and collagen/biphasic calcium phosphate scaffolds, separately. Cell viability was observed by Calcein-AM staining at 1 and 7 days; cell proliferation was detected by Alamar Blue method at 1, 3 and 7 days. RESULTS AND CONCLUSION: When the mass concentration of type I collagen solution was 0.5 g/L, the collagen/biphasic calcium phosphate scaffold had good porosity and water absorption, the compressive strength was (4.99±0.15) MPa and the compressive modulus was (95.24±0.57) MPa, which met the mechanical strength requirements of natural cancellous bone. Therefore, the coating mass concentration 0.5 g/L was selected for cell experiments. Both kinds of scaffolds supported the growth of mesenchymal stem cells. After 7 days of culture, cells almost covered the surface of the collagen/biphasic calcium phosphate scaffold. Most of them were fusiform or star-shaped, and the cells were well stretched, arranged closely and adhered to form network structure. However, there was still no cell adhesion in some areas of the biphasic calcium phosphate scaffold. There was no significant difference in cell proliferation between two kinds of cells at 1 and 3 days (P > 0.05). The proliferation of cells cultured on the collagen/biphasic calcium phosphate scaffold for 7 days was faster than that cultured on the biphasic calcium phosphate scaffold for the same duration (P < 0.05). The results show that the coating of type I collagen solution can improve the biological activity of the biphasic calcium phosphate scaffold under the condition of ensuring porosity and high mechanical strength. Figures and Tables | References | Related Articles | Metrics

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Finite element analysis and demonstration of scaffold material stacking Sun Kai, Li Ruixin, Li Hao, Li Dong, Li Hui 2019, 23 (30):  4787-4792.  doi: 10.3969/j.issn.2095-4344.1404 Abstract ( 456 )   PDF (21059KB) ( 175 )   Save BACKGROUND: The uncertainty of repairing results of tissue-engineered cartilage is related to the mechanical behavior of repairing area. The shape, depth and load characteristics of repairing defects will change the mechanical environment of repairing area in varying degrees. Therefore, the appropriate mechanical properties of artificial cartilage can be explored by studying the above parameters. OBJECTIVE: To analyze the effect of the shape and stacking method of the scaffold material on the mechanical behavior of the repairing area by finite element method. METHODS: MRI-3D printed silk fibroin/collagen composite scaffolds were used. These scaffolds were cut into circular and rectangular products. Each shape of products were stacked vertically and obliquely to form a three-dimensional entity. ANSYS12.0 and Solid95 units were used for modeling and mesh generation. 10 kPa load (Z=10 mm) was uniformly added to the top of the material. The displacement, stress, and strain distribution of the material were analyzed. RESULTS AND CONCLUSION: Vertical stacking of circular and rectangular products had regular shapes, with strict symmetry of X and Y axis. Oblique stacking of circular and rectangular products had irregular shapes, which can only meet the symmetry of the X axis, and Y and Z axes had characteristics of ladder. Compared with the vertical stacking, the axial displacement of obliquely stacked products was more obvious, which did not facilitate bone tissue ingrowth. Vertical stacking of circular and rectangular products led to uniform stress distribution, with strict axial symmetry. There was a small area of large strain (stress) region caused by stress concentration in the bottom edge or corner. When circular and rectangular products were obliquely stacked, asymmetries in shape and loads led to nonuniform and ladder-shaped local stress, and there was a large area of strain (stress) region. These results suggest that circular product is preferable over rectangular product, and vertical stacking is conductive to repairing bone tissue compared with oblique stacking. Figures and Tables | References | Related Articles | Metrics

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Preparation of polylactic acid/bioactive glass composite material by vacuum freeze-drying technique and study on its performance Ma Lijuan, Deng Jiupeng, Yin Haoyue, Tian Yiwen 2019, 23 (30):  4793-4798.  doi: 10.3969/j.issn.2095-4344.1435 Abstract ( 563 )   PDF (21713KB) ( 207 )   Save BACKGROUND: Bioactive glass added into polylactic acid can improve the mechanical property of the material. OBJECTIVE: To prepare the tissue-engineered scaffold of polylactic acid/bioactive glass composites by vacuum freeze-drying technique and study its performance. METHODS: For 1,4-dioxane and dichloromethane as pore-forming agents, polylactic acid containing 10%, 20% and 30% bioactive glass were prepared by vacuum freeze-drying technique. The porosity and compressive strength were detected. In order to observe the microstructure and element changes of composites before and after soaked into the simulated body fluid for 2 weeks. L929 fibroblasts were cultured with polylactic acid leach liquor, polylactic acid/bioactive glass composites leaching liquor and phenol solution, and the cells of being cultured in routine culture were used as control, respectively. After culture for 1, 3 and 5 days, MTT was used to detect cell proliferation. RESULTS AND CONCLUSION: (1) The porosity of polylactic acid containing 10% and 20% bioactive glass was higher than that of polylactic acid (P < 0.05). (2) The compressive strength of polylactic acid/bioactive glass composite was higher than that of polylactic acid (P < 0.05), and the compressive strength of 20% bioactive glass composite was higher than that of 10% and 30% bioactive glass composites (P < 0.05). (3) Scanning electron microscopy showed that the inner pore wall of polylactic acid materials has a large amount of micropore structures, bioactive glass distributed in the composite, the pore size was uneven and the pores communicated with each other. As the increasing of bioactive glass contents, there were lots of blocked pores. After immersion in simulated body fluid for 2 weeks, polylactic acid/bioactive glass containing composites showed obvious hydroxyapatite formation, but there was no hydroxyapatite formation in polylactic acid. The immersion of polylactic acid was only the change of PH value, but the ratio of calcium and phosphorus was higher than that before soaking in composite materials. After soaking, there was a large amount of hydroxyapatite formation, and the proportion of calcium and phosphorus was reduced accordingly. At the same time, the Si in bioactive glass was released. (4) The cell proliferation in the polylactic acid/bioactive glass composite containing 10% and 20% bioactive glass was significantly faster than that of positive control group after 1, 3 and 5 days of culture (P < 0.05), which showed no significant difference compared with the negative control and polylactic acid groups (P > 0.05) (5) These results suggest that polylactic acid/bioactive glass containing composite scaffolds with good porosity, compressive strength and cellular compatibility can be prepared by vacuum freeze-drying technique. Figures and Tables | References | Related Articles | Metrics

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Effect of stratified vessels on fluid-solid interaction of heart valves Liu Xingming, Yuan Quan, Cong Hua, Zhu Hongwei 2019, 23 (30):  4799-4803.  doi: 10.3969/j.issn.2095-4344.1418 Abstract ( 495 )   PDF (19367KB) ( 148 )   Save BACKGROUND: The main treatment for valvular heart disease is heart valve replacement. The design and performance optimization of artificial heart valves are currently the areas of research. Numerical analysis and experimental methods are major keys to analyzing the mechanical properties of artificial heart valves. Analyzing  the mechanical properties of the valves by finite element method and displaying the mciro-stress of the valves in vivo provide more accurate data for the design and performance optimization of artificial heart valve. OBJECTIVE: To establish a more realistic vascular model and investigate the effects of stratified vessels on the deformation characteristics and stress distribution of aortic valves, providing theoretical mechanical data for further improving the design of artificial heart valve. METHODS: Finite element geometric models and mathematical models including aortic valve, vessel wall and blood were established, in which the vessel wall was stratified. The effects of stratification characteristics on the fluid-solid interaction deformation and stress of the aortic valve were investigated to verify the importance of the stratified vessel wall. RESULTS AND CONCLUSION: Valve deformation mainly occurred in the leaflets, the arterial wall had no obvious deformation, the highest level of free deformation was observed at the leaflet free edge. The deformation from the free edge of the leaflet to the suture edge showed a gradient decrease tendency. The maximum equivalent stress of the whole heart valve model was located on the outer arterial wall (near the suture point of the valve leaflet and the arterial wall). The inner and outer arterial walls were greatly different in force. The equivalent stress value of the inner arterial wall was much smaller than that of the outer arterial wall. The stress between inner and outer arterial walls was not continuous. The maximum equivalent stress of the leaflets was at the suture edge of the leaflets and the arterial wall. Compared with the previous studies that did not consider the stratification characteristics of the arterial wall, the maximum equivalent stress value of the leaflets was closer to the ex vivo failure stress of the human mitral valve leaflets. Figures and Tables | References | Related Articles | Metrics

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Comparative analysis of hydroxyapatite, β-tricalcium phosphate, and carbonated hydroxyapatite alginate dental pulp replacement materials Cheng Yang, Liu Min, Zhu Zhongyan, Gao Shasha 2019, 23 (30):  4804-4810.  doi: 10.3969/j.issn.2095-4344.1419 Abstract ( 390 )   PDF (25621KB) ( 275 )   Save BACKGROUND: There are many kinds of dental pulp replacement materials, which can be divided into natural biological materials, artificial synthetic materials, and composite materials. Various types of materials can also be synthesized by chemical and biological methods, all of which have their own advantages and disadvantages. OBJECTIVE: To compare cytotoxicity and biological compatibility of three kinds of alveolar bone repair materials including hydroxyapatite/β-tricalcium phosphate, carbonated hydroxyapatite alginate, and pure hydroxyapatite. METHODS: Mouse pre-osteoblasts and human osteoblasts were cultured together with the leaching liquor of three biomaterials respectively. Cell mitochondrial activity was detected by XTT assay (cells cultured separately were used as the control group), and cytotoxicity was detected by crystal violet assay (cells cultured in DMSO were used as the control group).Twenty Wistar rats purchased from Beijing Vital River Laboratory Animal Technology Co., Ltd were used to prepare the alveolar bone defect model of the right maxillary central incisor. Then the alveolar bone defect models were randomly divided into four groups. In the control group, no material was implanted into the bone defect region. In the other three groups, hydroxyapatite/β-tricalcium phosphate, carbonated hydroxyapatite alginate, and pure hydroxyapatite were implanted into the bone defect region. At 7, 21 and 42 days after implantation, serum concentrations of receptor activator for nuclear factor-κB ligand and osteoprotegerin were measured. This study was approved by Animal Ethics Committee, Southwest Medical University, China (approval No. IACUC20170315-07). RESULTS AND CONCLUSION: There was no significant difference in the mitochondrial activity of the mouse preosteoblasts and human osteoblasts between three material groups and the control group (P > 0.05). The mitochondrial activity of mouse preosteoblasts and human osteoblasts was higher in the hydroxyapatite/β-tricalcium phosphate and carbonated hydroxyapatite alginate groups than in the pure hydroxyapatite group (P < 0.05). The cytotoxicity of the mouse pre-osteoblasts and human osteoblasts in the three material groups was lower than that in the control group (P < 0.05). Among three material groups, the leaching liquor of carbonated hydroxyapatite alginate had the lowest toxicity to the two kinds of cells. Serum concentration of receptor activator for nuclear factor-κB ligand at 7 days after implantation of carbonated hydroxyapatite alginate was significantly lower than that at 21 days after biomaterial implantation, and serum concentration of osteoprotegerin at 42 days after biomaterial implantation was significantly higher than that at 7 and 21 days (P < 0.001). These results suggest that carbonated hydroxyapatite alginate exhibits better biocompatibility than hydroxyapatite/β-tricalcium phosphate and pure hydroxyapatite. Figures and Tables | References | Related Articles | Metrics

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Application of Dentistry-ProConsult software to assist plaster tooth modeling in stomatology teaching Lu Lei, Yu Shibin, Shi Xiaowei, Ma Teng, Huang Jinghui, Yang Hongxu 2019, 23 (30):  4811-4815.  doi: 10.3969/j.issn.2095-4344.1410 Abstract ( 400 )   PDF (19297KB) ( 154 )   Save BACKGROUND: In the practice of stomatology teaching, the normal morphology of teeth and their occlusal relationship are always a difficult point in stomatology teaching. However, the occlusal relationship of teeth and their functional coupling are complicated and difficult to understand and are always the difficult point and focus of clinical teaching. OBJECTIVE: To investigate the application of Dentistry-ProConsult software to assist plaster tooth modeling in stomatology teaching. METHODS: Forty-four undergraduate students of five-year oral medicine major from the Air Force Medical University were randomly divided into two groups. In the control group (n=21), traditional teaching method was used to learn the anatomic structure and occlusion of different types of teeth and engrave wax teeth. In the experimental group (n=23), Dentistry-ProConsult software was used to learn the anatomic structure and occlusion of different types of teeth and to model plaster teeth. The teachers could guide students to learn the normal morphology of teeth and their occlusal relationship from different angles with the Dentistry-ProConsult software. In addition, the students were asked to carve the normal morphology of teeth in plaster model with the aid of 3D models. The theoretic and practicing test scores were compared between the control and experimental groups. RESULTS AND CONCLUSION: The theoretic (85.6±12.4 vs. 79.3±15.7) and practicing test scores (88.2±10.6 vs. 82.5±14.5) in the experimental group were significantly higher than those in the control group (t=6.735 for theoretic test, t=7.182 for practicing test, P < 0.05). The feedback questionnaires showed that the satisfaction rate in the experimental group (87.5±8.7) was significantly higher than that in the traditional teaching group (79.7±10.1, t=8.531, P < 0.05). These results showed that application of Dentistry-ProConsult in the stomatology teaching greatly enhanced student’s theoretic and practicing test scores and increases student’s degree of satisfaction in stomatology teaching. Figures and Tables | References | Related Articles | Metrics

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A fuzzy adaptive proportional-integral-derivative (PID) control strategy based on insulin-on-board control method of closed-loop insulin infusion Yu Liling, Zhang Gangping, Liu Wenping, Xu Binfeng, Jin Haoyu 2019, 23 (30):  4816-4821.  doi: 10.3969/j.issn.2095-4344.1420 Abstract ( 376 )   PDF (880KB) ( 456 )   Save BACKGROUND: Intelligent blood glucose control algorithm is an important part of closed loop artificial pancreas. OBJECTIVE: To effectively control the blood glucose level of patients with type 1 diabetes mellitus, reduce the incidence of high or low blood glucose level, and propose a closed-loop insulin control algorithm based on fuzzy adaptive proportional-integral-derivative control strategy.   METHODS: According to the real-time monitoring data of continuous human blood glucose, proportional-integral-derivative algorithm was used to simulate the physiological transmission process of insulin secretion from human β cells. Then the parameters of the proportional-integral-derivative controller were continuously optimized. The amount of insulin-on-board was used to correct the insulin dose calculated by fuzzy adaptive proportional-integral-derivative algorithm to realize the optimal control of insulin pump. RESULTS AND CONCLUSION: The performance of the proposed control algorithm was tested using the UVa/Padova stimulator jointly developed by the University of Virginia (USA) and University of Padova (Italy). Results showed that the insulin control algorithm significantly reduced hypoglycemia events, controlled blood glucose levels in the designated target range, increased the accuracy and effectiveness of insulin injection therapy, and greatly reduced the occurrence of various complications. Figures and Tables | References | Related Articles | Metrics

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A study of a safe area and angle for harvesting autogenous hamstring tendons for anterior cruciate ligament reconstruction Chen Yinghua, Wei Qingjun, Yao Jun 2019, 23 (30):  4822-4827.  doi: 10.3969/j.issn.2095-4344.1433 Abstract ( 556 )   PDF (23567KB) ( 162 )   Save BACKGROUND: More and more attention has been paid to the reconstruction of anterior cruciate ligament by autologous hamstring muscle transplantation, but it was found that some patients had abnormal sensation in the anterior knee and medial anterior leg, which was caused by the injury of the saphenous nerve or the inferior patellar branch of the saphenous nerve when the hamstring tendon was cut intraoperatively. OBJECTIVE: An incision was identified through the anatomy of the knee joint security area and angle, to avoid damaging the saphenous nerve and its infrapatellar branch in harvesting gracilis tendon and semitendinosus tendon. METHODS: Knee joint fresh specimens were harvested from 10 patients who underwent leg amputation. Written informed consent was obtained from each patient. This study was approved by the Ethics Committee of Langdong Hospital Affiliated to Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University. The saphenous nerve and its branches were isolated. The inner edge of patellar ligament tibial tubercle was marked as point A. A horizontal line through the point A was drawn. The intersection of the horizontal line with saphenous nerve trunk was marked as point C. The intersection of the horizontal line with saphenous nerve infrapatellar branch was marked as point B. The distance between point A and point C and between point A and point B was measured and recorded as distance AC and AB respectively. The scope of operation safety and incision angle would be calculated using analysis and statistic software. RESULTS AND CONCLUSION: Safe range of surgical incision: The distance AC was (5.5±0.3) cm, and the distance AB was (3.5±0.2) cm. Safe angle of surgical incision: The saphenous nerve infrapatellar branch was (50.7±4.8) °, The saphenous nerve tibial tubercle branch was (43.3±5.4) °. The safe range of surgical incision was within the (3.5±0.2) cm in the inner edge of patellar ligament tibial tubercle (A point) and the safe angle was (50.7±4.8) °. Figures and Tables | References | Related Articles | Metrics

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Dynamic impact on the rabbit spine single vertebral body: finite element analysis of the stress distribution of the vertebral body with different impact rates, mesh numbers and material properties  Han Shibing, Zhang Xushu, Guo Yuan, Du Yiming 2019, 23 (30):  4828-4835.  doi: 10.3969/j.issn.2095-4344.1417 Abstract ( 362 )   PDF (27220KB) ( 159 )   Save BACKGROUND: Car accidents and falling from high altitudes occur from time to time, most of which cause severe spinal injuries. Therefore, it is important to study the damage characteristics of the spine under impact load. It also provides a biomechanical basis for injury protection and repair of the spine. OBJECTIVE: The finite element analysis method was used to analyze the damage characteristics and regularity of the single vertebral body of rabbit under impact load, and the effects of different impact velocities, mesh numbers and material properties on the stress distribution of the vertebral body were analyzed. These provided the basis for the dynamic impact test of single vertebral body and the segmental experiment and simulation analysis of the spine. METHODS: The finite element model of rabbit single vertebral T12  was established by Mimics, HyperMesh and Abaqus. First, the sensitivity analysis of the mesh was carried out to select the appropriate number of meshes. Finite element analysis and simulation of vertical impact on vertebral bodies were conducted at different impact velocities. Stress distribution of vertebral body in osteoporotic patients under impact loading was simulated by adjusting the numerical value of material properties. The model was validated by a single vertebral impact test in rabbits. RESULTS AND CONCLUSION: (1) Through sensitivity analysis, it was found that when the number of grids was 74 224, the results of finite element analysis were much more reasonable than those of other grids. Therefore, the analysis was based on the premise of the number of grids 74 224. Vertebral material like most brittle materials, a 45° angle of failure could occur when subjected to vertical loads. The maximum stress value was mainly concentrated at the two ends of the vertebral body. The direction of stress transmission was consistent with the trend of the trabecular bone. (2) It is concluded that the appropriate number of grids was selected by sensitivity analysis, which makes the results of finite element analysis more reliable. The reliability of the finite element model was verified by experimental verification. The results of finite element analysis can reflect the true situation of the vertebral body under different impact velocities and osteoporotic vertebral body under impact. The finite element analysis method is economical and has strong control and applicability; and the parameters are easy to adjust. Figures and Tables | References | Related Articles | Metrics

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Experimental study on rat tail microvascular anastomosis with degradable micro-stent Han Bensong, Xue Feng, Mo Xiumei 2019, 23 (30):  4836-4840.  doi: 10.3969/j.issn.2095-4344.1402 Abstract ( 357 )   PDF (653KB) ( 318 )   Save BACKGROUND: Microvascular anastomosis is very risky. There have been many studies of solid, non-degradable stent-assisted small vessel anastomosis, but there are still temporary, traumatic issues. Thereafter, degradable woven-type stent becomes an issue of concern. OBJECTIVE: To investigate the feasibility of polylactic acid microvascular stent anastomosis for repairing micro vessels.  METHODS: Polylactic acid fiber-loops were multi-directionally hot-stretched and formed to prepare micro-stent of “M” shape. The diameter of the stent was 0.5 or 1mm. It was applied to the root and middle of the tail artery of 24 Sprague-Dawley rats (provided by Shanghai Xipuer-Beikai Experimental Animal Co., Ltd.). These rats were randomly divided into a stent anastomosis (group A) and a non-stent anastomosis (group B). The time of vascular anastomosis, the immediate patency rate of anastomotic vessels and the survival rate in both groups were recorded. Ultrasound Doppler observation was performed to observe the tail artery circulation at postoperative 2 weeks. The tail artery was histologically observed at postoperative 4 weeks. The experiment was approved by the Animal Ethics Committee of Fengxian Branch of the Sixth People’s Hospital of Shanghai (approval number: 20160225124025). RESULTS AND CONCLUSION: (1) The immediate patency rate of anastomotic vessels in both groups was 100%. The anastomosis time in the group A was significantly shorter than that in the group B [(3.0±0.5) vs. (5.0±0.6) minutes, P < 0.05]. The survival rate of replantation in the group A was significantly higher than that in the control group [(95.8±1.5)% vs. (91.7±1.7)%, P < 0.05]. (2) Ultrasound Doppler examination showed blood flow passed through the anastomotic orifice and its distal and proximal side in the group A, while in the group B, there was thrombosis at the anastomotic orifice and distal side, and the lumen was occluded. (3) Hematoxylin-eosin staining showed that there was no thrombus in the tail artery in the group A, the stent and the anastomosis were completely covered with the intima, and the lumen was smooth. The lumen in the group B was oblate, which showed a thrombus formation and a narrow lumen. (4) These results suggest that polylactic acid micro-stent can meet the requirements of microvascular anastomosis replantation, and can significantly shorten the time of vascular anastomosis, improve the effect of anastomosis and suture, and increase the survival rate of replantation. Figures and Tables | References | Related Articles | Metrics

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Preparation and biocompatibility evaluation of modified thermosensitive xyloglucan hydrogels Yan Zhiwen, Li Shuofeng, Li Ao, Hu Ziqi, Ma Litao, Zhang Ershuai, Li Jingwu, Yao Fanglian, Che Pengcheng, Sun Hong 2019, 23 (30):  4841-4847.  doi: 10.3969/j.issn.2095-4344.1409 Abstract ( 574 )   PDF (1090KB) ( 130 )   Save BACKGROUND: Injectable thermosensitive hydrogels have reversible phase transition with the change of ambient temperature and can be used in combination with minimally invasive therapy. This has attracted extensive attention in the field of postoperative adhesion prevention. However, the current injectable thermosensitive hydrogels for the prevention of postoperative adhesion have the problems of poor biosafety and anti-adhesion effects. OBJECTIVE: To prepare a kind of hydrogel with thermosensitive and injectable characters with the modified xyloglucan and to evaluate its biocompatibility. METHODS: Partial galactose of the side chain of xyloglucan was removed using mild enzymatic hydrolysis to obtain modified xyloglucan with reversible “sol-gel” transformation. The toxicity of modified xyloglucan hydrogel leaching liquor to human hepatoma cell line HepG2 and human lung adenocarcinoma cell line A549 was determined by acridine orange and propidium iodide staining and MTT assay. After 24 hours of culture, cell morphology was observed. Modified xyloglucan hydrogel leaching liquor, 0.1 and 1 g/L modified xyloglucan solution was added to the anticoagulated rabbit blood. The hemolysis rate was detected 1 hour later. The modified xyloglucan solution was subcutaneously injected into the back of the C57 mice (provided by Beijing Experimental Animal Center of the Chinese Academy of Military Medical Sciences, China) to track the in vivo degradation behavior of the material and evaluate the inflammatory response of the implant site and surrounding tissues. Animal experiments were approved by the Animal Ethics Committee, North China University of Science and Technology, China (approval No. SYXK (Ji) 2015-0038). RESULTS AND CONCLUSION: The acridine orange and propidium iodide staining and MTT assay revealed that the proliferation activity of HepG2 cells and A549 cells in different concentrations of modified xyloglucan hydrogel leaching liquor was about 100%. A549 cells embedded in modified xyloglucan hydrogel still had good viability. The hemolysis rate of the modified xyloglucan leaching liquor and 0.1, 1 g/L modified xyloglucan solution was both below 2%. As the injection time prolonged, the modified xyloglucan hydrogel in the animal body gradually became smaller, and the degradation was complete at about 6 weeks. Inflammatory reaction could be caused in the early stage of injection, but with the prolongation of time and degradation of the material, the inflammatory reaction gradually reduced and disappeared, and no obvious tissue lesions were observed in the injection site. These results suggest that the modified xyloglucan hydrogel is thermosensitive and has good cell compatibility, blood compatibility, and biodegradability. Figures and Tables | References | Related Articles | Metrics

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Bone tissue engineering in infectious bone defect: advantages and problems Zhan Huasong, Chen Yueping, Zhang Xiaoyun 2019, 23 (30):  4848-4854.  doi: 10.3969/j.issn.2095-4344.1477 Abstract ( 728 )   PDF (44118KB) ( 221 )   Save BACKGROUND: With the continuous improvement of modern technology and medical level, although there are many ways to treat infectious bone defects, there is a lack of a viable early treatment regimen that combines anti-inflammatory, fracture healing, and biodegradable therapies, for the purpose of primary treatment measures. This is also the goal and motivation of future medical workers. OBJECTIVE: To investigate the application and prospect of bone tissue engineering in the treatment of infectious bone defects. METHODS: PubMed and MEDLINE database, WanFang, CNKI, VIP and CBM database were searched from 2013 to 2019 for relevant domestic and foreign literatures, including: (1) clinical application and research literature of local antibiotics; (2) experimental study on sustained release system (DDS) for the treatment of bone infection; (3) clinical and experimental literature on biological scaffold materials in large bone defects; (4) application and progress of bone tissue engineering in the repair of infectious bone defects; (5) literature on 3D printing technology. A total of 60 literature analyses and summaries were included. RESULTS AND CONCLUSION: (1) The local use of antibiotics at bone infection site was effective. (2) Bone tissue engineering had a great development prospect and potential in inducing bone regeneration to repair bone defects, which also pointed out a new way for orthopedic surgeons to treat infectious bone defects in the future, and gave new hope to patients and their families. The breakthrough and challenge of this technology is to explore the most suitable high-quality cells. (3) To explore the perfect combination of bone tissue engineering technology, antimicrobial agents and absorbable biomaterials for the treatment of infectious bone defects with new technologies is a new development direction of the orthopedic clinical treatment for infectious bone defect in the future. Figures and Tables | References | Related Articles | Metrics

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Induced membrane technique for repair of bone defect: research status and modification of application methods Li Haifeng, Gu Sanjun, Rui Yongjun, Yi Qudong 2019, 23 (30):  4855-4860.  doi: 10.3969/j.issn.2095-4344.1427 Abstract ( 484 )   PDF (757KB) ( 478 )   Save BACKGROUND: Induced membrane technique has good effect on repair of bone defect, which is related to the bio-osteogenetic activity and mechanical encapsulation of induced membrane. Due to the large difference in bio-osteogenetic activity at different time of bone grafting, especially in the late phase, the bio-osteogenetic activity of the induced membrane is weak. OBJECTIVE: To review the research status and modification of application methods of induced membrane technique for repair of bone defect. METHODS: A computer-based online search of CNKI, PubMed, and Elsevier databases was performed for retrieving articles concerning the research status and modification of application methods of induced membrane technique for repair of bone defect published from January 1995 to December 2018. The search terms were “bone defect, induced membrane, induced membrane technique, bone cement” in Chinese and English, respectively. The types of literature included review, basic and clinical research. The literature was screened preliminarily by reading title and abstract, and the irrelevant articles were excluded. Finally 40 articles eligible for inclusion and exclusion criteria were enrolled for result analysis RESULTS AND CONCLUSION: The mechanism of induced membrane technique for repair of bone defect includes both biosteogenesis and mechanical encapsulation. Internal fixation can also be used in the first stage of surgery for infected bone defect; bone cement forming in vitro overcomes the shortcomings of fever damage and difficulty in removal. The osteogenetic activity of induced membrane was different at different timing of bone grafting. Therefore, amounts of bone grafting should be required according to different bone grafting times. However, there are few studies on the optimal amount of bone graft and the ratio of bone material. The emergence of degradable spacer makes a single surgery of induced membrane technique possible, but most of the degradable spacers have poor mechanical strength and weak membrane induction ability. It is expected that the emergence of new degradable spacer with better mechanical strength, stronger membrane induction or having the ability to promote bone growth will shorten the treatment time and reduce the amount of bone autograft. Figures and Tables | References | Related Articles | Metrics

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Methods for detecting glycosaminoglycan in the extracellular matrix of animal cells Zhang Wei, Chen Junlin, Hu Kang 2019, 23 (30):  4861-4867.  doi: 10.3969/j.issn.2095-4344.1428 Abstract ( 624 )   PDF (41005KB) ( 185 )   Save BACKGROUND: As a cell secretory product in every tissue and organ, the extracellular matrix, by virtue of its unique biological properties, has become a unique regenerative biomaterial in clinical applications. As one of the important active substances in the extracellular matrix, glycosaminoglycan has remarkable biological characteristics. OBJECTIVE: To review the research progress of the detection methods of glycosaminoglycan in extracellular matrix at home and abroad and compare these methods to provide reference information to optimize the methods of detecting glycosaminoglycan in the extracellular matrix. METHODS: A total of 2 037 publications were retrieved by searching CNKI database using search terms “glycosaminoglycan”, “extracellular matrix” and by searching PubMed using search terms “determination methods of glycosaminoglycan” “Animal-derived extracellular matrix”. Sixty-three literatures were screened and included in the final analysis. The common methods of detecting glycosaminoglycan were summarized. According to the ideas summarized during the literature review, the improved method for glycosaminoglycan extraction and detection was proposed and a comparative study was designed to validate the improved method.   RESULTS AND CONCLUSION: Glycosaminoglycan plays a vital role in the biological properties of animal-derived extracellular matrix and can confer superior biological activity and prosthetic function to extracellular matrix materials and products. Detection of glycosaminoglycan content in the extracellular matrix material can help to optimize extracellular matrix material. Therefore, the method of detecting glycosaminoglycan content in the extracellular matrix is of great importance. The currently available methods of detecting glycosaminoglycan include high performance liquid chromatography, uronic acid analysis, quantitative analysis of acetaminophen, and dimethyl methylene blue detection. All of these methods have certain limitations. Based on the existing research results, we only improved the sample digestion and glycosaminoglycan extraction in dimethylmethylene blue detection method, which greatly increased the accuracy of the detection results. This provides ideas and insights for other glycosaminoglycan detection methods. Figures and Tables | References | Related Articles | Metrics

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Pulsed electromagnetic fields and platelet rich plasma therapy for treatment of osteoarthritis: theoretical progress and clinical research Xiang Xiaona, Yu Xi, Liu Yan, Jiang Hongying, He Chengqi, He Hongchen 2019, 23 (30):  4868-4874.  doi: 10.3969/j.issn.2095-4344.1407 Abstract ( 572 )   PDF (36614KB) ( 185 )   Save BACKGROUND: Osteoarthritis is one of the most common joint diseases affecting human health. Pulsed electromagnetic fields and platelet rich plasma therapy have great potential for physical therapy. However, the precise mechanism of action and whether their combination can promote the rehabilitation of osteoarthritis remain poorly understood. OBJECTIVE: To summarize the theoretical progress of the basic research on the treatment of osteoarthritis by pulsed electromagnetic fields and platelet rich plasma therapy, and the current situation of clinical research. METHODS: A computer-based search of EMbase, MedLine, CENTRAL and Wanfang databases were performed for relevant articles published from 2009 to 2019 with the search terms “Wnt, β-catenin, NF-κB, TLRs, PEMFs, PRP, platelet-rich plasma, OA, osteoarthritis”. Initially, 448 articles were retrieved, and finally 49 eligible articles were included for final analysis. RESULTS AND CONCLUSION: Pulsed electromagnetic fields increased Ca2+ concentration in cells, altered membrane potential, caused apoptosis or deposit, and accelerated the formation of bone and cartilage. Pulsed electromagnetic fields inhibited the secretion of interleukin-1β and tumor necrosis factor-α by nucleus pulposus cells. There were many non-active growth factors in platelet rich plasma which helped cartilage differentiation, protected the joints and reduced the humoral and cellular immune response. The inflammatory regulators in platelet rich plasma inhibited the inflammatory response of chondrocytes by nuclear factor-κB pathway activation, thus inhibiting the expression of aseptic inflammatory factor mediated by interleukin-1 and the degradation of cartilage matrix. Toll-like receptors mediated bone marrow cell differentiation can affect bone metabolism. Activating Wnt/β-catenin pathway reduced bone absorption, increased bone formation, and increased Wnt/β-catenin signaling-conducted medium and down-stream effectors in osteoarthritis. These results suggest that pulsed electromagnetic fields in combination with platelet rich plasma therapy treated osteoarthritis through co-inhibiting the expression of inflammatory factors such as interleukin-1 and tumor necrosis factor-α, promoting the secretion of vascular endothelial growth factors via the Wnt/β-catenin pathway, and co-regulating the expression of Toll-like receptors. However, little is reported on the efficacy of platelet rich plasma therapy versus pulsed electromagnetic fields on osteoarthritis. Future studies will address on the mechanism of the platelet rich plasma therapy versus pulsed electromagnetic fields and application of their combination in the treatment of osteoarthritis. Figures and Tables | References | Related Articles | Metrics

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Platelet-rich plasma: its application in the repair of tendon and ligament injuries Wang Haonan, Wang Jihong, Wen Shuzheng 2019, 23 (30):  4875-4881.  doi: 10.3969/j.issn.2095-4344.1416 Abstract ( 509 )   PDF (36733KB) ( 308 )   Save BACKGROUND: Platelet-rich plasma contains high levels of platelets and a variety of growth factors and cytokines, which help promote ligament and tendon regeneration and the recovery of multiple musculoskeletal disorders.   OBJECTIVE: To analyze the latest publications regarding application of platelet-rich plasma in the repair of tendon and ligament injuries. METHODS: A computer-based online search of PubMed database was performed for related literatures published during 1990-2018 with the search terms “platelet-rich plasma, ligament injury, repair of ligament, tendon injury, repair of tendon, growth factors”. A total of 64 literatures were retrieved. CNKI was searched with “platelet-rich plasma” as the search term. One related literature was retrieved. These retrieved literatures were summarized from the perspectives of preparation and classification of platelet-rich plasma, release of platelet-derived growth factor, and promotion of ligament and tendon repair by platelet-rich plasma. RESULTS AND CONCLUSION: Although platelet-rich plasma has limited and inconclusive therapeutic effects on rotator cuff and iliac tendon lesions, ulnar collaterals and anterior cruciate ligament injury, many basic science and live animal experiments support the application of platelet-rich plasma in tendon and ligament diseases. At present, platelet-rich plasma is a feasible conservative treatment with a lower risk of complications or adverse reactions. The cause of disease may have certain effects on the injection methods of platelet-rich plasma. For example, leukocyte-poor platelet-rich plasma exhibits better therapeutic effects on the external humeral epicondylitis than leukocyte-rich platelet-rich plasma because it likely helps induce an inflammatory response to promote recovery. Platelet-rich plasma has not become one of the standard treatment methods of tendon and ligament injuries. With in-depth research on the optimal candidate, platelet-rich plasma may develop into a more common therapy in the future. Figures and Tables | References | Related Articles | Metrics

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Application of recombinant human bone morphogenetic protein-2 in limbs with bone trauma: in-depth investigation of ideal carriers and optimal dosage Xie Chengxin, Hu Zhuangming, Wang Wei, Yin Dong, Yu Chengqiang, Wang Chenglong 2019, 23 (30):  4882-4888.  doi: 10.3969/j.issn.2095-4344.1262 Abstract ( 441 )   PDF (34930KB) ( 134 )   Save BACKGROUND: Application of recombinant human bone morphogenetic protein-2 in bone trauma still has limitations, and its efficacy and safety remain unclear.   OBJECTIVE: To review the application progress of recombinant human bone morphogenetic protein-2 in limb bone trauma, and to fully understand the efficacy and safety of recombinant human bone morphogenetic protein-2, so as to provide guidance for clinical practice.   METHODS: “Recombinant human bone morphogenetic protein-2, fracture, bone trauma, bone defect, bone injuries, femur, tibia, ulna, long bone, complications” in English and Chinese, respectively were used as keywords. The literature concerning the application progress of recombinant human bone morphogenetic protein-2 in limb bone trauma published from 2008 to 2018 was retrieved in PubMed, Medline, Embase, CNKI, WanFang, and VIP databases. Sixty eligible articles were included after excluding repeated and irrelevant studies. RESULTS AND CONCLUSION: Recombinant human bone morphogenetic protein-2 has achieved satisfactory results in the treatment of femoral and tibial fractures, and bone defects, but less in the treatment of upper limb long bone fractures and extremity trauma. With the increasing number of related research, the safety and effectiveness of recombinant human bone morphogenetic protein-2 have become controversial. In the future, more ideal carriers and synergists need to be explored, and the optimal dosage of recombinant human bone morphogenetic protein-2 should be determined to ensure the efficacy and reduce complications and financial burden of patients. Figures and Tables | References | Related Articles | Metrics

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Molecular biological mechanism of intervertebral disc degeneration and the advantages and prospects of regenerative therapy Yu Chengqiang, Zhang Yu, Xie Chengxin, Ou Yufu, Wei Jianxun 2019, 23 (30):  4889-4896.  doi: 10.3969/j.issn.2095-4344.1424 Abstract ( 614 )   PDF (45475KB) ( 167 )   Save BACKGROUND: Severe low back pain caused by multi-factor disc degeneration is the most disabling spinal disease. However, existing treatments cannot cure this painful disease. Fortunately, with the development of medical molecular biology and the in-depth study of the mechanism of intervertebral disc degeneration, the regenerative therapy of intervertebral disc degeneration is possible to cure this refractory disease. OBJECTIVE: To summarize the researches on the related molecules of intervertebral disc degeneration and the application of various regenerative therapies in intervertebral disc degeneration in recent years. METHODS: A computer based online search of PubMed, Embase, Web of science, CNKI, Wanfang, VIP databases for related literature on the treatment of intervertebral disc degeneration and regeneration published during January 1995 to March 2019 using the search terms “intervertebral disc degeneration, low back pain, regenerative therapy, growth factor, cell therapy, gene therapy, viral vector, non-viral vector” in Chinese and English. The related literatures were included in the final analysis. RESULTS AND CONCLUSION: Studies have shown that nearly 20 genes affect the degeneration of nucleus pulposus cells, including various non-coding RNAs (such as microRNA, lincRNA and lncRNA). Currently, regeneration studies such as growth factor therapy, cell therapy, and gene therapy have achieved the desired results. Non-viral vector-transduced gene therapy can avoid the risk of infection and the possibility of target cell mutation, and will become a powerful tool for restoring or relieving disc degeneration, and has broad application prospects. However, these regenerative therapies also have certain limitations. Before they are applied to the clinic, a large number of basic and clinical experiments are needed to evaluate their efficacy and the effects on reversing degeneration. Figures and Tables | References | Related Articles | Metrics

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Magnetic resonance imaging-based 3D printing technology: advantages and prospects in clinical application   Wang Jian, Zhang Xiaodong 2019, 23 (30):  4897-4904.  doi: 10.3969/j.issn.2095-4344.1423 Abstract ( 542 )   PDF (45142KB) ( 202 )   Save BACKGROUND: 3D printing facilitates the creation of accurate physical models of patient-specific anatomy from medical imaging data sets. Until now, most models have been created from Computed Tomography (CT) data, but more and more people are interested in creating models from other data sets, such as ultrasound and magnetic resonance imaging. In particular, magnetic resonance imaging has great potential in 3D printing due to its good tissue characteristics and lack of ionizing radiation. OBJECTIVE: To systemically introduce the basic concept and process of 3D printing, to discuss the application of magnetic resonance imaging-based 3D printing technology in the clinical applications and bedside teaching in the fields of cardiovascular system, nervous system, osteoarticular system, oral and maxillofacial and genitourinary systems, and to briefly describe the research progress of the bio-3D printing technology. METHODS: We searched WanFang, CNKI, VIP, PubMed and web of science databases for relevant articles published from 2010 until now. The keywords were “3D printing, 3D printed, Additive Manufacturing, Rapid Prototyping, MRI, Magnetic Resonance Imaging” in Chinese and English, respectively. Fifty publications were in included in the final analysis. RESULTS AND CONCLUSION: 3D printing can be widely used in many fields of medicine. Magnetic resonance imaging plays an important role in 3D printing modeling due to its multi-planar reconstruction, multi-parameter MRI, multi-sequence imaging and high soft tissue resolution. It can not only print personalized models before operation, but also print personalized prostheses and implants. In addition, with the gradual development of bio-3D printing, more and more people begin to focus on this new field. Figures and Tables | References | Related Articles | Metrics

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Efficacy of transcatheter aortic vavle repalcement and surgical aortic vavle replacement for aortic stenosis: a Meta analysis Yin Peiyong, Cui Xiaohong, Xiong Ting, Li Sufang, He Ximin 2019, 23 (30):  4905-4912.  doi: 10.3969/j.issn.2095-4344.1411 Abstract ( 372 )   PDF (27428KB) ( 149 )   Save BACKGROUND: Transcatheter aortic vavle replacement and surgical aortic vavle replacement are the main treatment for aortic stenosis. However, the efficacy and prognosis between the two methods were still inconsistent. OBJECTIVE: To investigate the efficacy and prognosis of transcatheter aortic vavle repalcement and surgical aortic vavle replacement in the treatment of aortic stenosis with evidence-based medicine. METHODS: We searched relevant literature from Chinese and English databases such as EMbase, Medline, PubMed, and VIP to retrieve randomized controlled trial studies. Data were analyzed by Revman 5.0 to compare short-term (30 days) and long-term (1 year) mortality, incidence of stroke, incidence of myocardial infarction, incidence of hemorrhage, incidence of renal damage and rate of pacemaker implantation. RESULTS AND CONCLUSION: Eight randomized controlled trials involving 6 147 patients were included in the final analysis. Among these patients, 3 136 patients received transcatheter aortic valve replacement (study group) and 3 011 patients underwent surgical aortic valve replacement (control group). There were no significant differences in mortality, incidence of stroke, incidence of myocardial infarction, and incidence of hemorrhage between study and control groups at 30 days post-surgery [OR=0.92, 95%CI (0.74, 1.13), Z=0.83, P > 0.05; OR=0.82, 95%CI (0.49, 1.38), Z=0.74, P > 0.05; OR=0.63, 95%CI (0.38, 1.05), Z=1.77, P > 0.05; OR=0.50, 95%CI (0.20, 1.26), Z=1.47, P > 0.05]. At 30 days post-surgery, the incidence of renal damage in the study group was significantly lower than that in the control group [OR=0.43, 95%CI (0.33, 0.57), Z=5.89, P < 0.01], the rate of pacemaker implantation was significantly higher in the study group was significantly higher than that in the control group [OR=4.77, 95%CI (1.36, 16.72), Z=2.94, P < 0.01]. There were no significant differences in mortality, incidence of stroke, and incidence of myocardial infarction at 1 year post-surgery between study and control groups [OR=0.93, 95%CI (0.81, 1.07), Z=1.02, P > 0.05; OR=1.00, 95%CI (0.81, 1.23), Z=0.02, P > 0.05; OR=0.88, 95%CI (0.61, 1.28), Z = 0.65, P > 0.05]. At 1 year post-surgery, the rate of pacemaker implantation in the study group was significantly higher than that in the control group [OR=3.47, 95%CI (1.64, 7.34), Z=3.26, P < 0.01]. The results showed that the efficacy and prognosis of the two methods for the treatment of aortic stenosis were comparable, but the transcatheter aortic valve replacement treatment had less trauma and a higher rate of pacemaker implantation than the aortic valve replacement. Figures and Tables | References | Related Articles | Metrics

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Effects of MOTOmed lower limb function trainer on lower limb function in stroke patients with hemiplegia: a Meta-analysis Zhou Jing, Yang Dan, Wei Meng, Huang Caihong, Zhao Yan 2019, 23 (30):  4913-4920.  doi: 10.3969/j.issn.2095-4344.1408 Abstract ( 701 )   PDF (23211KB) ( 221 )   Save BACKGROUND: In clinical practice, MOTOmed lower limb function trainer combined with conventional rehabilitation training has been shown to be effective in the treatment of lower limb dysfunction after stroke, but it lacks evidence-based evidence. OBJECTIVE: To estimate the clinical efficacy of MOTOmed lower limb function trainer in the treatment of lower limb dysfunction in stroke patients with hemiplegia. METHODS: A computer-based online search of CBM, CNKI, Wanfang database, VIP Chinese Science and Technology Periodicals Database, Embase, Web of Science, PubMed, OVID, Cochrane Central Register of Controlled Trials, Cochrane Systematic Reviews for the randomized controlled studies of MOTOmed in the treatment of lower limb dysfunction in stroke patients with hemiplegia. Meta-analysis was performed using Revman5.3 software. RESULTS AND CONCLUSIONS: A total of 19 literatures were included, with a sample size of 1 099 cases. Patients in the experiment group received MOTOmed lower limb function exercise in combination with conventional rehabilitation treatment, and those in the control group only underwent conventional rehabilitation treatment. The results of meta-analysis showed that the Fugl-Meyer score of lower limb motor function in the experimental group was significantly higher than that in the control group [MD = 5.55, 95%CI (4.08, 7.03), Z=7.37, P < 0.01]. The Modified Ashworth Scale score in the experiment group was significantly lower than that in the control group [MD=-0.13, 95%CI (-1.37, -0.89), Z=9.19, P < 0.01]. The score of the 10-meter walking test in the experiment group was higher than that of the control group [MD=10.15, 95%CI (5.72, 14.58), Z=4.49, P < 0.01]. The Berg Balance scale score in the experiment group was significantly higher than that in the control group [MD=13.66, 95%CI (10.47, 16.85), Z=8.39, P < 0.01]. The functional ambulation category scale score in the experiment group was significantly higher than that in the control group [MD=0.85, 95%CI (0.68, 1.03), Z=9.48, P < 0.01]. The Modified Barthel Index in the experiment group was significantly higher than that in the control group [MD=11.49, 95%CI (8.96, 14.03), Z=8.89, P < 0.01]. The results show that MOTOmed lower limb function trainer has a good clinical effect in the treatment of lower limb dysfunction in stroke patients with hemiplegia, but more high-quality clinical studies are needed to verify it. Figures and Tables | References | Related Articles | Metrics