Objective To review the research advances of the tracheal prosthesis. Methods The articles concerned in recent years were extensively reviewed. Results There were still many arguments about the use of tracheal substitutes. Avariety of artificial trachea had been designed and assessed, but so far none of them had been satisfactory for clinical use. The failures were mainly due to their high mortality and incidence of complication such as prosthetic defluvium, granuloma formation, local infection, air leakage, anastomotic stenosis or obstruction. Conclusion The major causes of the poor effectiveness by the use of tracheal prosthesis are closely related to its biological compatibilities. The selected biomaterials and the design of prosthesis hold the key to a breakthrough in research and clinical use of tracheal prosthesis.
Objective To isolate，culture and expand bone marrow mesenchymal stem cells （MSCs） in vitro，induce MSCs to differentiate directionally towards chondrocytes，and provide experimental basis for clinical application of MSCs and construction of tissue engineering tracheal cartilage. Methods Cultured MSCs were isolated from bone marrow of Sprague-Dawley rats，purified using adherence separation，and identified by flow cytometry analysis. Transforming growth factor β1 （TGF-β1）and insulin-like growth factor 1 （IGF-1） were used as main induction factors to induce MSCs to differentiate directionally towards chondrocytes. The expression of collagen typeⅡwas evaluated by immunocytochemical staining 21 days after induction. Light microscope and electron microscope were used to observe tiny and ultrastructural changes of the cells before and after induction. Results The expression of collagen typeⅡwas positive by immunocytochemical staining 21 days after induction. MSCs were fusiform before induction under light microscope and electron microscope. After induction，the cells became larger，polygon，star-shaped or triangular. Transmission electron microscope showed that the cells had abundant organelles，larger nuclei and more nucleoli after induction. Conclusion Abundant organelles，larger nuclei and more nucleoli are the ultrastructure changes of chondrocytes differentiated from MSCs，indicating that the cells are active in differentiation and metabolism.
More and more solitary pulmonary nodules (SPN) are discovered with the development of imaging technology. Early and appropriate evaluation of SPN is of great importance for following treatment and patients' prognosis, as early differentiation between benign and malignant is difficult, while its possibility of being malignant does exist. In this review, we make a comprehensive evaluation about diagnostic value of some risk factors of solitary pulmonary nodules, including age, nodule diameter, doubling time, nodule location, air bronchogram, ground-glass opacitie, vacuole, lobulation, spiculation, vascular convergence, pleural indentation, nodule calcification, past medical history, smoking history, past symptoms and nodule density. Future perspective of diagnostic strategies is also discussed.
Objective To review the research of the artificial tracheal prosthesis in the past decade so as to provide theoretical references for the development of the artificial tracheal prosthesis. Methods The l iterature about the artificial tracheal prosthesis was extensively reviewed and analyzed. Results Many new materials are used for the research of artificialtracheal prosthesis which have excellent biocompatibil ity and stabil ity of the structural characteristics. And many compl ications such as migration, obstruction, and infection have been resolved, but so far none of the new materials has been used for cl inical treatment successfully. Conclusion The choice of the materials for artificial tracheal prosthesis is the key to succeed. Biodegradable polymer materials with its unique biological properties become the new direction of the tracheal prosthesis research.
The extracellular matrix provides a unique tissue-specific microenvironment for resident cells, supporting the essential functions required for tissue architecture and biochemical signaling. Decellularized extracellular matrix (dECM) is designed to eliminate cells that mediate immunological rejection while preserving the native tissue structure and matrix functionality. dECM has attracted significant attention in tissue engineering applications and has evolved into a novel and increasingly sophisticated biomaterial. This article summarizes representative protocols for decellularization methods, explores the latest applications of decellularized tissue-derived materials and bioinks in the field of cardiothoracic surgery, analyzes the current challenges and issues confronting dECM, and discusses future perspectives for its development.
A variety of benign and malignant disorders affecting the trachea can theoretically be treated by simple resection and subsequent end-to-end anastomosis of remained trachea. Unfortunately, it is feasible only when the affected tracheal length does not exceed 50% of the entire length in adults and about 30% in children. Tracheal transplantation may be a treatment option for those patients, but still has many problems to be solved, such as immunological rejection, revascularization, infection and granulation tissue hyperplasia. This review focuses on how to use different methods to inhibit immunological rejection of tracheal transplantation, and current research progress of immunological rejection in tracheal allograft.
The widespread use of low-dose computed tomography (LDCT) in lung cancer screening has enabled more and more lung nodules to get identified of which more than 20% are multiple pulmonary nodules. At present, there is no guideline or consensus for multiple pulmonary nodules whose management is based primarily on the pulmonary imaging characteristics and associated risk factors. Herein, this review covers the imaging methods, CT appearances and management of multiple pulmonary nodules.
Tissue-engineered tracheal transplantation has been reported and the technique of decellularized scaffold's preparation is mature. Regeneration of epithelium, cartilage and blood vessel is particularly important during tracheal transplantation. With the increasing improvement on cell acquisition and cell culture, as well as the factor of auxesis and cell differentiation, tissue-engineered technique provided possibility and clinical value for regeneration of epithelium, cartilage and blood vessel. This review focuses on the improvement and prospect of regeneration of epithelium, cartilage and blood vessel during tracheal transplantation.
Objective To review the recent research progress of the bioreactor biophysical factors in cartilage tissue engineering. Methods The related literature concerning the biophysical factors of bioreactor in cartilage tissue engineering was reviewed, analyzed, and summarized. Results Oxygen concentration, hydrostatic pressure, compressive force, and shear load in the bioreactor system have no unified standard parameters. Hydrostatic pressure and shear load have been in controversy, which restricts the application of bioreactors. Conclusion The biophysical factors of broreactor in cartilage tissue engineering have to be studied deeply.
ObjectiveTo explore the independent risk factors for benign and malignant subsolid pulmonary nodules and establish a malignant probability prediction model.MethodsA retrospective analysis was performed in 443 patients with subsolid pulmonary nodules admitted to Subei People's Hospital of Jiangsu Province from 2014 to 2018 with definite pathological findings. The patients were randomly divided into a modeling group and a validation group. There were 296 patients in the modeling group, including 125 males and 171 females, with an average age of 55.9±11.1 years. There were 147 patients in the verification group, including 68 males and 79 females, with an average age of 56.9±11.6 years. Univariate and multivariate analysis was used to screen the independent risk factors for benign and malignant lesions of subsolid pulmonary nodules, and then a prediction model was established. Based on the validation data, the model of this study was compared and validated with Mayo, VA, Brock and PKUPH models.ResultsUnivariate and multivariate analysis showed that gender, consolidation/tumor ratio (CTR), boundary, spiculation, lobulation and carcinoembryonic antigen (CEA) were independent risk factors for the diagnosis of benign and malignant subsolid pulmonary nodules. The prediction model formula for malignant probability was: P=ex/(1+ex). X=0.018+(1.436×gender)+(2.068×CTR)+(−1.976×boundary)+ (2.082×spiculation)+(1.277×lobulation)+(2.296×CEA). In this study, the area under the curve was 0.856, the sensitivity was 81.6%, the specificity was 75.6%, the positive predictive value was 95.4%, and the negative predictive value was 39.8%. Compared with the traditional model, the predictive value of this model was significantly better than that of Mayo, VA, Brock and PKUPH models.ConclusionCompared with Mayo, VA, Brock and PKUPH models, the predictive value of the model is more ideal and has greater clinical application value, which can be used for early screening of subsolid nodules.