In ultraviolet cured-in-place-pipe(UV-CIPP)pipeline rehabilitation,resin performance critically determines repair effectiveness.Current UV-curable resins exhibit high volatile organic compound(VOC)emissions and inadeq...In ultraviolet cured-in-place-pipe(UV-CIPP)pipeline rehabilitation,resin performance critically determines repair effectiveness.Current UV-curable resins exhibit high volatile organic compound(VOC)emissions and inadequate post-cure toughness,which compromise fatigue resistance during service.To address these issues,we synthesized hydroxyl-terminated polyurethane acrylate prepolymers using diphenylmethane diisocyanate(MDI),polypropylene glycol(PPG),and hydroxyethyl methacrylate(HEMA).Fourier transform infrared spectroscopy(FTIR)confirmed successful prepolymer synthesis.We developed UV-curable resins by incorporating various crosslinking monomers and optimized the formulations through mechanical property analysis.Testing revealed that the polyurethane-acrylic UV-cured resin system combines polyurethane's mechanical excellence with acrylics'high UV-curing activity.The PPG200/MDI/HEMA formulation achieved superior performance,with a tensile strength of 55.31 MPa,an impact toughness of 22.7 kJ/m^(2),and a heat deflection temperature(HDT)of 132℃.The optimized system eliminates volatile components while maintaining high reactivity,addressing critical limitations in trenchless pipeline rehabilitation.The improved mechanical properties meet the operational demands of underground pipes,suggesting practical applicability in trenchless pipeline repair.展开更多
Spinal cord injury(SCI)is a debilitating ailment that leads to the loss of motor and sensory functions,often leaving the patient paralyzed below the injury site(Chen et al.,2013).Globally around 250,000-300,000 people...Spinal cord injury(SCI)is a debilitating ailment that leads to the loss of motor and sensory functions,often leaving the patient paralyzed below the injury site(Chen et al.,2013).Globally around 250,000-300,000 people are diagnosed with SCI annually(Singh et al.,2014),and while this number appears quite low,the effect that an SCI has on the patient’s quality of life is drastic,due to the current difficulties to comprehensively treat this illness.The cost of patient care can also be quite costly,amounting to an estimated$1.69 billion in healthcare costs in the USA alone(Mahabaleshwarkar and Khanna,2014).展开更多
Exogenous neural stem cell transplantation has become one of the most promising treatment methods for chronic stroke.Recent studies have shown that most ischemia-reperfusion model rats recover spontaneously after inju...Exogenous neural stem cell transplantation has become one of the most promising treatment methods for chronic stroke.Recent studies have shown that most ischemia-reperfusion model rats recover spontaneously after injury,which limits the ability to observe long-term behavioral recovery.Here,we used a severe stroke rat model with 150 minutes of ischemia,which produced severe behavioral deficiencies that persisted at 12 weeks,to study the therapeutic effect of neural stem cells on neural restoration in chronic stroke.Our study showed that stroke model rats treated with human neural stem cells had long-term sustained recovery of motor function,reduced infarction volume,long-term human neural stem cell survival,and improved local inflammatory environment and angiogenesis.We also demonstrated that transplanted human neural stem cells differentiated into mature neurons in vivo,formed stable functional synaptic connections with host neurons,and exhibited the electrophysiological properties of functional mature neurons,indicating that they replaced the damaged host neurons.The findings showed that human fetal-derived neural stem cells had long-term effects for neurological recovery in a model of severe stroke,which suggests that human neural stem cells-based therapy may be effective for repairing damaged neural circuits in stroke patients.展开更多
Mesenchymal stromal cell transplantation is an effective and promising approach for treating various systemic and diffuse diseases.However,the biological characteristics of transplanted mesenchymal stromal cells in hu...Mesenchymal stromal cell transplantation is an effective and promising approach for treating various systemic and diffuse diseases.However,the biological characteristics of transplanted mesenchymal stromal cells in humans remain unclear,including cell viability,distribution,migration,and fate.Conventional cell tracing methods cannot be used in the clinic.The use of superparamagnetic iron oxide nanoparticles as contrast agents allows for the observation of transplanted cells using magnetic resonance imaging.In 2016,the National Medical Products Administration of China approved a new superparamagnetic iron oxide nanoparticle,Ruicun,for use as a contrast agent in clinical trials.In the present study,an acute hemi-transection spinal cord injury model was established in beagle dogs.The injury was then treated by transplantation of Ruicun-labeled mesenchymal stromal cells.The results indicated that Ruicunlabeled mesenchymal stromal cells repaired damaged spinal cord fibers and partially restored neurological function in animals with acute spinal cord injury.T2*-weighted imaging revealed low signal areas on both sides of the injured spinal cord.The results of quantitative susceptibility mapping with ultrashort echo time sequences indicated that Ruicun-labeled mesenchymal stromal cells persisted stably within the injured spinal cord for over 4 weeks.These findings suggest that magnetic resonance imaging has the potential to effectively track the migration of Ruicun-labeled mesenchymal stromal cells and assess their ability to repair spinal cord injury.展开更多
BACKGROUND The surgical management of bile duct injuries(BDIs)after laparoscopic cholecystectomy(LC)is challenging and the optimal timing of surgery remains unclear.The primary aim of this study was to systematically ...BACKGROUND The surgical management of bile duct injuries(BDIs)after laparoscopic cholecystectomy(LC)is challenging and the optimal timing of surgery remains unclear.The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature.AIM To assess timing of surgical repair of BDI and postoperative complications.METHODS The MEDLINE,EMBASE,and The Cochrane Library databases were systematically screened up to August 2021.Risk of bias was assessed via the Newcastle Ottawa scale.The primary outcomes of this review included the timing of BDI repair and postoperative complications.RESULTS A total of 439 abstracts were screened,and 24 studies were included with 15609 patients included in this review.Of the 5229 BDIs reported,4934(94%)were classified as major injury.Timing of bile duct repair was immediate(14%,n=705),early(28%,n=1367),delayed(28%,n=1367),or late(26%,n=1286).Standardization of definition for timing of repair was remarkably poor among studies.Definitions for immediate repair ranged from<24 h to 6 wk after LC while early repair ranged from<24 h to 12 wk.Likewise,delayed(>24 h to>12 wk after LC)and late repair(>6 wk after LC)showed a broad overlap.CONCLUSION The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC.This finding indicates an urgent need for a standardized reporting system of BDI repair.展开更多
CD47 is a ubiquitous and pleiotropic cell-surface receptor.Disrupting CD47 enhances injury repair in various tissues but the role of CD47 has not been studied in bone injuries.In a murine closed-fracture model,CD47-nu...CD47 is a ubiquitous and pleiotropic cell-surface receptor.Disrupting CD47 enhances injury repair in various tissues but the role of CD47 has not been studied in bone injuries.In a murine closed-fracture model,CD47-null mice showed decreased callus bone formation as assessed by microcomputed tomography 10 days post-fracture and increased fibrous volume as determined by histology.To understand the cellular basis for this phenotype,mesenchymal progenitors(MSC)were harvested from bone marrow.CD47-null MSC showed decreased large fibroblast colony formation(CFU-F),significantly less proliferation,and fewer cells in Sphase,although osteoblast differentiation was unaffected.However,consistent with prior research,CD47-null endothelial cells showed increased proliferation relative to WT cells.Similarly,in a murine ischemic fracture model,CD47-null mice showed reduced fracture callus size due to a reduction in bone relative to WT 15 days-post fracture.Consistent with our in vitro results,in vivo EdU labeling showed decreased cell proliferation in the callus of CD47-null mice,while staining for CD31 and endomucin demonstrated increased endothelial cell density.Finally,WT mice with ischemic fracture that were administered a CD47 morpholino,which blocks CD47 protein production,showed a callus phenotype similar to that of ischemic fractures in CD47-null mice,suggesting the phenotype was not due to developmental changes in the knockout mice.Thus,inhibition of CD47 during bone healing reduces both non-ischemic and ischemic fracture healing,in part,by decreasing MSC proliferation.Furthermore,the increase in endothelial cell proliferation and early blood vessel density caused by CD47 disruption is not sufficient to overcome MSC dysfunction.展开更多
Repairing the endothelial barrier is essential for maintaining pulmonary fuid balance and regulating leukocyte infiltration during sepsis[1].Tissue kallikrein-related peptidases(KLKs)are secreted serine proteases invo...Repairing the endothelial barrier is essential for maintaining pulmonary fuid balance and regulating leukocyte infiltration during sepsis[1].Tissue kallikrein-related peptidases(KLKs)are secreted serine proteases involved in angiogenesis[2].However,their involvement in regulating endothelial regeneration remains largely unknown.展开更多
BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection(TBAD),significantly impacting long-term survival.Accurate ...BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection(TBAD),significantly impacting long-term survival.Accurate risk prediction is essential for optimized clinical management.AIM To develop and validate a logistic regression-based risk prediction model for aortic adverse remodeling following TEVAR in patients with TBAD.METHODS This retrospective observational cohort study analyzed 140 TBAD patients undergoing TEVAR at a tertiary center(2019–2024).Based on European guidelines,patients were categorized into adverse remodeling(aortic growth rate>2.9 mm/year,n=45)and favorable remodeling groups(n=95).Comprehensive variables(clinical/imaging/surgical)were analyzed using multivariable logistic regression to develop a predictive model.Model performance was assessed via receiver operating characteristic-area under the curve(AUC)and Hosmer-Lemeshow tests.RESULTS Multivariable analysis identified several strong independent predictors of negative aortic remodeling.Larger false lumen diameter at the primary entry tear[odds ratio(OR):1.561,95%CI:1.197–2.035;P=0.001]and patency of the false lumen(OR:5.639,95%CI:4.372-8.181;P=0.004)were significant risk factors.False lumen involvement extending to the thoracoabdominal aorta was identified as the strongest predictor,significantly increasing the risk of adverse remodeling(OR:11.751,95%CI:9.841-15.612;P=0.001).Conversely,false lumen involvement confined to the thoracic aorta demonstrated a significant protective effect(OR:0.925,95%CI:0.614–0.831;P=0.015).The prediction model exhibited excellent discrimination(AUC=0.968)and calibration(Hosmer-Lemeshow P=0.824).CONCLUSION This validated risk prediction model identifies aortic adverse remodeling with high accuracy using routinely available clinical parameters.False lumen involvement thoracoabdominal aorta is the strongest predictor(11.751-fold increased risk).The tool enables preoperative risk stratification to guide tailored TEVAR strategies and improve long-term outcomes.展开更多
BACKGROUND Descending thoracic aortic aneurysms are dangerous and have to be treated quickly.The primary treatment methods are thoracic endovascular aortic repair(TEVAR)and open surgical repair(OSR).The comparative ef...BACKGROUND Descending thoracic aortic aneurysms are dangerous and have to be treated quickly.The primary treatment methods are thoracic endovascular aortic repair(TEVAR)and open surgical repair(OSR).The comparative effectiveness and safety of TEVAR and OSR were evaluated in this meta-analysis,focusing on perioperative and long-term outcomes.AIM To compare and contrast the efficacy and safety of TEVAR vs OSR in the treatment of descending thoracic aortic aneurysms.This study aims to assess both perioperative and long-term outcomes through a systematic review and metaanalysis.METHODS A comprehensive search of PubMed,EMBASE,and Cochrane was conducted from inception to January 2025.Baseline characteristics and outcomes were evaluated.Odds ratios(OR)for dichotomous data and mean differences for continuous data with 95%confidence intervals(CI)were analyzed using random-effects models.RESULTS A meta-analysis of 21 studies involving 29465 patients(8261 TEVAR;21204 OR)showed TEVAR associated with lower operative mortality(OR=0.60,95%CI:0.42-0.85,P=0.004),shorter intensive care unit(-2.94 days,95%CI:-4.76 to-1.12,P=0.002)and hospital stays(-7.35 days,95%CI:-10.54 to-4.17,P<0.00001),and reduced rates of paraplegia(OR=0.44,95%CI:0.27-0.73,P=0.002),spinal ischemia(OR=0.30,95%CI:0.16-0.56,P=0.0002),renal failure(OR=0.29,95%CI:0.14-0.61,P=0.001),and wound infections(OR=0.28,95%CI:0.13-0.61,P=0.001).However,TEVAR had higher rates of vascular complications.No significant differences were noted in 1-year and 5-year mortality rates,the rate of non-elective surgery,neurological complications,or stroke rates.CONCLUSION Compared to EVAR,TEVAR revealed lower operative mortality and better perioperative outcomes across all indicators,including hospital and intensive care unit stays,as well as fewer complications,except for those related to vascular problems.Mortality results were also similar in the long run;consequently,more research is required concerning the long-term durability.展开更多
The global demand for effective skin injury treatments has prompted the exploration of tissue engineering solutions.While three-dimensional(3D)bioprinting has shown promise,challenges persist with respect to achieving...The global demand for effective skin injury treatments has prompted the exploration of tissue engineering solutions.While three-dimensional(3D)bioprinting has shown promise,challenges persist with respect to achieving timely and compatible solutions to treat diverse skin injuries.In situ bioprinting has emerged as a key new technology,since it reduces risks during the implantation of printed scaffolds and demonstrates superior therapeutic effects.However,maintaining printing fidelity during in situ bioprinting remains a critical challenge,particularly with respect to model layering and path planning.This study proposes a novel optimization-based conformal path planning strategy for in situ bioprinting-based repair of complex skin injuries.This strategy employs constrained optimization to identify optimal waypoints on a point cloud-approximated curved surface,thereby ensuring a high degree of similarity between predesigned planar and surface-mapped 3D paths.Furthermore,this method is applicable for skin wound treatments,since it generates 3D-equidistant zigzag curves along surface tangents and enables multi-layer conformal path planning to facilitate the treatment of volumetric injuries.Furthermore,the proposed algorithm was found to be a feasible and effective treatment in a murine back injury model as well as in other complex models,thereby showcasing its potential to guide in situ bioprinting,enhance bioprinting fidelity,and facilitate improvement of clinical outcomes.展开更多
The exchange of information and materials between organelles plays a crucial role in regulating cellular physiological functions and metabolic levels.Mitochondria-associated endoplasmic reticulum membranes serve as ph...The exchange of information and materials between organelles plays a crucial role in regulating cellular physiological functions and metabolic levels.Mitochondria-associated endoplasmic reticulum membranes serve as physical contact channels between the endoplasmic reticulum membrane and the mitochondrial outer membrane,formed by various proteins and protein complexes.This microstructural domain mediates several specialized functions,including calcium(Ca^(2+))signaling,autophagy,mitochondrial morphology,oxidative stress response,and apoptosis.Notably,the dysregulation of Ca^(2+)signaling mediated by mitochondria-associated endoplasmic reticulum membranes is a critical factor in the pathogenesis of neurological diseases.Certain proteins or protein complexes within these membranes directly or indirectly regulate the distance between the endoplasmic reticulum and mitochondria,as well as the transduction of Ca^(2+)signaling.Conversely,Ca^(2+)signaling mediated by mitochondria-associated endoplasmic reticulum membranes influences other mitochondria-associated endoplasmic reticulum membraneassociated functions.These functions can vary significantly across different neurological diseases—such as ischemic stroke,traumatic brain injury,Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,and Huntington's disease—and their respective stages of progression.Targeted modulation of these disease-related pathways and functional proteins can enhance neurological function and promote the regeneration and repair of damaged neurons.Therefore,mitochondria-associated endoplasmic reticulum membranes-mediated Ca^(2+)signaling plays a pivotal role in the pathological progression of neurological diseases and represents a significant potential therapeutic target.This review focuses on the effects of protein complexes in mitochondria-associated endoplasmic reticulum membranes and the distinct roles of mitochondria-associated endoplasmic reticulum membranes-mediated Ca^(2+)signaling in neurological diseases,specifically highlighting the early protective effects and neuronal damage that can result from prolonged mitochondrial Ca^(2+)overload or deficiency.This article provides a comprehensive analysis of the various mechanisms of Ca^(2+)signaling mediated by mitochondria-associated endoplasmic reticulum membranes in neurological diseases,contributing to the exploration of potential therapeutic targets for promoting neuroprotection and nerve repair.展开更多
Successful polyethylene glycol fusion(PEG-fusion)of severed axons following peripheral nerve injuries for PEG-fused axons has been reported to:(1)rapidly restore electrophysiological continuity;(2)prevent distal Walle...Successful polyethylene glycol fusion(PEG-fusion)of severed axons following peripheral nerve injuries for PEG-fused axons has been reported to:(1)rapidly restore electrophysiological continuity;(2)prevent distal Wallerian Degeneration and maintain their myelin sheaths;(3)promote primarily motor,voluntary behavioral recoveries as assessed by the Sciatic Functional Index;and,(4)rapidly produce correct and incorrect connections in many possible combinations that produce rapid and extensive recovery of functional peripheral nervous system/central nervous system connections and reflex(e.g.,toe twitch)or voluntary behaviors.The preceding companion paper describes sensory terminal field reo rganization following PEG-fusion repair of sciatic nerve transections or ablations;howeve r,sensory behavioral recovery has not been explicitly explored following PEG-fusion repair.In the current study,we confirmed the success of PEG-fusion surgeries according to criteria(1-3)above and more extensively investigated whether PEG-fusion enhanced mechanical nociceptive recovery following sciatic transection in male and female outbred Sprague-Dawley and inbred Lewis rats.Mechanical nociceptive responses were assessed by measuring withdrawal thresholds using von Frey filaments on the dorsal and midplantar regions of the hindpaws.Dorsal von Frey filament tests were a more reliable method than plantar von Frey filament tests to assess mechanical nociceptive sensitivity following sciatic nerve transections.Baseline withdrawal thresholds of the sciatic-mediated lateral dorsal region differed significantly across strain but not sex.Withdrawal thresholds did not change significantly from baseline in chronic Unoperated and Sham-operated rats.Following sciatic transection,all rats exhibited severe hyposensitivity to stimuli at the lateral dorsal region of the hindpaw ipsilateral to the injury.However,PEG-fused rats exhibited significantly earlier return to baseline withdrawal thresholds than Negative Control rats.Furthermore,PEG-fused rats with significantly improved Sciatic Functional Index scores at or after 4 weeks postoperatively exhibited yet-earlier von Frey filament recove ry compared with those without Sciatic Functional Index recovery,suggesting a correlation between successful PEG-fusion and both motor-dominant and sensory-dominant behavioral recoveries.This correlation was independent of the sex or strain of the rat.Furthermore,our data showed that the acceleration of von Frey filament sensory recovery to baseline was solely due to the PEG-fused sciatic nerve and not saphenous nerve collateral outgrowths.No chronic hypersensitivity developed in any rat up to 12 weeks.All these data suggest that PEG-fusion repair of transection peripheral nerve injuries co uld have important clinical benefits.展开更多
BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time ...BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.展开更多
The plasma membrane(PM)plays an essential role in maintaining cell homeostasis,therefore,timely and effective repair of damage caused by factors such as mechanical rupture,pore-forming toxins,or pore-forming proteins ...The plasma membrane(PM)plays an essential role in maintaining cell homeostasis,therefore,timely and effective repair of damage caused by factors such as mechanical rupture,pore-forming toxins,or pore-forming proteins is crucial for cell survival.PM damage induces membrane rupture and stimulates an immune response.However,damage resulting from regulated cell death processes,including pyroptosis,ferroptosis,and necroptosis,cannot be repaired by simple sealing mechanisms and thus,requires specialized repair machinery.Recent research has identified a PM repair mechanism of regulated cell death-related injury,mediated by the endosomal sorting complexes required for transport(ESCRT)machinery.Here,we review recent progress in elucidating the ESCRT machinery-mediated repair mechanism of PM injury,with particular focus on processes related to regulated cell death.This overview,along with continued research in this field,may provide novel insights into therapeutic targets for diseases associated with dysregulation of regulated cell death pathways.展开更多
Four types of Mg-5Zn porous scaffolds with different pore geometries,including body-centered cubic(bcc),the rhombic dodecahedron(RD),gyroid(G),and primitive(P)types,were designed and fabricated using selective laser m...Four types of Mg-5Zn porous scaffolds with different pore geometries,including body-centered cubic(bcc),the rhombic dodecahedron(RD),gyroid(G),and primitive(P)types,were designed and fabricated using selective laser melting.Their forming quality,compression mechanical properties,and degradation behavior were investigated.Results indicate that the fabricated scaffolds exhibit good dimensional accuracy,and the surface chemical polishing treatment significantly improves the forming quality and reduces porosity error in porous scaffolds.Compared to the ones with rod structures(bcc,RD),the scaffolds with surface structures(G,P)have less powder particle adhesion.The G porous scaffold exhibits the best forming quality for the same design porosity.The predominant failure mode of scaffolds during compression is a 45°shear fracture.At a porosity of 75%,the compression property of all scaffolds meets the compressive property requirements of cancellous bone,while bcc and G structures show relatively better compression property.After immersion in Hank's solution for 168 h,the B-2-75% pore structure scaffold exhibits severe localized corrosion,with fractures in partial pillar connections.In contrast,the G-3-75% pore structure scaffold mainly undergoes uniform corrosion,maintaining structural integrity,and its corrosion rate and loss of compressive properties are less than those of the B-2-75%structure.After comparison,the G-pore structure scaffold is preferred.展开更多
BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since th...BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since the coronavirus disease 2019 pandemic,digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.AIM To determine if digitally assisted rehabilitation could be as practical,or even more effective,than the traditional methods most patients currently follow.METHODS Six electronic databases,including PubMed,Scopus,Cochrane Library,Google Scholar,EMBASE,and Web of Science,were searched to find articles that compare digital-based rehabilitation and conventional treatment.Outcomes of interest were Disabilities of the Arm,Shoulder and Hand(DASH)score and range of motion.The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.RESULTS Three randomized controlled trial studies were enrolled in this study,including 195 cases.We did not find any significant differences between the two groups in terms of DASH score,flexion range of motion,and external rotation range of motion.There was a significant difference between the two groups for abduction range of motion.CONCLUSION Digital home-based rehab seems to be a strong alternative to traditional methods,offering similar results for people recovering from rotator cuff surgery.This approach might also make rehab more accessible and engaging for patients.That said,further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.展开更多
BACKGROUND Observational studies reported characteristics and outcomes of patients with secondary mitral valve regurgitation(MR)who underwent transcatheter edge-toedge repair of the mitral valve.No study investigated ...BACKGROUND Observational studies reported characteristics and outcomes of patients with secondary mitral valve regurgitation(MR)who underwent transcatheter edge-toedge repair of the mitral valve.No study investigated the temporal trend of patient characteristics and outcomes in comparison with the published randomized trials.AIM To investigate the temporal trend in baseline characteristics and outcomes of patients with secondary MR who underwent transcatheter edge-to-edge repair of the mitral valve in the real world compared with those from the published landmark trials.METHODS A comprehensive systematic literature search was conducted using MEDLINE,EMBASE,and CENTRAL databases,and the identified observational studies were divided into two five-year recruitment periods.The first period included 36 studies that enrolled patients between 2008 and 2012,and the second period included 25 studies that recruited patients between 2013 and 2017-2018.Pooled variables of each five-year recruitment period were compared with those of the landmark trials.A random-effects model was used for statistical comparisons.RStudio and RevMan software were used for the analysis.RESULTS Overall,there were no major variations in the findings between the first and the second five-year recruitment periods.EVEREST program vs observational studies:Patients in the EVEREST program were more likely to have non-ischemic MR etiology[odds ratio(OR)=3.59,95%confidence interval(CI):2.92-4.42]and atrial fibrillation(OR=1.71,95%CI:1.42-2.06).They were less likely to receive angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers(OR=0.72,95%CI:0.58-0.90)and implantable cardiac device(OR=0.41,95%CI:0.33-0.49)as well as less likely to be symptomatic at hospital presentation without a difference in MR grade≤2+or mortality at 12-month follow-up.COAPT trial vs observational studies:COAPT patients were more likely to have prior myocardial infarction(OR=1.62,95%CI:1.27-2.06)and renal insufficiency(OR=2.66,95%CI:2.05-3.45).They were more likely to receive beta-blockers(OR=2.54,95%CI:1.68-3.85)and an implanted cardiac device(OR=2.20,95%CI:1.71-2.84).There was no difference in procedure success or mortality.MITRA-FR trial vs observational studies:MITRA-FR patients were less likely to have atrial fibrillation(OR=0.49,95%CI:0.34-0.69)and renal insufficiency(OR=0.18,95%CI:0.11-0.28)but more likely to have a history of myocardial infarction(OR=1.48,95%CI:1.06-2.05)and to receive diuretics(OR=19.81,95%CI:2.75-142.48)and implantable cardiac devices(OR=1.69,95%CI:1.21-2.37).At hospital presentation,they were less likely to be symptomatic(OR=0.25,95%CI:0.18-0.35)without a difference in MR grades 3+and 4+.There was no difference in terms of MR grade or mortality at 12-month follow-up.CONCLUSION Patients in the landmark studies may have favourable or unfavourable characteristics when compared to those in the observational studies,but this did not translate into different outcomes over time.展开更多
Objectives:To assess outcomes of rectourethral fistula repair utilizing a gracilis flap in a largely radiated cohort.Patients and Methods:We performed a retrospective review of all gracilis interposition flap reconstr...Objectives:To assess outcomes of rectourethral fistula repair utilizing a gracilis flap in a largely radiated cohort.Patients and Methods:We performed a retrospective review of all gracilis interposition flap reconstruction surgeries performed for RUF at a university hospital in South Carolina between January 2010 and June 2023.All repairs utilized a multidisciplinary approach with urology,colorectal,and plastic surgery teams.Postoperatively,patients were maximally drained with foley catheter and suprapubic tube(SPT).Initial voiding cystourethrogram(VCUG)was performed at 4 weeks post-repair.If there was a persistent leak,catheter drainage was maintained for 4 additional weeks and VCUG was repeated.Success was defined as absence of leak on VCUG within 3 months after surgery.Results:22 patients met inclusion criteria.68%of patients had history of external beam radiation therapy(EBRT),13.6%had brachytherapy,and 40.9%had cryotherapy.Initial post-operative VCUG was negative in 10 patients(45.5%).Of the 12 patients with a persistent fistula,5(42%)had no evidence of fistula on subsequent VCUG after 4 weeks.Overall,68%of patients were successfully treated with gracilis interposition flap.There was a significant difference of repair success based on EBRT status(p<0.05).Conclusions:We report a success rate of 68%for gracilis flap repair of RUF.Our cohort had a higher rate of prior radiation therapy compared to other studies.A clinically significant portion of patients with an initial positive VCUG will seal their fistula with prolonged catheter drainage.Gracilis interposition flap is a reasonable surgical treatment for RUF.展开更多
Osteochondral defects pose an enormous challenge,and no satisfactory therapy is available to date due to the hierarchy of the native tissue consisting of articular cartilage and subchondral bone.Constructing a scaffol...Osteochondral defects pose an enormous challenge,and no satisfactory therapy is available to date due to the hierarchy of the native tissue consisting of articular cartilage and subchondral bone.Constructing a scaffold with biological function and biomimetic structure is the key to achieving a high-quality repair effect.Herein,a natural polymer-based bilayer scaffold with a porous architecture similar to that of osteochondral tissue is designed,involving the transforming growth factor-beta3-liposome-loaded upper layer for superficial cartilage regeneration and the nanohydroxyapatite-coated lower layer for subchondral bone rehabilitation.This research is conducted to evaluate the effects of nanoparticle-modified bilayer scaffold to mimic the hierarchical pro-chondrogenic and proosteogenic microenvironment for the recruited endogenous bone marrow mesenchymal stem cells.The fabricated composites were evaluated for mechanical,physicochemical,biological properties,in vitro and in vivo tissue regeneration potential.Overall,the current bilayer scaffold could regenerate a cartilage-bone integrated tissue with a seamless interfacial integration and exhibited superior tissue repair outcomes compared to other single layer scaffolds based on morphological,radiological and histological evaluation,verifying that this novel graft could be an effective approach to tissue-engineered analogs of cartilage-subchondral bone and offer new therapeutic opportunities for osteochondral defect-associated diseases.展开更多
BACKGROUND Inguinal and umbilical hernias are common neonatal conditions.Open hernia repair is currently the primary surgical treatment,but postoperative recurrence remains a significant risk.AIM To identify the risk ...BACKGROUND Inguinal and umbilical hernias are common neonatal conditions.Open hernia repair is currently the primary surgical treatment,but postoperative recurrence remains a significant risk.AIM To identify the risk factors for recurrence following open neonatal hernia repair.METHODS We retrospectively reviewed the data of 56 neonates who underwent open hernia repair at Shijiazhuang Maternal and Child Health Hospital between March 2021 and December 2023.The patients were categorized into recurrence and non-recurrence groups based on their experience of postoperative recurrence.Uni-variate analysis was performed to examine various factors,and those with P<0.1 in univariate analysis were included in multivariate logistic regression.No-mogram models were constructed,and their performance was evaluated using receiver operating characteristic curves.RESULTS Of the 56 children,11(19.64%)experienced postoperative recurrence,whereas the remaining 45(80.36%)did not.Univariate analysis identified anemia(P=0.079),persistent postoperative pain(P=0.049),and low birth weight(P=0.017)as factors associated with recurrence.Multivariate logistic regression analysis re-vealed that anemia(P=0.029),persistent postoperative pain(P=0.008),and low birth weight(P=0.009)were independent risk factors for recurrence after open hernia repair in neonates.CONCLUSION The risk of recurrence after open hernia repair should be closely monitored in neonates with low birth weight,anemia,and persistent postoperative pain.展开更多
基金Funded by the National Natural Science Foundation of China(No.52473077)China Three Gorges Corporation(No.202403190)。
文摘In ultraviolet cured-in-place-pipe(UV-CIPP)pipeline rehabilitation,resin performance critically determines repair effectiveness.Current UV-curable resins exhibit high volatile organic compound(VOC)emissions and inadequate post-cure toughness,which compromise fatigue resistance during service.To address these issues,we synthesized hydroxyl-terminated polyurethane acrylate prepolymers using diphenylmethane diisocyanate(MDI),polypropylene glycol(PPG),and hydroxyethyl methacrylate(HEMA).Fourier transform infrared spectroscopy(FTIR)confirmed successful prepolymer synthesis.We developed UV-curable resins by incorporating various crosslinking monomers and optimized the formulations through mechanical property analysis.Testing revealed that the polyurethane-acrylic UV-cured resin system combines polyurethane's mechanical excellence with acrylics'high UV-curing activity.The PPG200/MDI/HEMA formulation achieved superior performance,with a tensile strength of 55.31 MPa,an impact toughness of 22.7 kJ/m^(2),and a heat deflection temperature(HDT)of 132℃.The optimized system eliminates volatile components while maintaining high reactivity,addressing critical limitations in trenchless pipeline rehabilitation.The improved mechanical properties meet the operational demands of underground pipes,suggesting practical applicability in trenchless pipeline repair.
基金supported by the Irish Research Council under the Government of Ireland Postdoctoral Fellowship Project ID-GOIPD/2023/1431(to AS).
文摘Spinal cord injury(SCI)is a debilitating ailment that leads to the loss of motor and sensory functions,often leaving the patient paralyzed below the injury site(Chen et al.,2013).Globally around 250,000-300,000 people are diagnosed with SCI annually(Singh et al.,2014),and while this number appears quite low,the effect that an SCI has on the patient’s quality of life is drastic,due to the current difficulties to comprehensively treat this illness.The cost of patient care can also be quite costly,amounting to an estimated$1.69 billion in healthcare costs in the USA alone(Mahabaleshwarkar and Khanna,2014).
文摘Exogenous neural stem cell transplantation has become one of the most promising treatment methods for chronic stroke.Recent studies have shown that most ischemia-reperfusion model rats recover spontaneously after injury,which limits the ability to observe long-term behavioral recovery.Here,we used a severe stroke rat model with 150 minutes of ischemia,which produced severe behavioral deficiencies that persisted at 12 weeks,to study the therapeutic effect of neural stem cells on neural restoration in chronic stroke.Our study showed that stroke model rats treated with human neural stem cells had long-term sustained recovery of motor function,reduced infarction volume,long-term human neural stem cell survival,and improved local inflammatory environment and angiogenesis.We also demonstrated that transplanted human neural stem cells differentiated into mature neurons in vivo,formed stable functional synaptic connections with host neurons,and exhibited the electrophysiological properties of functional mature neurons,indicating that they replaced the damaged host neurons.The findings showed that human fetal-derived neural stem cells had long-term effects for neurological recovery in a model of severe stroke,which suggests that human neural stem cells-based therapy may be effective for repairing damaged neural circuits in stroke patients.
基金supported by the National Key R&D Program of China,Nos.2017YFA0104302(to NG and XM)and 2017YFA0104304(to BW and ZZ)
文摘Mesenchymal stromal cell transplantation is an effective and promising approach for treating various systemic and diffuse diseases.However,the biological characteristics of transplanted mesenchymal stromal cells in humans remain unclear,including cell viability,distribution,migration,and fate.Conventional cell tracing methods cannot be used in the clinic.The use of superparamagnetic iron oxide nanoparticles as contrast agents allows for the observation of transplanted cells using magnetic resonance imaging.In 2016,the National Medical Products Administration of China approved a new superparamagnetic iron oxide nanoparticle,Ruicun,for use as a contrast agent in clinical trials.In the present study,an acute hemi-transection spinal cord injury model was established in beagle dogs.The injury was then treated by transplantation of Ruicun-labeled mesenchymal stromal cells.The results indicated that Ruicunlabeled mesenchymal stromal cells repaired damaged spinal cord fibers and partially restored neurological function in animals with acute spinal cord injury.T2*-weighted imaging revealed low signal areas on both sides of the injured spinal cord.The results of quantitative susceptibility mapping with ultrashort echo time sequences indicated that Ruicun-labeled mesenchymal stromal cells persisted stably within the injured spinal cord for over 4 weeks.These findings suggest that magnetic resonance imaging has the potential to effectively track the migration of Ruicun-labeled mesenchymal stromal cells and assess their ability to repair spinal cord injury.
文摘BACKGROUND The surgical management of bile duct injuries(BDIs)after laparoscopic cholecystectomy(LC)is challenging and the optimal timing of surgery remains unclear.The primary aim of this study was to systematically evaluate the evidence behind the timing of BDI repair after LC in the literature.AIM To assess timing of surgical repair of BDI and postoperative complications.METHODS The MEDLINE,EMBASE,and The Cochrane Library databases were systematically screened up to August 2021.Risk of bias was assessed via the Newcastle Ottawa scale.The primary outcomes of this review included the timing of BDI repair and postoperative complications.RESULTS A total of 439 abstracts were screened,and 24 studies were included with 15609 patients included in this review.Of the 5229 BDIs reported,4934(94%)were classified as major injury.Timing of bile duct repair was immediate(14%,n=705),early(28%,n=1367),delayed(28%,n=1367),or late(26%,n=1286).Standardization of definition for timing of repair was remarkably poor among studies.Definitions for immediate repair ranged from<24 h to 6 wk after LC while early repair ranged from<24 h to 12 wk.Likewise,delayed(>24 h to>12 wk after LC)and late repair(>6 wk after LC)showed a broad overlap.CONCLUSION The lack of standardization among studies precludes any conclusive recommendation on optimal timing of BDI repair after LC.This finding indicates an urgent need for a standardized reporting system of BDI repair.
基金supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases(NIAMS)of the National Institutes of Health(NIH)under award numbers F30AR071201(R.L.Z.)and R01 AR066028(K.D.H.)Additional research support is provided by the NIH under a training award T32TR004371(C.A.C.).
文摘CD47 is a ubiquitous and pleiotropic cell-surface receptor.Disrupting CD47 enhances injury repair in various tissues but the role of CD47 has not been studied in bone injuries.In a murine closed-fracture model,CD47-null mice showed decreased callus bone formation as assessed by microcomputed tomography 10 days post-fracture and increased fibrous volume as determined by histology.To understand the cellular basis for this phenotype,mesenchymal progenitors(MSC)were harvested from bone marrow.CD47-null MSC showed decreased large fibroblast colony formation(CFU-F),significantly less proliferation,and fewer cells in Sphase,although osteoblast differentiation was unaffected.However,consistent with prior research,CD47-null endothelial cells showed increased proliferation relative to WT cells.Similarly,in a murine ischemic fracture model,CD47-null mice showed reduced fracture callus size due to a reduction in bone relative to WT 15 days-post fracture.Consistent with our in vitro results,in vivo EdU labeling showed decreased cell proliferation in the callus of CD47-null mice,while staining for CD31 and endomucin demonstrated increased endothelial cell density.Finally,WT mice with ischemic fracture that were administered a CD47 morpholino,which blocks CD47 protein production,showed a callus phenotype similar to that of ischemic fractures in CD47-null mice,suggesting the phenotype was not due to developmental changes in the knockout mice.Thus,inhibition of CD47 during bone healing reduces both non-ischemic and ischemic fracture healing,in part,by decreasing MSC proliferation.Furthermore,the increase in endothelial cell proliferation and early blood vessel density caused by CD47 disruption is not sufficient to overcome MSC dysfunction.
基金supported by the National Natural Science Foundation of China(Grant Nos.:32171124,31871156,31971101,32271180,82272229,and 81471852)Hunan Provincial Natural Science Foundation of China(Grant No.:2021JJ31058).
文摘Repairing the endothelial barrier is essential for maintaining pulmonary fuid balance and regulating leukocyte infiltration during sepsis[1].Tissue kallikrein-related peptidases(KLKs)are secreted serine proteases involved in angiogenesis[2].However,their involvement in regulating endothelial regeneration remains largely unknown.
基金Supported by Zhangjiajie"Xiao He(Young Talent)"Project,No.2024XHRC03Jishou University School-Level Research Project.
文摘BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair(TEVAR)for Stanford type B aortic dissection(TBAD),significantly impacting long-term survival.Accurate risk prediction is essential for optimized clinical management.AIM To develop and validate a logistic regression-based risk prediction model for aortic adverse remodeling following TEVAR in patients with TBAD.METHODS This retrospective observational cohort study analyzed 140 TBAD patients undergoing TEVAR at a tertiary center(2019–2024).Based on European guidelines,patients were categorized into adverse remodeling(aortic growth rate>2.9 mm/year,n=45)and favorable remodeling groups(n=95).Comprehensive variables(clinical/imaging/surgical)were analyzed using multivariable logistic regression to develop a predictive model.Model performance was assessed via receiver operating characteristic-area under the curve(AUC)and Hosmer-Lemeshow tests.RESULTS Multivariable analysis identified several strong independent predictors of negative aortic remodeling.Larger false lumen diameter at the primary entry tear[odds ratio(OR):1.561,95%CI:1.197–2.035;P=0.001]and patency of the false lumen(OR:5.639,95%CI:4.372-8.181;P=0.004)were significant risk factors.False lumen involvement extending to the thoracoabdominal aorta was identified as the strongest predictor,significantly increasing the risk of adverse remodeling(OR:11.751,95%CI:9.841-15.612;P=0.001).Conversely,false lumen involvement confined to the thoracic aorta demonstrated a significant protective effect(OR:0.925,95%CI:0.614–0.831;P=0.015).The prediction model exhibited excellent discrimination(AUC=0.968)and calibration(Hosmer-Lemeshow P=0.824).CONCLUSION This validated risk prediction model identifies aortic adverse remodeling with high accuracy using routinely available clinical parameters.False lumen involvement thoracoabdominal aorta is the strongest predictor(11.751-fold increased risk).The tool enables preoperative risk stratification to guide tailored TEVAR strategies and improve long-term outcomes.
文摘BACKGROUND Descending thoracic aortic aneurysms are dangerous and have to be treated quickly.The primary treatment methods are thoracic endovascular aortic repair(TEVAR)and open surgical repair(OSR).The comparative effectiveness and safety of TEVAR and OSR were evaluated in this meta-analysis,focusing on perioperative and long-term outcomes.AIM To compare and contrast the efficacy and safety of TEVAR vs OSR in the treatment of descending thoracic aortic aneurysms.This study aims to assess both perioperative and long-term outcomes through a systematic review and metaanalysis.METHODS A comprehensive search of PubMed,EMBASE,and Cochrane was conducted from inception to January 2025.Baseline characteristics and outcomes were evaluated.Odds ratios(OR)for dichotomous data and mean differences for continuous data with 95%confidence intervals(CI)were analyzed using random-effects models.RESULTS A meta-analysis of 21 studies involving 29465 patients(8261 TEVAR;21204 OR)showed TEVAR associated with lower operative mortality(OR=0.60,95%CI:0.42-0.85,P=0.004),shorter intensive care unit(-2.94 days,95%CI:-4.76 to-1.12,P=0.002)and hospital stays(-7.35 days,95%CI:-10.54 to-4.17,P<0.00001),and reduced rates of paraplegia(OR=0.44,95%CI:0.27-0.73,P=0.002),spinal ischemia(OR=0.30,95%CI:0.16-0.56,P=0.0002),renal failure(OR=0.29,95%CI:0.14-0.61,P=0.001),and wound infections(OR=0.28,95%CI:0.13-0.61,P=0.001).However,TEVAR had higher rates of vascular complications.No significant differences were noted in 1-year and 5-year mortality rates,the rate of non-elective surgery,neurological complications,or stroke rates.CONCLUSION Compared to EVAR,TEVAR revealed lower operative mortality and better perioperative outcomes across all indicators,including hospital and intensive care unit stays,as well as fewer complications,except for those related to vascular problems.Mortality results were also similar in the long run;consequently,more research is required concerning the long-term durability.
基金supported in part by the National Natural Science Foundation of China(Nos.52205532 and 624B2077)the National Key Research and Development Program of China(No.2023YFB4302003).
文摘The global demand for effective skin injury treatments has prompted the exploration of tissue engineering solutions.While three-dimensional(3D)bioprinting has shown promise,challenges persist with respect to achieving timely and compatible solutions to treat diverse skin injuries.In situ bioprinting has emerged as a key new technology,since it reduces risks during the implantation of printed scaffolds and demonstrates superior therapeutic effects.However,maintaining printing fidelity during in situ bioprinting remains a critical challenge,particularly with respect to model layering and path planning.This study proposes a novel optimization-based conformal path planning strategy for in situ bioprinting-based repair of complex skin injuries.This strategy employs constrained optimization to identify optimal waypoints on a point cloud-approximated curved surface,thereby ensuring a high degree of similarity between predesigned planar and surface-mapped 3D paths.Furthermore,this method is applicable for skin wound treatments,since it generates 3D-equidistant zigzag curves along surface tangents and enables multi-layer conformal path planning to facilitate the treatment of volumetric injuries.Furthermore,the proposed algorithm was found to be a feasible and effective treatment in a murine back injury model as well as in other complex models,thereby showcasing its potential to guide in situ bioprinting,enhance bioprinting fidelity,and facilitate improvement of clinical outcomes.
基金supported by Yunnan Province Innovation Team of Prevention and Treatment for Brain Disease with Acupuncture and Tuina,No.202405AS350007Youth Top Talent Project of 10-thousand Talent Plan in Yunnan Province,No.YNWR-QNBJ-2018-345+3 种基金the National Natural Science Foundation of China,No.81960731Joint Special Project of Traditional Chinese Medicine in Science and Technology Department of Yunnan Province,Nos.2019FF002[-008],202001AZ070001-002 and 202001AZ070001-030Yunnan Province University Innovation Team Projects No.2019YGC04Yunnan Province Project Education Fund,Nos.2024Y406,2024Y414(all to PZ)。
文摘The exchange of information and materials between organelles plays a crucial role in regulating cellular physiological functions and metabolic levels.Mitochondria-associated endoplasmic reticulum membranes serve as physical contact channels between the endoplasmic reticulum membrane and the mitochondrial outer membrane,formed by various proteins and protein complexes.This microstructural domain mediates several specialized functions,including calcium(Ca^(2+))signaling,autophagy,mitochondrial morphology,oxidative stress response,and apoptosis.Notably,the dysregulation of Ca^(2+)signaling mediated by mitochondria-associated endoplasmic reticulum membranes is a critical factor in the pathogenesis of neurological diseases.Certain proteins or protein complexes within these membranes directly or indirectly regulate the distance between the endoplasmic reticulum and mitochondria,as well as the transduction of Ca^(2+)signaling.Conversely,Ca^(2+)signaling mediated by mitochondria-associated endoplasmic reticulum membranes influences other mitochondria-associated endoplasmic reticulum membraneassociated functions.These functions can vary significantly across different neurological diseases—such as ischemic stroke,traumatic brain injury,Alzheimer's disease,Parkinson's disease,amyotrophic lateral sclerosis,and Huntington's disease—and their respective stages of progression.Targeted modulation of these disease-related pathways and functional proteins can enhance neurological function and promote the regeneration and repair of damaged neurons.Therefore,mitochondria-associated endoplasmic reticulum membranes-mediated Ca^(2+)signaling plays a pivotal role in the pathological progression of neurological diseases and represents a significant potential therapeutic target.This review focuses on the effects of protein complexes in mitochondria-associated endoplasmic reticulum membranes and the distinct roles of mitochondria-associated endoplasmic reticulum membranes-mediated Ca^(2+)signaling in neurological diseases,specifically highlighting the early protective effects and neuronal damage that can result from prolonged mitochondrial Ca^(2+)overload or deficiency.This article provides a comprehensive analysis of the various mechanisms of Ca^(2+)signaling mediated by mitochondria-associated endoplasmic reticulum membranes in neurological diseases,contributing to the exploration of potential therapeutic targets for promoting neuroprotection and nerve repair.
基金supported by DOD AFIRMⅢW81XWH-20-2-0029 subcontract,UT POC19-1774-13Neuraptive Therapeutics Inc.26-7724-56+1 种基金NIH R01-NS128086 grantsLone Star Paralysis gift(to GDB)。
文摘Successful polyethylene glycol fusion(PEG-fusion)of severed axons following peripheral nerve injuries for PEG-fused axons has been reported to:(1)rapidly restore electrophysiological continuity;(2)prevent distal Wallerian Degeneration and maintain their myelin sheaths;(3)promote primarily motor,voluntary behavioral recoveries as assessed by the Sciatic Functional Index;and,(4)rapidly produce correct and incorrect connections in many possible combinations that produce rapid and extensive recovery of functional peripheral nervous system/central nervous system connections and reflex(e.g.,toe twitch)or voluntary behaviors.The preceding companion paper describes sensory terminal field reo rganization following PEG-fusion repair of sciatic nerve transections or ablations;howeve r,sensory behavioral recovery has not been explicitly explored following PEG-fusion repair.In the current study,we confirmed the success of PEG-fusion surgeries according to criteria(1-3)above and more extensively investigated whether PEG-fusion enhanced mechanical nociceptive recovery following sciatic transection in male and female outbred Sprague-Dawley and inbred Lewis rats.Mechanical nociceptive responses were assessed by measuring withdrawal thresholds using von Frey filaments on the dorsal and midplantar regions of the hindpaws.Dorsal von Frey filament tests were a more reliable method than plantar von Frey filament tests to assess mechanical nociceptive sensitivity following sciatic nerve transections.Baseline withdrawal thresholds of the sciatic-mediated lateral dorsal region differed significantly across strain but not sex.Withdrawal thresholds did not change significantly from baseline in chronic Unoperated and Sham-operated rats.Following sciatic transection,all rats exhibited severe hyposensitivity to stimuli at the lateral dorsal region of the hindpaw ipsilateral to the injury.However,PEG-fused rats exhibited significantly earlier return to baseline withdrawal thresholds than Negative Control rats.Furthermore,PEG-fused rats with significantly improved Sciatic Functional Index scores at or after 4 weeks postoperatively exhibited yet-earlier von Frey filament recove ry compared with those without Sciatic Functional Index recovery,suggesting a correlation between successful PEG-fusion and both motor-dominant and sensory-dominant behavioral recoveries.This correlation was independent of the sex or strain of the rat.Furthermore,our data showed that the acceleration of von Frey filament sensory recovery to baseline was solely due to the PEG-fused sciatic nerve and not saphenous nerve collateral outgrowths.No chronic hypersensitivity developed in any rat up to 12 weeks.All these data suggest that PEG-fusion repair of transection peripheral nerve injuries co uld have important clinical benefits.
文摘BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.
文摘The plasma membrane(PM)plays an essential role in maintaining cell homeostasis,therefore,timely and effective repair of damage caused by factors such as mechanical rupture,pore-forming toxins,or pore-forming proteins is crucial for cell survival.PM damage induces membrane rupture and stimulates an immune response.However,damage resulting from regulated cell death processes,including pyroptosis,ferroptosis,and necroptosis,cannot be repaired by simple sealing mechanisms and thus,requires specialized repair machinery.Recent research has identified a PM repair mechanism of regulated cell death-related injury,mediated by the endosomal sorting complexes required for transport(ESCRT)machinery.Here,we review recent progress in elucidating the ESCRT machinery-mediated repair mechanism of PM injury,with particular focus on processes related to regulated cell death.This overview,along with continued research in this field,may provide novel insights into therapeutic targets for diseases associated with dysregulation of regulated cell death pathways.
基金Science and Technology Planning Project of Inner Mongolia Science and Technology Department(2022YFSH0021)Key Research and Development Program of Shaanxi Province(2024SF2-GJHX-14,2021SF-296)。
文摘Four types of Mg-5Zn porous scaffolds with different pore geometries,including body-centered cubic(bcc),the rhombic dodecahedron(RD),gyroid(G),and primitive(P)types,were designed and fabricated using selective laser melting.Their forming quality,compression mechanical properties,and degradation behavior were investigated.Results indicate that the fabricated scaffolds exhibit good dimensional accuracy,and the surface chemical polishing treatment significantly improves the forming quality and reduces porosity error in porous scaffolds.Compared to the ones with rod structures(bcc,RD),the scaffolds with surface structures(G,P)have less powder particle adhesion.The G porous scaffold exhibits the best forming quality for the same design porosity.The predominant failure mode of scaffolds during compression is a 45°shear fracture.At a porosity of 75%,the compression property of all scaffolds meets the compressive property requirements of cancellous bone,while bcc and G structures show relatively better compression property.After immersion in Hank's solution for 168 h,the B-2-75% pore structure scaffold exhibits severe localized corrosion,with fractures in partial pillar connections.In contrast,the G-3-75% pore structure scaffold mainly undergoes uniform corrosion,maintaining structural integrity,and its corrosion rate and loss of compressive properties are less than those of the B-2-75%structure.After comparison,the G-pore structure scaffold is preferred.
文摘BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since the coronavirus disease 2019 pandemic,digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.AIM To determine if digitally assisted rehabilitation could be as practical,or even more effective,than the traditional methods most patients currently follow.METHODS Six electronic databases,including PubMed,Scopus,Cochrane Library,Google Scholar,EMBASE,and Web of Science,were searched to find articles that compare digital-based rehabilitation and conventional treatment.Outcomes of interest were Disabilities of the Arm,Shoulder and Hand(DASH)score and range of motion.The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.RESULTS Three randomized controlled trial studies were enrolled in this study,including 195 cases.We did not find any significant differences between the two groups in terms of DASH score,flexion range of motion,and external rotation range of motion.There was a significant difference between the two groups for abduction range of motion.CONCLUSION Digital home-based rehab seems to be a strong alternative to traditional methods,offering similar results for people recovering from rotator cuff surgery.This approach might also make rehab more accessible and engaging for patients.That said,further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.
文摘BACKGROUND Observational studies reported characteristics and outcomes of patients with secondary mitral valve regurgitation(MR)who underwent transcatheter edge-toedge repair of the mitral valve.No study investigated the temporal trend of patient characteristics and outcomes in comparison with the published randomized trials.AIM To investigate the temporal trend in baseline characteristics and outcomes of patients with secondary MR who underwent transcatheter edge-to-edge repair of the mitral valve in the real world compared with those from the published landmark trials.METHODS A comprehensive systematic literature search was conducted using MEDLINE,EMBASE,and CENTRAL databases,and the identified observational studies were divided into two five-year recruitment periods.The first period included 36 studies that enrolled patients between 2008 and 2012,and the second period included 25 studies that recruited patients between 2013 and 2017-2018.Pooled variables of each five-year recruitment period were compared with those of the landmark trials.A random-effects model was used for statistical comparisons.RStudio and RevMan software were used for the analysis.RESULTS Overall,there were no major variations in the findings between the first and the second five-year recruitment periods.EVEREST program vs observational studies:Patients in the EVEREST program were more likely to have non-ischemic MR etiology[odds ratio(OR)=3.59,95%confidence interval(CI):2.92-4.42]and atrial fibrillation(OR=1.71,95%CI:1.42-2.06).They were less likely to receive angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers(OR=0.72,95%CI:0.58-0.90)and implantable cardiac device(OR=0.41,95%CI:0.33-0.49)as well as less likely to be symptomatic at hospital presentation without a difference in MR grade≤2+or mortality at 12-month follow-up.COAPT trial vs observational studies:COAPT patients were more likely to have prior myocardial infarction(OR=1.62,95%CI:1.27-2.06)and renal insufficiency(OR=2.66,95%CI:2.05-3.45).They were more likely to receive beta-blockers(OR=2.54,95%CI:1.68-3.85)and an implanted cardiac device(OR=2.20,95%CI:1.71-2.84).There was no difference in procedure success or mortality.MITRA-FR trial vs observational studies:MITRA-FR patients were less likely to have atrial fibrillation(OR=0.49,95%CI:0.34-0.69)and renal insufficiency(OR=0.18,95%CI:0.11-0.28)but more likely to have a history of myocardial infarction(OR=1.48,95%CI:1.06-2.05)and to receive diuretics(OR=19.81,95%CI:2.75-142.48)and implantable cardiac devices(OR=1.69,95%CI:1.21-2.37).At hospital presentation,they were less likely to be symptomatic(OR=0.25,95%CI:0.18-0.35)without a difference in MR grades 3+and 4+.There was no difference in terms of MR grade or mortality at 12-month follow-up.CONCLUSION Patients in the landmark studies may have favourable or unfavourable characteristics when compared to those in the observational studies,but this did not translate into different outcomes over time.
文摘Objectives:To assess outcomes of rectourethral fistula repair utilizing a gracilis flap in a largely radiated cohort.Patients and Methods:We performed a retrospective review of all gracilis interposition flap reconstruction surgeries performed for RUF at a university hospital in South Carolina between January 2010 and June 2023.All repairs utilized a multidisciplinary approach with urology,colorectal,and plastic surgery teams.Postoperatively,patients were maximally drained with foley catheter and suprapubic tube(SPT).Initial voiding cystourethrogram(VCUG)was performed at 4 weeks post-repair.If there was a persistent leak,catheter drainage was maintained for 4 additional weeks and VCUG was repeated.Success was defined as absence of leak on VCUG within 3 months after surgery.Results:22 patients met inclusion criteria.68%of patients had history of external beam radiation therapy(EBRT),13.6%had brachytherapy,and 40.9%had cryotherapy.Initial post-operative VCUG was negative in 10 patients(45.5%).Of the 12 patients with a persistent fistula,5(42%)had no evidence of fistula on subsequent VCUG after 4 weeks.Overall,68%of patients were successfully treated with gracilis interposition flap.There was a significant difference of repair success based on EBRT status(p<0.05).Conclusions:We report a success rate of 68%for gracilis flap repair of RUF.Our cohort had a higher rate of prior radiation therapy compared to other studies.A clinically significant portion of patients with an initial positive VCUG will seal their fistula with prolonged catheter drainage.Gracilis interposition flap is a reasonable surgical treatment for RUF.
基金supported by grants from the China Postdoctoral Science Foundation(Nos.2022TQ0397,2022MD723744,2022M710564,2022M720603)Natural Science Foundation of China(Nos.82272553,82102571,81974346,8210257,82472404)+8 种基金Chongqing Municipal Medical Youth Talent Support Program,Chongqing,China(No.YXQN202408)Natural Science Foundation of Chongqing,China(Nos.CSTB2022NSCQ-MSX0089,CSTB2022NSCQ-MSX0104,CSTB2024NSCQMSX0532)Joint Medical Research Project of Health Commission&Science and Technology Bureau of Chongqing,China(No.2024QNXM032)Special Project for the Central Government to Guide the Development of Local Science and Technology in Sichuan Province(No.2023ZYD0071)National Natural Science Foundation of Sichuan(No.24NSFSC1274)Project of Innovative Science Research for Postgraduate of Chongqing Municipal Education Committee,Chongqing,China(Nos.CYS22389,CYB240224)National Natural Science Foundation of Sichuan(No.2024NSFSC0678)Research Project of the Affiliated Hospital of North Sichuan Medical College(Nos.2023ZD002,2023-2ZD001,2024JB001)Disciplines Construction Program of The Third Affiliated Hospital of Chongqing Medical University(Nos.KY23035,KY23041).
文摘Osteochondral defects pose an enormous challenge,and no satisfactory therapy is available to date due to the hierarchy of the native tissue consisting of articular cartilage and subchondral bone.Constructing a scaffold with biological function and biomimetic structure is the key to achieving a high-quality repair effect.Herein,a natural polymer-based bilayer scaffold with a porous architecture similar to that of osteochondral tissue is designed,involving the transforming growth factor-beta3-liposome-loaded upper layer for superficial cartilage regeneration and the nanohydroxyapatite-coated lower layer for subchondral bone rehabilitation.This research is conducted to evaluate the effects of nanoparticle-modified bilayer scaffold to mimic the hierarchical pro-chondrogenic and proosteogenic microenvironment for the recruited endogenous bone marrow mesenchymal stem cells.The fabricated composites were evaluated for mechanical,physicochemical,biological properties,in vitro and in vivo tissue regeneration potential.Overall,the current bilayer scaffold could regenerate a cartilage-bone integrated tissue with a seamless interfacial integration and exhibited superior tissue repair outcomes compared to other single layer scaffolds based on morphological,radiological and histological evaluation,verifying that this novel graft could be an effective approach to tissue-engineered analogs of cartilage-subchondral bone and offer new therapeutic opportunities for osteochondral defect-associated diseases.
文摘BACKGROUND Inguinal and umbilical hernias are common neonatal conditions.Open hernia repair is currently the primary surgical treatment,but postoperative recurrence remains a significant risk.AIM To identify the risk factors for recurrence following open neonatal hernia repair.METHODS We retrospectively reviewed the data of 56 neonates who underwent open hernia repair at Shijiazhuang Maternal and Child Health Hospital between March 2021 and December 2023.The patients were categorized into recurrence and non-recurrence groups based on their experience of postoperative recurrence.Uni-variate analysis was performed to examine various factors,and those with P<0.1 in univariate analysis were included in multivariate logistic regression.No-mogram models were constructed,and their performance was evaluated using receiver operating characteristic curves.RESULTS Of the 56 children,11(19.64%)experienced postoperative recurrence,whereas the remaining 45(80.36%)did not.Univariate analysis identified anemia(P=0.079),persistent postoperative pain(P=0.049),and low birth weight(P=0.017)as factors associated with recurrence.Multivariate logistic regression analysis re-vealed that anemia(P=0.029),persistent postoperative pain(P=0.008),and low birth weight(P=0.009)were independent risk factors for recurrence after open hernia repair in neonates.CONCLUSION The risk of recurrence after open hernia repair should be closely monitored in neonates with low birth weight,anemia,and persistent postoperative pain.
