The effects of large piece xenogeneic bone which was separated from healthy pigs as a scaffold on repair of mandibular defect was investigated and the applicability of antigen-extracted xenogeneic cancellous bone (AXC...The effects of large piece xenogeneic bone which was separated from healthy pigs as a scaffold on repair of mandibular defect was investigated and the applicability of antigen-extracted xenogeneic cancellous bone (AXCB) soaked with rhBMP-2 in bone defect repair was assessed. Mandibular defects were created in 48 New Zealand Rabbits, and then randomly divided into 4 groups, which was grafted in the mandibular defects with AXCB, AXCB soaked with rhBMP-2, autograft bone, or blank. Equal number of animals from each group was classified into three time points (4, 8, and 12 weeks) after operation for gross pathological observation, hematoxylin and eosin (H & E) staining, radiographic examination, and bone density measurement. H & E staining revealed that the area percentage of bone regeneration in the group of AXCB/rhBMP-2 graft was 27.72 ± 4.68, 53.90 ± 21.92, and 77.35 ± 9.83 when at 4, 8, and 12 weeks, which was better than that of auto bone graft, prompting that the group of AXCB/rhBMP-2 graft had commendable osteogenic effect. And comparing with the AXCB without rhBMP-2, of which the area percentage of bone regeneration was only 14.03 ± 5.02, 28.49 ± 11.35, and 53.90 ± 21.92, the osteogenic effect of AXCB/rhBMP-2 graft was demonstrated to be much better. In the group of AXCB/rhBMP-2 graft, the area percentage of bone regeneration increased, and the implanted materials were gradually degraded and replaced by autogenous bone regeneration over time. We concluded that antigen-extracted xenogeneic cancellous bone (AXCB) graft soaked with rhBMP-2 had shown excellent osteogenic effect in repair of bone defects, with good biocompability.展开更多
BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown...BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.展开更多
Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface.Multilayered or gradient scaffolds,often in co...Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface.Multilayered or gradient scaffolds,often in conjunction with stem cells and growth factors,have been developed to mimic the respective layers for osteochondral defect repair.In this study,we designed a hyaline cartilage-hypertrophic cartilage bilayer graft(RGD/RGDW)with chondrocytes.Previously,we demonstrated that RGD peptide-modified chondroitin sulfate cryogel(RGD group)is chondro-conductive and capable of hyaline cartilage formation.Here,we incorporated whitlockite(WH),a Mg^(2+)-containing calcium phosphate,into RGD cryogel(RGDW group)to induce chondrocyte hypertrophy and form collagen X-rich hypertrophic cartilage.This is the first study to use WH to produce hypertrophic cartilage.Chondrocytes-laden RGDW cryogel exhibited significantly upregulated expression of hypertrophy markers in vitro and formed ectopic hypertrophic cartilage in vivo,which mineralized into calcified cartilage in bone microenvironment.Subsequently,RGD cryogel and RGDW cryogel were combined into bilayer(RGD/RGDW group)and implanted into rabbit osteochondral defect,where RGD layer supports hyaline cartilage regeneration and bioceramic-containing RGDW layer promotes calcified cartilage formation.While the RGD group(monolayer)formed hyaline-like neotissue that extends into the subchondral bone,the RGD/RGDW group(bilayer)regenerated hyaline cartilage tissue confined to its respective layer and promoted osseointegration for integrative defect repair.展开更多
The reconstruction of critical-size calvarial defects remains a fundamental challenge.Recombinant collagen has gained significant attention in bone tissue engineering owing to its remarkable bioactivity and non-immuno...The reconstruction of critical-size calvarial defects remains a fundamental challenge.Recombinant collagen has gained significant attention in bone tissue engineering owing to its remarkable bioactivity and non-immunogenicity.Herein,we have for the first time developed a bioactive poly(ethylene glycol)-chondroitin sulfate-triple helical recombinant collagen(PEG-ChS-THRC)hydrogel for enhanced bone regeneration in cranial defects.A simple and mild crosslinking reaction of two-arm polyethylene glycol active ester(NHS-PEG-NHS),adipic dihydrazide modified chondroitin sulfate(ChS-ADH)and triple helical recombinant collagen(THRC)leads to the formation of the PEG-ChS-THRC hydrogel.The hydrogel demonstrates interconnected porous structures,enhanced mechanical strength,diminished swelling ratios and adjustable biodegradability.It possesses exceptional biocompatibility and bioactivity,significantly facilitating cell proliferation,adhesion,migration,and osteogenic differentiation of BMSCs.Micro-computed tomography(micro-CT),magnetic resonance imaging(MRI)and histological characterization of rat models with critical-size cranial defects have consistently demonstrated that the PEG-ChS-THRC hydrogel significantly promotes bone tissues regeneration.The innovative bioactive scaffold provides a remarkably improved remedy for critical-size cranial defects,holding greatly promising applications in the fields of bone tissue regeneration.展开更多
Biodegradable metals are promising candidates for bone defect repair.With an evidence-based approach,this study investigated and analyzed the performance and degradation properties of biodegradable metals in animal mo...Biodegradable metals are promising candidates for bone defect repair.With an evidence-based approach,this study investigated and analyzed the performance and degradation properties of biodegradable metals in animal models for bone defect repair to explore their potential clinical translation.Animal studies on bone defect repair with biodegradable metals in comparison with other traditional biomaterials were reviewed.Data was carefully collected after identification of population,intervention,comparison,outcome,and study design(PICOS),and following the inclusion criteria of biodegradable metals in animal studies.30 publications on pure Mg,Mg alloys,pure Zn and Zn alloys were finally included after extraction from a collected database of 2543 publications.A qualitative systematic review and a quantitative meta-analysis were performed.Given the heterogeneity in animal model,anatomical site and critical size defect(CSD),biodegradable metals exhibited mixed effects on bone defect repair and degradation in animal studies in comparison with traditional non-degradable metals,biodegradable polymers,bioceramics,and autogenous bone grafts.The results indicated that there were limitations in the experimental design of the included studies,and quality of the evidence presented by the studies was very low.To enhance clinical translation of biodegradable metals,evidence-based research with data validity is needed.Future studies should adopt standardized experimental protocols in investigating the effects of biodegradable metals on bone defect repair with animal models.展开更多
Graphene has excellent theoretical properties and a wide range of applications in metal-based composites. However, because of defects on the graphene surface, the actual performance of the material is far below theore...Graphene has excellent theoretical properties and a wide range of applications in metal-based composites. However, because of defects on the graphene surface, the actual performance of the material is far below theoretical expectations. In addition, graphene containing defects could easily react with a matrix alloy, such as Al, to generate brittle and hydrolyzed phases that could further reduce the performance of the resulting composite. Therefore, defect repair is an important area of graphene research. The repair methods reported in the present paper include chemical vapor deposition, doping, liquid-phase repair, external energy graphitization, and alloying. Detailed analyses and comparisons of these methods are carried out, and the characterization methods of graphene are introduced. The mechanism, research value, and future outlook of graphene repair are also discussed at length. Graphene defect repair mainly relies on the spontaneous movement of C atoms or heteroatoms to the pore defects under the condition of applied energy. The repair degree and mechanism of graphene repair are also different according to different preparations. The current research on graphene defect repair is still in its infancy, and it is believed that the problem of defect evolution will be explained in more depth in the future.展开更多
Physiological repair of large-sized bone defects is great challenging in clinic due to a lack of ideal grafts suitable for bone regeneration.Decalcified bone matrix(DBM)is considered as an ideal bone regeneration scaf...Physiological repair of large-sized bone defects is great challenging in clinic due to a lack of ideal grafts suitable for bone regeneration.Decalcified bone matrix(DBM)is considered as an ideal bone regeneration scaffold,but low cell seeding efficiency and a poor osteoinductive microenvironment greatly restrict its application in large-sized bone regeneration.To address these problems,we proposed a novel strategy of bone regeneration units(BRUs)based on microgels produced by photo-crosslinkable and microfluidic techniques,containing both the osteogenic ingredient DBM and vascular endothelial growth factor(VEGF)for accurate biomimic of an osteoinductive microenvironment.The physicochemical properties of microgels could be precisely controlled and the microgels effectively promoted adhesion,proliferation,and osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)in vitro.BRUs were successfully constructed by seeding BMSCs onto microgels,which achieved reliable bone regeneration in vivo.Finally,by integrating the advantages of BRUs in bone regeneration and the advantages of DBM scaffolds in 3D morphology and mechanical strength,a BRU-loaded DBM framework successfully regenerated bone tissue with the desired 3D morphology and effectively repaired a large-sized bone defect of rabbit tibia.The current study developed an ideal bone biomimetic microcarrier and provided a novel strategy for bone regeneration and large-sized bone defect repair.展开更多
Bone defects caused by diseases or surgery are a common clinical problem.Researchers are devoted to finding biological mechanisms that accelerate bone defect repair,which is a complex and continuous process controlled...Bone defects caused by diseases or surgery are a common clinical problem.Researchers are devoted to finding biological mechanisms that accelerate bone defect repair,which is a complex and continuous process controlled by many factors.As members of transcriptional costimulatory molecules,Yes-associated protein(YAP)and transcriptional co-activator with PDZ-binding motif(TAZ)play an important regulatory role in osteogenesis,and they affect cell function by regulating the expression of osteogenic genes in osteogenesis-related cells.Macrophages are an important group of cells whose function is regulated by YAP/TAZ.Currently,the relationship between YAP/TAZ and macrophage polarization has attracted increasing attention.In bone tissue,YAP/TAZ can realize diverse osteogenic regulation by mediating macrophage polarization.Macrophages polarize into M1 and M2 phenotypes under different stimuli.M1 macrophages dominate the inflammatory response by releasing a number of inflammatory mediators in the early phase of bone defect repair,while massive aggregation of M2 macrophages is beneficial for inflammation resolution and tissue repair,as they secrete many anti-inflammatory and osteogenesis-related cytokines.The mechanism of YAP/TAZ-mediated macrophage polarization during osteogenesis warrants further study and it is likely to be a promising strategy for bone defect repair.In this article,we review the effect of Hippo-YAP/TAZ signaling and macrophage polarization on bone defect repair,and highlight the regulation of macrophage polarization by YAP/TAZ.展开更多
Long-term nonunion of bone defects has always been a major problem in orthopedic treatment.Artificial bone graft materials such as Poly(lactic-co-glycolic acid)/β-tricalcium phosphate(PLGA/β-TCP)scaffolds are expect...Long-term nonunion of bone defects has always been a major problem in orthopedic treatment.Artificial bone graft materials such as Poly(lactic-co-glycolic acid)/β-tricalcium phosphate(PLGA/β-TCP)scaffolds are expected to solve this problem due to their suitable degradation rate and good osteoconductivity.However,insufficient mechanical properties,lack of osteoinductivity and infections after implanted limit its large-scale clinical application.Hence,we proposed a novel bone repair bioscaffold by adding zinc submicron particles to PLGA/β-TCP using low temperature rapid prototyping 3D printing technology.We first screened the scaffolds with 1 wt%Zn that had good biocompatibility and could stably release a safe dose of zinc ions within 16 weeks to ensure long-term non-toxicity.As designed,the scaffold had a multi-level porous structure of biomimetic cancellous bone,and the Young’s modulus(63.41±1.89 MPa)and compressive strength(2.887±0.025 MPa)of the scaffold were close to those of cancellous bone.In addition,after a series of in vitro and in vivo experiments,the scaffolds proved to have no adverse effects on the viability of BMSCs and promoted their adhesion and osteogenic differentiation,as well as exhibiting higher osteogenic and anti-inflammatory properties than PLGA/β-TCP scaffold without zinc particles.We also found that this osteogenic and anti-inflammatory effect might be related to Wnt/β-catenin,P38 MAPK and NFkB pathways.This study lay a foundation for the follow-up study of bone regeneration mechanism of Zn-containing biomaterials.We envision that this scaffold may become a new strategy for clinical treatment of bone defects.展开更多
Objective: to analyze the application effect and clinical improvement of personalized free anterolateral femoral flap in the repair of oral and maxillofacial soft tissue defects. Methods: the initial time of this stud...Objective: to analyze the application effect and clinical improvement of personalized free anterolateral femoral flap in the repair of oral and maxillofacial soft tissue defects. Methods: the initial time of this study was January 2020 and the deadline was December 2021. A total of 30 patients with oral and maxillofacial soft tissue injury were selected as the research objects. Randomly divided into two groups, 15 cases were treated with personalized free anterolateral femoral flap as the observation group, and the remaining 15 cases were treated with forearm flap repair as the control group. Results: the rates of pruritus, scar hyperplasia, numbness in the skin graft area, pigmentation, necrosis in the donor area, paresthesia in the skin graft area, temporary dysfunction and permanent dysfunction in the observation group were lower than those in the control group (P < 0.05);The recovery of language function in the observation group accounted for 86.67%, which was significantly better than 66.67% in the control group (P < 0.05);The grade I recovery of swallowing function in the observation group accounted for 20%, which was significantly better than 6.67% in the control group (P < 0.05). Conclusion: in the clinical application of oral and maxillofacial soft tissue defect repair, the postoperative recovery effect of patients is better, reducing the impact of surgical operation on the patient, and the recovery effect of language and swallowing function is more ideal, which is worth promotion and application.展开更多
The groove defect formed in the friction stir welding dramatically deteriorates weld appearances and mechanical properties of the joints owing to its larger size and penetration. Therefore, the friction stir repair we...The groove defect formed in the friction stir welding dramatically deteriorates weld appearances and mechanical properties of the joints owing to its larger size and penetration. Therefore, the friction stir repair welding was utilized to remove such a groove defect, and the focus was placed on the mechanical properties and microstructural characteristics of the repair joints so as to obtain an optimum repair welding process. The experimental results indicate that the groove defect can be removed by friction stir repair welding, and the offset repair welding process is superior to the symmetrical repair welding process. In the symmetrical repair welding process, a large number of fine cavity defects and an obvious aggregation of hard-brittle phase Al2Cu occur, accordingly the mechanical properties of the repair joint are weakened, and the fracture feature of repair joint is partially brittle and partially plastic. A good-quality repair joint can be obtained by the offset repair welding process, and the repair joint is fractured near the interface between the weld nugget zone and thermal-mechanically affected zone.展开更多
Pretreatment of nerve allografts by exposure to irradiation or green tea polyphenols can elimi- nate neuroimmunogenicity, inhibit early immunological rejection, encourage nerve regeneration and functional recovery, im...Pretreatment of nerve allografts by exposure to irradiation or green tea polyphenols can elimi- nate neuroimmunogenicity, inhibit early immunological rejection, encourage nerve regeneration and functional recovery, improve tissue preservation, and minimize postoperative infection. In the present study, we investigate which intervention achieves better results. We produced a 1.0 cm sciatic nerve defect in rats, and divided the rats into four treatment groups： autograft, fresh nerve allograft, green tea polyphenol-pretreated （1 mg/mL, 4~C） nerve allograft, and irradiation-pre- treated nerve allograft （26.39 Gy/min for 12 hours; total 19 kGy）. The animals were observed, and sciatic nerve electrophysiology, histology, and transmission electron microscopy were carried out at 6 and 12 weeks after grafting. The circumference and structure of the transplanted nerve in rats that received autografts or green tea polyphenol-pretreated nerve allografts were similar to those of the host sciatic nerve. Compared with the groups that received fresh or irradiation-pre- treated nerve allografts, motor nerve conduction velocity in the autograft and fresh nerve allograft groups was greater, more neurites grew into the aUografts, Schwann cell proliferation was evident, and a large number of new blood vessels was observed; in addition, massive myelinated nerve fibers formed, and abundant microfilaments and microtubules were present in the axoplasm. Our findings indicate that nerve allografts pretreated by green tea polyphenols are equivalent to trans- planting autologous nerves in the repair of sciatic nerve defects, and promote nerve regeneration. Pretreatment using green tea polyphenols is better than pretreatment with irradiation.展开更多
BACKGROUND： Animal experiments and clinical studies about tissue engineering method applied to repair nerve injury mainly focus on seeking ideal artificial nerve grafts, nerve conduit and seed cells. Autologous nerve...BACKGROUND： Animal experiments and clinical studies about tissue engineering method applied to repair nerve injury mainly focus on seeking ideal artificial nerve grafts, nerve conduit and seed cells. Autologous nerve, allogeneic nerve and xenogeneic nerve are used to bridge nerve defects, it is one of the methods to promote the repair of nerve injury by culturing and growing Schwann cells, which can secrete various neurotrophic factor activities, in the grafts. OBJECTIVE ： To observe the effect of acellular nerve grafts co-cultured with Schwann cells in repairing defects of sciatic nerve. DESIGN： An observational comparative study.SETTING： Tissue Engineering Laboratory of China Medical University.MATERIALS： The experiment was carried out in the Tissue Engineering Laboratory of China Medical University between April 2004 and April 2005. Forty neonatal Sprague-Dawley rats of 5-8 days （either males or females） and 24 male Wistar rats of 180-220 g were provided by the experimental animal center of China Medical University. METHODS： ① Culture of Schwann cells： The bilateral sciatic nerves and branchial plexus were isolated from the 40 neonatal SD rats. The sciatic nerves were enzymatically digested with collagenase and dispase, isolatd, purified and cultured with the method of speed-difference adhersion, and identified with the SABC immunohistochemical method. ② Model establishment： In vitro Schwann cells were microinjected into 10-mm long acellular nerve grafts repairing a surgically created gap in the rat sciatic nerve. According to the different grafted methods, the animals were randomly divided into three groups： autografts （n=8）, acellular nerve grafts （n=8）, or acellular nerve grafts with Schwann cells （n=8）. ③ The regenerated nerve fiber number and average diameter of myeline sheath after culture were statistically anlayzed. MAIN OUTCOME MEASURES： ① The regenerated nerve ultrastructure, total number and density of myelinated nerve fibers, and the thickness of myeline sheath were observed under electron microscope. ② The images were processed with the Mias-1000 imaging analytical system to calculate the number of myelinated nerve fibers, and the thickness of myeline sheath. RESULTS： All the 24 Wistar rats were involved in the analysis of results. ① Results observed under transmission electron microscope： The regenerated myelinated nerve fibers in the group of acellular nerve grafts with Schwann cells were more even than those in the group of acellular nerve grafts, the number of myelinated nerve fibers and thickness of myelin sheath were close to those in the allografts group （P 〉 0.05）, but significantly different from those in the group of acellular nerve grafts （P 〈 0.05）. ② Results observed under scanning electron microscope： A great amount of Schwann cells with two polars were observed in the group of grafts with Schwann cells, the feature of cultured Schwann cells showed shoulder by shoulder, head to head. ③ The number of myelinated nerve fibers and thickness of myelin sheath analyzed by Mias-1000 imaging system in the group of acellular nerve grafts with Schwann cells were close to those in the autografts group （P 〉 0.05）, but significantly different from those in the group of acellular nerve grafts （P 〈 0.05）.CONCLUSION： Host axonal regeneration is significantly increased after implant of acellular nerve grafts. Acellular nerve grafts with Schwann cells offers a novel approach for repairing the gap of nerve defect.展开更多
OBJECTIVE： Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect ...OBJECTIVE： Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians. DATA SOURCES ： Using the terms ＂nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation＂ in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting ＂ peripheral nerve defect, nerve repair, nerve regeneration and nerve graft＂ in Chinese. STUDY SELECTION ： The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria： nerve conduits related animal experiments and clinical studies. Exclusive criteria： review or repetitive studies. DATA EXTRACTION： Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited. DATA SYNTHESIS ： Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials. CONCLUSION： There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.展开更多
<strong>Rationale:</strong> The three-dimensional (3D) computer-made titanium mesh is widely used in the skull repair for those patients receiving decompression of the bone flap. It can restore normal anat...<strong>Rationale:</strong> The three-dimensional (3D) computer-made titanium mesh is widely used in the skull repair for those patients receiving decompression of the bone flap. It can restore normal anatomy to a greater extent and make a better appearance. <strong>Case Presentation: </strong>We reported two cases of patients admitted to our hospital who have experienced high scalp tension after skull repair. At first, these two patients underwent decompression of the bone flap, and the physical examination results showed a defect of skull. No neurological symptoms and signs were found. The 3D computed tomography (CT) reconstruction of skull was performed, and then the skull repair with 3D titanium mesh was conducted. But because of high scalp tension, they underwent a second operation, during which we re-trimmed and reduce the arc of the titanium mesh. The scalp incision of both patients healed well and no titanium mesh was exposed. Both patients have a good prognosis. <strong>Lessons:</strong> We highlight that the high tension of scalp due to overstretching after 3D titanium mesh repair for skull defect should be paid much attention to. Trimming and reducing the arc of titanium mesh is an effective treatment for this situation.展开更多
Objective: Severe craniomaxillofacial injuries and craniomaxillofacial tumors can lead to craniomaxillofacial bone defects and deformities. Seriously affect the patients’ appearance and quality of life. So one-stage ...Objective: Severe craniomaxillofacial injuries and craniomaxillofacial tumors can lead to craniomaxillofacial bone defects and deformities. Seriously affect the patients’ appearance and quality of life. So one-stage repair and reconstruction of craniomaxillofacial bone defects is of great significance. The current study summarizes the clinical experience of one-stage repair and reconstruction of craniomaxillofacial bone defects. Material and Methods: Data in one-stage repair and reconstruction of?craniomaxillofacial bone defects performed on 13 patients were retrospectively analyzed out of 34 patients with?craniomaxillofacial injuries or tumors who received treatment at the outpatient department between January 2002 and March 2011. Surgical indications and approaches were explored after two typical cases were detected. Results: One-stage repair and reconstruction of bone defects was suitable for patients with craniomaxillofacial injuries and excised craniomaxillofacial benign tumors. Adjacent autogenous bones and artificial materials (such as titanium plates, titanium mesh, and so on) work well for the repair of the craniomaxillofacial bone frame and restoration of facial features. Conclusions: Surgical indications should be strictly selected in one-stage repair and reconstruction of craniomaxillofacial bone defects and deformities. Furthermore, the adoption of autogenous bones and artificial materials is a good choice in restoring the craniofacial features.展开更多
Background We previously showed that nano-hydroxyapatite/carboxymethyl chitosan （n-Ha/CMCS） displayed excellent mechanical properties, good degradation rates and exceptional biocompatibility, with negligible toxicit...Background We previously showed that nano-hydroxyapatite/carboxymethyl chitosan （n-Ha/CMCS） displayed excellent mechanical properties, good degradation rates and exceptional biocompatibility, with negligible toxicity. The aim of this study was to determine the effect of the same composite with vascular endothelial growth factor （VEGF）transfected bone marrow stromal cells （BMSCs） in a rabbit radial defect model.展开更多
Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our...Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our technique in which central zone of mesh is fixed only after closure of hernial defect. Patients and Methods: This study included 27 males patients (14 indirect inguinal hernias, 9 direct inguinal hernias, 4 both direct and indirect inguinal hernias on the same side). These cases are undergoing tension-free mesh repair after closure of hernial defect, and the mesh is fixed only at its central zone using Gulbran 2, between April 2011 and March 2013. The follow-up period ranged from 6 to 30 months. The intra and postoperative complications were recorded. Results: Mean hospital stay was 1 day. The age of this group of patients ranged from 23 to 63 years (mean, 47 years). The operative time ranged from 30 to 100 minutes (mean, 45 minutes). The intraoperative complications were in form of mild bleeding in 7 patients (25.9%) during hernial sac dissection. Postoperative complications were mild inguinal pain in 4 patients (14.8%) for three weeks. Mild hydrocele in 3 patients (11%) was recorded. No recurrence or bulging at hernia site was noticed during the period of follow-up. Conclusion: Laparoscopic inguinal hernia repair with central mesh fixation after closure of hernial defect is effective, easy and free of complications.展开更多
Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith m...Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith mandibular defects which were repaired with rib compos-展开更多
文摘The effects of large piece xenogeneic bone which was separated from healthy pigs as a scaffold on repair of mandibular defect was investigated and the applicability of antigen-extracted xenogeneic cancellous bone (AXCB) soaked with rhBMP-2 in bone defect repair was assessed. Mandibular defects were created in 48 New Zealand Rabbits, and then randomly divided into 4 groups, which was grafted in the mandibular defects with AXCB, AXCB soaked with rhBMP-2, autograft bone, or blank. Equal number of animals from each group was classified into three time points (4, 8, and 12 weeks) after operation for gross pathological observation, hematoxylin and eosin (H & E) staining, radiographic examination, and bone density measurement. H & E staining revealed that the area percentage of bone regeneration in the group of AXCB/rhBMP-2 graft was 27.72 ± 4.68, 53.90 ± 21.92, and 77.35 ± 9.83 when at 4, 8, and 12 weeks, which was better than that of auto bone graft, prompting that the group of AXCB/rhBMP-2 graft had commendable osteogenic effect. And comparing with the AXCB without rhBMP-2, of which the area percentage of bone regeneration was only 14.03 ± 5.02, 28.49 ± 11.35, and 53.90 ± 21.92, the osteogenic effect of AXCB/rhBMP-2 graft was demonstrated to be much better. In the group of AXCB/rhBMP-2 graft, the area percentage of bone regeneration increased, and the implanted materials were gradually degraded and replaced by autogenous bone regeneration over time. We concluded that antigen-extracted xenogeneic cancellous bone (AXCB) graft soaked with rhBMP-2 had shown excellent osteogenic effect in repair of bone defects, with good biocompability.
基金National Natural Science Foundation of China,No.U20A20403This study was conducted in accordance with the Animal Ethics Committee of the Institute of Antler Science and Product Technology,Changchun Sci-Tech University(AEC No:CKARI202309).
文摘BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government(NRF-2021K1A3A1A57086407,NRF-2021R1A2C2008821,NRF-2022R1I1A1A01071991)Arun Kumar Rajendran was supported by the National Research Foundation of Korea(NRF)grant Brain Pool program funded by the Ministry of Science and ICT through the National Research Foundation of Korea(2020H1D3A1A04081286)The Institute of Engineering Research at Seoul National University provided research facilities,and additional support came from the SNU Engineering-Medicine Collaboration grant.
文摘Osteochondral tissue is a highly specialized and complex tissue composed of articular cartilage and subchondral bone that are separated by a calcified cartilage interface.Multilayered or gradient scaffolds,often in conjunction with stem cells and growth factors,have been developed to mimic the respective layers for osteochondral defect repair.In this study,we designed a hyaline cartilage-hypertrophic cartilage bilayer graft(RGD/RGDW)with chondrocytes.Previously,we demonstrated that RGD peptide-modified chondroitin sulfate cryogel(RGD group)is chondro-conductive and capable of hyaline cartilage formation.Here,we incorporated whitlockite(WH),a Mg^(2+)-containing calcium phosphate,into RGD cryogel(RGDW group)to induce chondrocyte hypertrophy and form collagen X-rich hypertrophic cartilage.This is the first study to use WH to produce hypertrophic cartilage.Chondrocytes-laden RGDW cryogel exhibited significantly upregulated expression of hypertrophy markers in vitro and formed ectopic hypertrophic cartilage in vivo,which mineralized into calcified cartilage in bone microenvironment.Subsequently,RGD cryogel and RGDW cryogel were combined into bilayer(RGD/RGDW group)and implanted into rabbit osteochondral defect,where RGD layer supports hyaline cartilage regeneration and bioceramic-containing RGDW layer promotes calcified cartilage formation.While the RGD group(monolayer)formed hyaline-like neotissue that extends into the subchondral bone,the RGD/RGDW group(bilayer)regenerated hyaline cartilage tissue confined to its respective layer and promoted osseointegration for integrative defect repair.
基金supported by grants from the National Natural Science Foundation of China(grant nos.22074057,21775059 and 21305056)
文摘The reconstruction of critical-size calvarial defects remains a fundamental challenge.Recombinant collagen has gained significant attention in bone tissue engineering owing to its remarkable bioactivity and non-immunogenicity.Herein,we have for the first time developed a bioactive poly(ethylene glycol)-chondroitin sulfate-triple helical recombinant collagen(PEG-ChS-THRC)hydrogel for enhanced bone regeneration in cranial defects.A simple and mild crosslinking reaction of two-arm polyethylene glycol active ester(NHS-PEG-NHS),adipic dihydrazide modified chondroitin sulfate(ChS-ADH)and triple helical recombinant collagen(THRC)leads to the formation of the PEG-ChS-THRC hydrogel.The hydrogel demonstrates interconnected porous structures,enhanced mechanical strength,diminished swelling ratios and adjustable biodegradability.It possesses exceptional biocompatibility and bioactivity,significantly facilitating cell proliferation,adhesion,migration,and osteogenic differentiation of BMSCs.Micro-computed tomography(micro-CT),magnetic resonance imaging(MRI)and histological characterization of rat models with critical-size cranial defects have consistently demonstrated that the PEG-ChS-THRC hydrogel significantly promotes bone tissues regeneration.The innovative bioactive scaffold provides a remarkably improved remedy for critical-size cranial defects,holding greatly promising applications in the fields of bone tissue regeneration.
文摘Biodegradable metals are promising candidates for bone defect repair.With an evidence-based approach,this study investigated and analyzed the performance and degradation properties of biodegradable metals in animal models for bone defect repair to explore their potential clinical translation.Animal studies on bone defect repair with biodegradable metals in comparison with other traditional biomaterials were reviewed.Data was carefully collected after identification of population,intervention,comparison,outcome,and study design(PICOS),and following the inclusion criteria of biodegradable metals in animal studies.30 publications on pure Mg,Mg alloys,pure Zn and Zn alloys were finally included after extraction from a collected database of 2543 publications.A qualitative systematic review and a quantitative meta-analysis were performed.Given the heterogeneity in animal model,anatomical site and critical size defect(CSD),biodegradable metals exhibited mixed effects on bone defect repair and degradation in animal studies in comparison with traditional non-degradable metals,biodegradable polymers,bioceramics,and autogenous bone grafts.The results indicated that there were limitations in the experimental design of the included studies,and quality of the evidence presented by the studies was very low.To enhance clinical translation of biodegradable metals,evidence-based research with data validity is needed.Future studies should adopt standardized experimental protocols in investigating the effects of biodegradable metals on bone defect repair with animal models.
基金This work was financially supported by the National Natural Science Foundation of China(Nos.51871073,51871072,51771063,61604086,and U1637201)China Postdoctoral Science Foundation(Nos.2016M590280 and 2017T100240)+1 种基金Heilongjiang Postdoctoral Foundation(No.LBH-Z16075)the Fundamental Research Funds for the Central Universities(Nos.HIT.NSRIF.20161 and HIT.MKSTISP.201615).
文摘Graphene has excellent theoretical properties and a wide range of applications in metal-based composites. However, because of defects on the graphene surface, the actual performance of the material is far below theoretical expectations. In addition, graphene containing defects could easily react with a matrix alloy, such as Al, to generate brittle and hydrolyzed phases that could further reduce the performance of the resulting composite. Therefore, defect repair is an important area of graphene research. The repair methods reported in the present paper include chemical vapor deposition, doping, liquid-phase repair, external energy graphitization, and alloying. Detailed analyses and comparisons of these methods are carried out, and the characterization methods of graphene are introduced. The mechanism, research value, and future outlook of graphene repair are also discussed at length. Graphene defect repair mainly relies on the spontaneous movement of C atoms or heteroatoms to the pore defects under the condition of applied energy. The repair degree and mechanism of graphene repair are also different according to different preparations. The current research on graphene defect repair is still in its infancy, and it is believed that the problem of defect evolution will be explained in more depth in the future.
基金financially supported by the National Key Research and Development Program of China(2017YFC1103900)the National Natural Science Foundation of China(81871502,81701843,and 81671837)+3 种基金the Shanghai Excellent Technical Leader(18XD1421500)the Program of Shanghai Academic/Technology Research Leader(19XD1431100)the Shanghai Collaborative Innovation Program on Regenerative Medicine and Stem Cell Research(2019CXJQ01)the Clinical Research Plan of SHDC(No.SHDC2020CR2045B).
文摘Physiological repair of large-sized bone defects is great challenging in clinic due to a lack of ideal grafts suitable for bone regeneration.Decalcified bone matrix(DBM)is considered as an ideal bone regeneration scaffold,but low cell seeding efficiency and a poor osteoinductive microenvironment greatly restrict its application in large-sized bone regeneration.To address these problems,we proposed a novel strategy of bone regeneration units(BRUs)based on microgels produced by photo-crosslinkable and microfluidic techniques,containing both the osteogenic ingredient DBM and vascular endothelial growth factor(VEGF)for accurate biomimic of an osteoinductive microenvironment.The physicochemical properties of microgels could be precisely controlled and the microgels effectively promoted adhesion,proliferation,and osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)in vitro.BRUs were successfully constructed by seeding BMSCs onto microgels,which achieved reliable bone regeneration in vivo.Finally,by integrating the advantages of BRUs in bone regeneration and the advantages of DBM scaffolds in 3D morphology and mechanical strength,a BRU-loaded DBM framework successfully regenerated bone tissue with the desired 3D morphology and effectively repaired a large-sized bone defect of rabbit tibia.The current study developed an ideal bone biomimetic microcarrier and provided a novel strategy for bone regeneration and large-sized bone defect repair.
基金supported by grants from the National Natural Science Foundation of China(No.82170997)the Project of Chengdu Science and Technology Bureau(No.2021-YF05-02054-SN)the Research Funding from West China School/Hospital of Stomatology Sichuan University,China(No.RCDWJS2020-6).
文摘Bone defects caused by diseases or surgery are a common clinical problem.Researchers are devoted to finding biological mechanisms that accelerate bone defect repair,which is a complex and continuous process controlled by many factors.As members of transcriptional costimulatory molecules,Yes-associated protein(YAP)and transcriptional co-activator with PDZ-binding motif(TAZ)play an important regulatory role in osteogenesis,and they affect cell function by regulating the expression of osteogenic genes in osteogenesis-related cells.Macrophages are an important group of cells whose function is regulated by YAP/TAZ.Currently,the relationship between YAP/TAZ and macrophage polarization has attracted increasing attention.In bone tissue,YAP/TAZ can realize diverse osteogenic regulation by mediating macrophage polarization.Macrophages polarize into M1 and M2 phenotypes under different stimuli.M1 macrophages dominate the inflammatory response by releasing a number of inflammatory mediators in the early phase of bone defect repair,while massive aggregation of M2 macrophages is beneficial for inflammation resolution and tissue repair,as they secrete many anti-inflammatory and osteogenesis-related cytokines.The mechanism of YAP/TAZ-mediated macrophage polarization during osteogenesis warrants further study and it is likely to be a promising strategy for bone defect repair.In this article,we review the effect of Hippo-YAP/TAZ signaling and macrophage polarization on bone defect repair,and highlight the regulation of macrophage polarization by YAP/TAZ.
基金supported by Tsinghua University-Peking Union Medical College Hospital Initiative Scientific Research Program(20191080871)the National Natural Science Foundation of China(82272464,82002314).
文摘Long-term nonunion of bone defects has always been a major problem in orthopedic treatment.Artificial bone graft materials such as Poly(lactic-co-glycolic acid)/β-tricalcium phosphate(PLGA/β-TCP)scaffolds are expected to solve this problem due to their suitable degradation rate and good osteoconductivity.However,insufficient mechanical properties,lack of osteoinductivity and infections after implanted limit its large-scale clinical application.Hence,we proposed a novel bone repair bioscaffold by adding zinc submicron particles to PLGA/β-TCP using low temperature rapid prototyping 3D printing technology.We first screened the scaffolds with 1 wt%Zn that had good biocompatibility and could stably release a safe dose of zinc ions within 16 weeks to ensure long-term non-toxicity.As designed,the scaffold had a multi-level porous structure of biomimetic cancellous bone,and the Young’s modulus(63.41±1.89 MPa)and compressive strength(2.887±0.025 MPa)of the scaffold were close to those of cancellous bone.In addition,after a series of in vitro and in vivo experiments,the scaffolds proved to have no adverse effects on the viability of BMSCs and promoted their adhesion and osteogenic differentiation,as well as exhibiting higher osteogenic and anti-inflammatory properties than PLGA/β-TCP scaffold without zinc particles.We also found that this osteogenic and anti-inflammatory effect might be related to Wnt/β-catenin,P38 MAPK and NFkB pathways.This study lay a foundation for the follow-up study of bone regeneration mechanism of Zn-containing biomaterials.We envision that this scaffold may become a new strategy for clinical treatment of bone defects.
文摘Objective: to analyze the application effect and clinical improvement of personalized free anterolateral femoral flap in the repair of oral and maxillofacial soft tissue defects. Methods: the initial time of this study was January 2020 and the deadline was December 2021. A total of 30 patients with oral and maxillofacial soft tissue injury were selected as the research objects. Randomly divided into two groups, 15 cases were treated with personalized free anterolateral femoral flap as the observation group, and the remaining 15 cases were treated with forearm flap repair as the control group. Results: the rates of pruritus, scar hyperplasia, numbness in the skin graft area, pigmentation, necrosis in the donor area, paresthesia in the skin graft area, temporary dysfunction and permanent dysfunction in the observation group were lower than those in the control group (P < 0.05);The recovery of language function in the observation group accounted for 86.67%, which was significantly better than 66.67% in the control group (P < 0.05);The grade I recovery of swallowing function in the observation group accounted for 20%, which was significantly better than 6.67% in the control group (P < 0.05). Conclusion: in the clinical application of oral and maxillofacial soft tissue defect repair, the postoperative recovery effect of patients is better, reducing the impact of surgical operation on the patient, and the recovery effect of language and swallowing function is more ideal, which is worth promotion and application.
基金Project supported by the Program of Excellent Team in Harbin Institute of Technology, ChinaProject(2006BAF04B09) supported by the National Key Technology Research and Development Program of China
文摘The groove defect formed in the friction stir welding dramatically deteriorates weld appearances and mechanical properties of the joints owing to its larger size and penetration. Therefore, the friction stir repair welding was utilized to remove such a groove defect, and the focus was placed on the mechanical properties and microstructural characteristics of the repair joints so as to obtain an optimum repair welding process. The experimental results indicate that the groove defect can be removed by friction stir repair welding, and the offset repair welding process is superior to the symmetrical repair welding process. In the symmetrical repair welding process, a large number of fine cavity defects and an obvious aggregation of hard-brittle phase Al2Cu occur, accordingly the mechanical properties of the repair joint are weakened, and the fracture feature of repair joint is partially brittle and partially plastic. A good-quality repair joint can be obtained by the offset repair welding process, and the repair joint is fractured near the interface between the weld nugget zone and thermal-mechanically affected zone.
基金supported by grants from Research Fund of Lanzhou Military Area Command of Chinese PLA,No.CLZ12JA07Gansu Provincial Science and Technology Program,No.1208RJZA108
文摘Pretreatment of nerve allografts by exposure to irradiation or green tea polyphenols can elimi- nate neuroimmunogenicity, inhibit early immunological rejection, encourage nerve regeneration and functional recovery, improve tissue preservation, and minimize postoperative infection. In the present study, we investigate which intervention achieves better results. We produced a 1.0 cm sciatic nerve defect in rats, and divided the rats into four treatment groups： autograft, fresh nerve allograft, green tea polyphenol-pretreated （1 mg/mL, 4~C） nerve allograft, and irradiation-pre- treated nerve allograft （26.39 Gy/min for 12 hours; total 19 kGy）. The animals were observed, and sciatic nerve electrophysiology, histology, and transmission electron microscopy were carried out at 6 and 12 weeks after grafting. The circumference and structure of the transplanted nerve in rats that received autografts or green tea polyphenol-pretreated nerve allografts were similar to those of the host sciatic nerve. Compared with the groups that received fresh or irradiation-pre- treated nerve allografts, motor nerve conduction velocity in the autograft and fresh nerve allograft groups was greater, more neurites grew into the aUografts, Schwann cell proliferation was evident, and a large number of new blood vessels was observed; in addition, massive myelinated nerve fibers formed, and abundant microfilaments and microtubules were present in the axoplasm. Our findings indicate that nerve allografts pretreated by green tea polyphenols are equivalent to trans- planting autologous nerves in the repair of sciatic nerve defects, and promote nerve regeneration. Pretreatment using green tea polyphenols is better than pretreatment with irradiation.
基金the National Natural Science Foundation of China, No. 30070775 a grant from the Scientific Research Foundation of Liaoning Department of Education, No. 2005L5371
文摘BACKGROUND： Animal experiments and clinical studies about tissue engineering method applied to repair nerve injury mainly focus on seeking ideal artificial nerve grafts, nerve conduit and seed cells. Autologous nerve, allogeneic nerve and xenogeneic nerve are used to bridge nerve defects, it is one of the methods to promote the repair of nerve injury by culturing and growing Schwann cells, which can secrete various neurotrophic factor activities, in the grafts. OBJECTIVE ： To observe the effect of acellular nerve grafts co-cultured with Schwann cells in repairing defects of sciatic nerve. DESIGN： An observational comparative study.SETTING： Tissue Engineering Laboratory of China Medical University.MATERIALS： The experiment was carried out in the Tissue Engineering Laboratory of China Medical University between April 2004 and April 2005. Forty neonatal Sprague-Dawley rats of 5-8 days （either males or females） and 24 male Wistar rats of 180-220 g were provided by the experimental animal center of China Medical University. METHODS： ① Culture of Schwann cells： The bilateral sciatic nerves and branchial plexus were isolated from the 40 neonatal SD rats. The sciatic nerves were enzymatically digested with collagenase and dispase, isolatd, purified and cultured with the method of speed-difference adhersion, and identified with the SABC immunohistochemical method. ② Model establishment： In vitro Schwann cells were microinjected into 10-mm long acellular nerve grafts repairing a surgically created gap in the rat sciatic nerve. According to the different grafted methods, the animals were randomly divided into three groups： autografts （n=8）, acellular nerve grafts （n=8）, or acellular nerve grafts with Schwann cells （n=8）. ③ The regenerated nerve fiber number and average diameter of myeline sheath after culture were statistically anlayzed. MAIN OUTCOME MEASURES： ① The regenerated nerve ultrastructure, total number and density of myelinated nerve fibers, and the thickness of myeline sheath were observed under electron microscope. ② The images were processed with the Mias-1000 imaging analytical system to calculate the number of myelinated nerve fibers, and the thickness of myeline sheath. RESULTS： All the 24 Wistar rats were involved in the analysis of results. ① Results observed under transmission electron microscope： The regenerated myelinated nerve fibers in the group of acellular nerve grafts with Schwann cells were more even than those in the group of acellular nerve grafts, the number of myelinated nerve fibers and thickness of myelin sheath were close to those in the allografts group （P 〉 0.05）, but significantly different from those in the group of acellular nerve grafts （P 〈 0.05）. ② Results observed under scanning electron microscope： A great amount of Schwann cells with two polars were observed in the group of grafts with Schwann cells, the feature of cultured Schwann cells showed shoulder by shoulder, head to head. ③ The number of myelinated nerve fibers and thickness of myelin sheath analyzed by Mias-1000 imaging system in the group of acellular nerve grafts with Schwann cells were close to those in the autografts group （P 〉 0.05）, but significantly different from those in the group of acellular nerve grafts （P 〈 0.05）.CONCLUSION： Host axonal regeneration is significantly increased after implant of acellular nerve grafts. Acellular nerve grafts with Schwann cells offers a novel approach for repairing the gap of nerve defect.
文摘OBJECTIVE： Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians. DATA SOURCES ： Using the terms ＂nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation＂ in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting ＂ peripheral nerve defect, nerve repair, nerve regeneration and nerve graft＂ in Chinese. STUDY SELECTION ： The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria： nerve conduits related animal experiments and clinical studies. Exclusive criteria： review or repetitive studies. DATA EXTRACTION： Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited. DATA SYNTHESIS ： Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials. CONCLUSION： There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.
文摘<strong>Rationale:</strong> The three-dimensional (3D) computer-made titanium mesh is widely used in the skull repair for those patients receiving decompression of the bone flap. It can restore normal anatomy to a greater extent and make a better appearance. <strong>Case Presentation: </strong>We reported two cases of patients admitted to our hospital who have experienced high scalp tension after skull repair. At first, these two patients underwent decompression of the bone flap, and the physical examination results showed a defect of skull. No neurological symptoms and signs were found. The 3D computed tomography (CT) reconstruction of skull was performed, and then the skull repair with 3D titanium mesh was conducted. But because of high scalp tension, they underwent a second operation, during which we re-trimmed and reduce the arc of the titanium mesh. The scalp incision of both patients healed well and no titanium mesh was exposed. Both patients have a good prognosis. <strong>Lessons:</strong> We highlight that the high tension of scalp due to overstretching after 3D titanium mesh repair for skull defect should be paid much attention to. Trimming and reducing the arc of titanium mesh is an effective treatment for this situation.
文摘Objective: Severe craniomaxillofacial injuries and craniomaxillofacial tumors can lead to craniomaxillofacial bone defects and deformities. Seriously affect the patients’ appearance and quality of life. So one-stage repair and reconstruction of craniomaxillofacial bone defects is of great significance. The current study summarizes the clinical experience of one-stage repair and reconstruction of craniomaxillofacial bone defects. Material and Methods: Data in one-stage repair and reconstruction of?craniomaxillofacial bone defects performed on 13 patients were retrospectively analyzed out of 34 patients with?craniomaxillofacial injuries or tumors who received treatment at the outpatient department between January 2002 and March 2011. Surgical indications and approaches were explored after two typical cases were detected. Results: One-stage repair and reconstruction of bone defects was suitable for patients with craniomaxillofacial injuries and excised craniomaxillofacial benign tumors. Adjacent autogenous bones and artificial materials (such as titanium plates, titanium mesh, and so on) work well for the repair of the craniomaxillofacial bone frame and restoration of facial features. Conclusions: Surgical indications should be strictly selected in one-stage repair and reconstruction of craniomaxillofacial bone defects and deformities. Furthermore, the adoption of autogenous bones and artificial materials is a good choice in restoring the craniofacial features.
文摘Background We previously showed that nano-hydroxyapatite/carboxymethyl chitosan （n-Ha/CMCS） displayed excellent mechanical properties, good degradation rates and exceptional biocompatibility, with negligible toxicity. The aim of this study was to determine the effect of the same composite with vascular endothelial growth factor （VEGF）transfected bone marrow stromal cells （BMSCs） in a rabbit radial defect model.
文摘Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our technique in which central zone of mesh is fixed only after closure of hernial defect. Patients and Methods: This study included 27 males patients (14 indirect inguinal hernias, 9 direct inguinal hernias, 4 both direct and indirect inguinal hernias on the same side). These cases are undergoing tension-free mesh repair after closure of hernial defect, and the mesh is fixed only at its central zone using Gulbran 2, between April 2011 and March 2013. The follow-up period ranged from 6 to 30 months. The intra and postoperative complications were recorded. Results: Mean hospital stay was 1 day. The age of this group of patients ranged from 23 to 63 years (mean, 47 years). The operative time ranged from 30 to 100 minutes (mean, 45 minutes). The intraoperative complications were in form of mild bleeding in 7 patients (25.9%) during hernial sac dissection. Postoperative complications were mild inguinal pain in 4 patients (14.8%) for three weeks. Mild hydrocele in 3 patients (11%) was recorded. No recurrence or bulging at hernia site was noticed during the period of follow-up. Conclusion: Laparoscopic inguinal hernia repair with central mesh fixation after closure of hernial defect is effective, easy and free of complications.
文摘Objective To study feasibility and value of repair of oral mandibular defects with rib composite flap pedicled with internal thoracic vessels in basic level hospitals. Methods The clinical materials in 13 cases uith mandibular defects which were repaired with rib compos-
