Objective To investigate the morphology and biomechanics of in vivo osteogensis after repairing rabbit skull defects with plastic engineered bone which was prefabricated with alginate gel, osteoblasts and bone granules. Methods Twenty-eight rabbits were divided into group A (n=16), group B(n=8) and group C(n=4).The bilateral skull defects of 1 cm in diameter were made. Left skull defects filled with alginate gel-osteoblasts-bone granules(group A1) and right skull defects filled withalginate gel-bone granules(group A2).The defects of group B was left, as blank control and group C had no defect as normal control. The morphological change and bone formation were observed by methods of gross, histology and biomechanics. Results In group A1, the skull defects were almost entirely repaired by hard tissue 12 weeks after operation. The alginate gel-osteoblasts-bone granule material had changed into bone tissue with fewbone granules and some residuary alginate gel. The percentage of bone formation area was 40.92%±19.36%. The maximum compression loading on repairing tissue ofdefects was 37.33±2.95 N/mm; the maximum strain was 1.05±0.20 mm; andloading/strain ratio was 35.82±6.48 N/mm. In group A2, the alginate and bone granules material partially changed into bone tissue 12 weeks after operation. The percentage of bone formation area was 18.51%±6.01%. The maximum compression loading was 30.59±4.65 N; the maximum strain was 1.35±0.44 mm; and the loading/strainratio was 24.95±12.40 N/mm. In group B, the skull defects were mainly repaired bymembrane-like soft tissue with only few bone in marginal area；the percentage of bone formation area was 12.72%±9.46%. The maximum compression loading was 29.5±2.05 N; the maximum strain was 1.57±0.31mm；and the loading/strainratio was 19.90±5.47 N/mm.In group C, the maximum compression loading was 41.55±2.52 N; the maximum strain was 095±017 mm; and the l oading/strain ratio was 47.57±11.22 N/mm. 〖 WTHZ〗Conclusion〓〖WTBZ〗The plastic engineered bone prefabricated with algina te gelosteoblastsbone granule may shape according to the bone defects and ha s good ability to form bone tissue, whose maximum compression loading can reach 89 % of normal skull and the hardness at 12 weeks after operation is similar to that of normal skull.
【Abstract】 Objective To discuss the role of leukocyte activation and inflammatory processes in the disease of chronic venous insufficiency （CVI）. Methods The relevant literatures about the role of leukocyte activation and inflammatory reaction in CVI were reviewed. Results The role of inflammatory reaction in occurrence and development of venous diseases has been studied a lot in recent years. It was found that the leukocyte activation and inflammatory reaction are involved in the structural remodeling of venous valves and walls, leading to valvular incompetence and formation of varicose veins. Conclusion Leukocyte activation and inflammatory processes take important roles in the occurrence and progression of CVI.
Objective To investigate the left ventricular reverse remodeling (LVRR) in patients with aortic valve insufficiency with reduced ejection fraction (AIrEF) and aortic valve insufficiency with preserved ejection fraction (AIpEF) after transcatheter aortic valve replacement (TAVR). MethodsThe clinical and follow-up data of patients who underwent TAVR in the Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from 2018 to 2021 were retrospectively analyzed. According to the guideline, the patients with left ventricular ejection fraction<55% were allocated to an AIrEF group, and the patients with left ventricular ejection fraction≥55% were allocated to an AIpEF group. ResultsA total of 50 patients were enrolled. There were 19 patients in the AIrEF group, including 15 males and 4 females with a mean age of 74.5±7.1 years. There were 31 patients in the AIpEF group, including 19 males and 12 females with a mean age of 72.0±4.8 years. All patients underwent TAVR successfully. Echocardiographic results showed that TAVR significantly promoted LVRR in the patients. Significant LVRR occurred in the early postoperative period (the first day after the surgery) in both groups. It remained relatively stable after the LVRR in the early postoperative period (the first day after surgery) in the AIpEF patients, while it continued to occur in the early postoperative period (the first day after surgery) to three months after the surgery in the AIrEF patients, and then remained relatively stable. Compared to preoperative values, AIrEF patients had a reduction in the average left ventricular end-diastolic volume index and left ventricular end-systolic volume index by 16.8 mL/m2 (P=0.003) and 8.6 mL/m2 (P=0.005), respectively, and the average left ventricular end-diastolic diameter index and end-systolic diameter index decreased by 2.5 mm/m2 (P=0.003) and 1.9 mm/m2 (P=0.003), respectively on the first day after the surgery. In comparison to the first day after the surgery, AIrEF patients experienced an average increase of 12.1% in the left ventricular ejection fraction three months after the surgery (P＜0.001). ConclusionTAVR has achieved good therapeutic effects in patients with aortic valve insufficiency, significantly promoting the LVRR in patients, and has better curative effects in AIrEF patients.
ObjectiveTo investigate the effect of isokinetic training of thigh muscle group on graft remodeling after anterior cruciate ligament (ACL) reconstruction, and summarize the relevant rules to guide the clinic.MethodsBetween August 2016 and December 2016, forty patients underwent arthroscopic ACL reconstruction using hamstring tendon were randomly divided into isokinetic group and control group (n=20). The two groups of patients underwent staged rehabilitation treatment. The isokinetic group replaced the traditional intervention with the corresponding isokinetic strength training from 3 to 6 months after operation, and the traditional rehabilitation intervention was used in the control group. Finally, 12 cases of isokinetic group and 12 cases of control group with complete follow-up were enrolled in study. There was no significant difference in gender, age, body mass index, side of injury, the interval between injury and operation, and preoperative International Knee Documentation Committee (IKDC) score between the two groups (P>0.05). The peak torque (PT) of knee extension and flexion and hamstring quadriceps ratio (H/Q) were measured at 3 months, 6 months, 12 months, and the second-look arthroscopy. The MRI examination was performed at the same time to evaluate graft remodeling. The shape, tension, and degree of vascularization of grafts were observed under arthroscopy. The grafts were harvested and observed by HE staining.ResultsThe invertal between ACL reconstruction and the second-look arthroscopy was (23.57±3.23) months in isokinetic group and (23.22±3.56) months in control group, showing no significant difference between the two groups (P>0.05). At the second-look arthroscopy, the IKDC score was 90.45±4.73 in isokinetic group and 89.32±4.54 in control group, showing significant differences when compared with preoperative scores in the two groups (P<0.05). But there was no significant difference between the two groups (t=0.868, P=0.404). At 3 months after operation, there was no significant difference in the PT of knee extension and flexion between the two groups (P>0.05). At 6 months, 12 months, and the second-look arthroscopy, the PT of knee extension and flexion in isokinetic group were higher than those in control group (P<0.05). The H/Q at 6 months and 12 months were higher in isokinetic group than in control group, and the differences were significant (P<0.05). There was no significant difference in MRI score between the two groups at 3 months, 6 months, and the second-look arthroscopy (P>0.05). The MRI score at 12 months was significantly higher in isokinetic group than in control group (P<0.05). At the second-look arthroscopy, there was no significant difference in the arthroscopic score between the two groups (P>0.05), and the histological score of the isokinetic group was superior to the control group (P<0.05).ConclusionOn the basis of regular rehabilitation training, using the isokinetic training system to develop a suitable post-surgical isokinetic rehabilitation training program is helpful in early muscle strength recovery, early graft remodeling, and even long-term histological results after ACL reconstruction.
ObjectiveTo review the research progress on the establishment of prevertebral pathway in the treatment of unilateral total brachial plexus injury, cerebral palsy, stroke, and traumatic brain injury by contralateral C7 nerve root transfer.MethodsThe literature about contralateral C7 nerve root transfer via prevertebral pathway at home and abroad was extensively reviewed, and the development, changes, advantages and disadvantages of various operation methods were analyzed and summarized.ResultsAfter unilateral total brachial plexus injury, cerebral palsy, stroke, and traumatic brain injury, it can be repaired by a variety of surgical methods of the contralateral C7 nerve root transfer via prevertebral pathway, which include the anterior subcutaneous tissue tunnel of the vertebral body, the passage under the sternocleidomastoid muscle, the posterior pharyngeal space and the anterior vertebral fascia passage, the modified posterior esophageal anterior vertebral passage, the anterior vertebral passage that cuts off the bilateral anterior scalene, and Huashan anterior pathway, etc. Among them, how to establish the shortest, safe, and effective way of anterior vertebral canal has been paid more attention and discussed by peripheral nerve repair doctors.ConclusionIt is a safe and effective surgical method to repair unilateral total brachial plexus injury, cerebral palsy, stroke, and traumatic brain injury patients with contralateral C7 nerve root transfer via prevertebral pathway.
ObjectiveTo investigate the impact of anatomical variations of the isolated left vertebral artery (ILVA) on clinical outcomes and imaging outcomes in patients with Stanford type B aortic dissection (TBAD) who underwent thoracic endovascular aortic repair. MethodsThe clinical data of patients with TBAD in West China Hospital, Sichuan University from January 2016 to December 2023 were collected, and the differences of clinical outcomes and imaging outcomes between patients with and without ILVA were compared. ResultsBased on the inclusion criteria and the result of propensity score-based matching, 82 patients with TBAD were included, including 17 patients with ILVA (ILVA group) and 65 patients without ILVA (control group). There was no significant difference between the two groups in terms of the radiological and surgical information (P>0.05). The median time of the follow-up for these 82 patients were 37 months, during which there were no significant differences in aortic-related death, aortic event, stroke, adverse aortic remodeling, type Ⅰ A endoleak, and retrograde progression between the two groups (P>0.05). Compared with the control group, the re-intervention rate [HR=2.56, 95%CI (1.55, 8.11), P=0.03] and the incidence of type Ⅱ internal leakage [OR=1.36, 95%CI (1.08, 2.11), P=0.04] in the ILVA group were higher. ConclusionsNo significant differences were observed for ILVA patients in terms of serious adverse events such as aortic-related death and retrograde progression, comparing with the patients with normal aortic arch. However, the patients with ILVA were more susceptible to complications such as reintervention and type Ⅱ endoleak, which warranted the necessity of intensive postoperative follow-up for these patients.
Myocardial remodeling is a common pathological physiology change for a variety of heart diseases under stimulation such as stress or ischemia. The engine body will release a lot of cytokines to promote the change of myocardial structure and ultimately lead to heart failure. Myocardial remodeling includes myocardial cells remodeling and the extracellular matrix remodeling. In recent years, we find that the function of adipose tissue is not only about energy storage, buffering to protect, supporting and filling, but also has a powerful function of secretion. Adipose tissue can secrete various adipocytokines, such as leptin, adiponectin, visfatin, omentin, angiotensin Ⅱ, and so on. Current studies have shown that adipocytokines and myocardial remodeling are intimated. And this article will summarize the function of adipocytokines on myocardial remodeling.
ObjectiveTo summarize the research progress of pathological manifestations and mechanism of endochondral ossification in osteoarthritis (OA). MethodsThe literature about endochondral ossification, bone-cartilage remodeling in OA, and joints development was reviewed, analyzed, and summarized. ResultsChondrocyte hypertrophy and apoptosis, vascular invasion, replication of the tidemark, thickening calcified cartilage, and thinning superficial cartilage are the characteristics of cartilage degeneration in OA. Articular cartilage and growth plate are similar in structure, and cartilage degeneration in OA is similar to a process of endochondral ossification of the growth plate. ConclusionLoss of stability characterization from resting metabolic balance to a high conversion state of temporary cartilage in stimulation of abnormal mechanical stresses and cytokines would subsequently contributed to continual calcification and remodeling of articular cartilage, which may be the key link of the initiation and development of OA.
Lung injury could be classified as acute and chronic injuries, such as acute respiratory distress syndrome and chronic obstructive pulmonary disease. Lung function recovery mainly depends on inflammation adjusting, lung and airway remodeling, endogenous stem cell proliferation and differentiation, and tissue repair. The principles of clinical therapy include inhibition of inflammation, balancing coagulation and fibrinolysis, and protective lung ventilation for acute lung injury; while reduction of hyper-secretion, bronchodilation, adjusting airway mucosal inflammation and immunity, as well as improving airway remodeling for chronic obstructive pulmonary disease. The functional recovery of lung and airway depends on endogenous stem cell proliferation and repair. The purpose of clinical treatment is to provide assistance for lung and airway repair besides pathophysiological improvement.
In medical research, latent subgroups often emerge with characteristics or trends distinct from the general population, yet identifying them directly remain challenging. The latent variable mixture modeling, grounded in the idea that a population consists of a limited mixture of subgroups, assigns latent categories to individuals based on posterior probabilities. This model is suitable for both cross-sectional and longitudinal datasets. Approaching from a statistical perspective, this paper thoroughly explicates the foundational principles of four prevalent methods within the latent variable mixture modeling realm, outlining the essential modeling workflow. By integrating insights from previous cases and real-world data, we review the rational applications of these methods. The latent variable mixture modeling stands as a flexible classification tool for identifying and analyzing latent categories within research populations, further facilitating the in-depth exploration of predictors influencing these latent categories and their consequent effects on outcome variables.