Next-generation craniomaxillofacial implants(CMFIs) are redefining personalized bone reconstruction by balancing and optimizing biomechanics,biocompatibility,and bioactivity—the "3Bs".This review highlights...Next-generation craniomaxillofacial implants(CMFIs) are redefining personalized bone reconstruction by balancing and optimizing biomechanics,biocompatibility,and bioactivity—the "3Bs".This review highlights recent progress in implant design,material development,additive manufacturing,and preclinical evaluation.Emerging biomaterials,including bioresorbable polymers,magnesium alloys,and composites with bioactive ceramics,enable patient-specific solutions with improved safety and functionality.Triply periodic minimal surface(TPMS) architectures exemplify how structural design can enhance both mechanical performance and biological integration.Additive manufacturing technologies further allow the fabrication of geometrically complex,customized impla nts that meet individual anatomical and pathological needs.In parallel,multiscale evaluation techniques—from mechanical testing to in vitro and in vivo models—provide comprehensive insights into implant performance and safety.Looking ahead,the field is poised to benefit from several transformative trends:the development of smart and multifunctional biomaterials;Al-driven design frameworks that leverage patient-specific data and computational modeling;predictive additive manufacturing with real-time quality control;and advanced biological testing platforms for preclinical evaluation.Together,these advances form the foundation of a data-informed,translational pipeline from bench to bedside.Realizing the full potential of nextgene ration CMFIs will require close interdisciplina ry collaboration across mate rials science,computational engineering,and clinical medicine.展开更多
Objective:To explore the application effect of digital intraoral scanning impression technique in oral implant restoration for periodontitis patients and analyze its impact on patients’Visual Analogue Scale(VAS)score...Objective:To explore the application effect of digital intraoral scanning impression technique in oral implant restoration for periodontitis patients and analyze its impact on patients’Visual Analogue Scale(VAS)scores.Methods:A total of 80 periodontitis patients who received implant restoration in our hospital from May 2023 to May 2025 were selected as research subjects.They were randomly divided into an observation group and a control group using a random number table method,with 40 cases in each group.The observation group used the digital intraoral scanning impression technique to obtain impressions,while the control group used the traditional silicone rubber impression technique.The impression-taking time,the number of prostheses try-ins,implant survival rate,periodontal health indicators(probing depth,gingival index,bleeding index),and VAS scores(pain during treatment and comfort after restoration)were compared between the two groups.Results:The observation group was superior to the control group in terms of impression-taking time,the number of prostheses try-ins,and implant survival rate(p<0.05).Six months after restoration,the improvement in periodontal health indicators in the observation group was significantly better than that in the control group(p<0.05).In addition,the pain VAS score of the observation group during treatment was lower than that of the control group,and the comfort VAS score after restoration was higher than that of the control group(p<0.05).Conclusion:Digital intraoral scanning impression technology can effectively enhance the efficiency and success rate of implant restoration in periodontitis patients,improve periodontal health,alleviate patients’discomfort during treatment,and increase post-restoration comfort,demonstrating high clinical application value.展开更多
Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,random...Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,randomized controlled trial at three different centers in Indonesia.A total of 531 participants that met inclusion and exclusion criteria were randomized into two groups,with 264 participants in the Sinoplant group and 267 participants in the Indoplant group.At each center,participants were divided into two groups for Sinoplant and Indoplant.The participants were followed up for 36 months.Four parameters were evaluated:implant effectiveness,safety,acceptability,and confounding factors.Results:A total of 531 eligible participants were enrolled in this study.Both Sinoplant and Indoplant showed 100%efficacy in preventing pregnancy,with no significant differences in side effects.24.22%of the Sinoplant group and 22.18%of the Indoplant group reported weight changes.8.60%of the Sinoplant group and 9.73%of the Indoplant group reported menstrual changes,and 1.17%of the both groups experienced intermenstrual bleeding.Implant acceptability was 96.61%,with 3.39%dropout rates.Confounding factors such as age,parity,and contraceptive history did not significantly differ between the two groups.Conclusions:Sinoplant and Indoplant did not differ significantly in contraceptive effectiveness,safety,acceptability,and confounding factors.展开更多
Objective:To investigate the spatial gradient of intraoperative impedance across the cochlear electrode array in pediatric cochlear implant recipients and assess its potential as a physiological indicator for the elec...Objective:To investigate the spatial gradient of intraoperative impedance across the cochlear electrode array in pediatric cochlear implant recipients and assess its potential as a physiological indicator for the electrode-neural interface.Methods:A prospective observational study involving 56 pediatric patients underwent cochlear implantation with Cochlear Nucleus devices.Intraoperative polarized impedance and electrically evoked compound action potential(ECAP)threshold were recorded across all 1232 electrodes using AutoNRT software.Eight electrodes with open-or short-circuit were excluded,leaving 1,224 for analysis.Impedance values were categorized by cochlear region(basal,middle,apical),and electrodes with elevated impedance(10-20 kΩ)were analyzed for regional distribution and clinical relevance.Data were analyzed for spatial patterns and correlation with the ECAP threshold profiles.Results:A consistent basal-to-apical increase in impedance was observed(7.7±1.9,9.2±1.4,10.8±1.5 kΩ;p<0.001).Impedance and ECAP threshold were weakly correlated(ρ=-0.20,p<0.001;β=-1.26,p<0.001),with a positive association in the apical region(ρ=0.12,p=0.048).Electrodes with higher impedance(1020 kΩ)were less likely to show elevated or absent TNRT(OR=0.175,p=0.02).The impedance gradient persisted across age groups and was significantly correlated with ECAP threshold patterns.Conclusion:Intraoperative impedance monitoring reveals a strong and physiologically consistent gradient,with higher values in apical electrodes.This gradient reflects anatomical and tissue interface variations,which may offer a valuable physiological indicator for intraoperative electrode positioning and neural interface integrity.展开更多
Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study ...Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study aimed to analyze the long-term survival of penile prostheses and identify risk factors associated with survival without reintervention.Methods:This is a retrospective,single-center study of patients who underwent IPP implantation between January 2014 and December 2022.Preoperative data related to the patient and the etiology of ED,as well as perioperative data,were collected.The primary outcome was survival without reintervention,defined as prosthesis revision or explantation due to mechanical dysfunction or infection.We conducted survival analyses without reintervention and searched for risk factors using a multivariate Cox model.Results:In total,33 out of 137 patients underwent reintervention(24.1%),including 24(17.5%)prosthesis revisions and 9(6.6%)had explantations.Median follow-up was 39 months with an interquartile range(IQR)of 9.00 to 62.00.Median survival without reintervention was 7 years.In univariate analysis,downsizing(p=0.046)was associated with reintervention.Smoking(p=0.003)and age(p=0.034)were associated with prosthesis explantation.The number of implantations(p=0.009)was associated with prosthesis revision.Multivariate analysis by the Cox model did not identify any independent predictive factors for reintervention.Conclusion:Smoking may play a role in infection post-IPP implantation.Primary implantations seem to be associated with better survival.Adjusting cylinder size,known as downsizing,is likely to be a proxy for the complexity of the procedure and thus linked to earlier reintervention.展开更多
AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabe...AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.展开更多
Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hy...Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hypoplasia(CH)and common cavity(CC).Methods:Twelve children(eight males,four females),aged 10 to 43 months,with special IEMs were enrolled,and their inner ear structures were analyzed using detailed segmentation.Two surgical approaches were employed:the transmastoid slot labyrinthotomy approach(TSLA)for cases requiring customized electrodes,and the round window or cochleostomy approach for the remaining cases.Outcomes were evaluated using Categories of Auditory Performance(CAP),Speech Intelligibility Rating(SIR),and Meaningful Auditory Integration Scale(MAIS/IT-MAIS)at 12 months post-implantation.Results:Two main types of malformed cochleae were identified:common cavity-like and primitive CH types.All patients exhibited cochlear nerve deficiency and significant bilateral differences in their inner ear structures.Four patients underwent TSLA with customized electrodes,while the remaining patients received lateral wall electrodes via the round window or cochleostomy approach.Most patients showed improvement in auditory and speech capabilities following implantation.Conclusion:Inner ear malformations with transitional forms between CH and CC present unique challenges,requiring detailed preoperative evaluation and customized surgical plans.Even in severe cases,carefully planned surgery can lead to meaningful auditory rehabilitation.展开更多
AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS...AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.展开更多
Background:Chronic endometritis(CE)is an important pathological factor contributing to female infertility and recurrent pregnancy loss.Although antibiotics are the primary clinical treatment for CE,they do not effecti...Background:Chronic endometritis(CE)is an important pathological factor contributing to female infertility and recurrent pregnancy loss.Although antibiotics are the primary clinical treatment for CE,they do not effectively improve pregnancy outcomes.Wen Yang Hua Zhuo(WYHZ)is a clinically employed classical formula known for its effects in warming yang,tonifying the spleen and kidneys,and resolving dampness.However,its underlying mechanisms remain unclear.This study aimed to elucidate how WYHZ modulates the immunometabolic microenvironment at the maternal-fetal interface in CE by targeting the MCT/HIF-1α/LDHA pathway to promote embryo implantation.Methods:In vivo,the model of CE was established by intrauterine injection of lipopolysaccharide(LPS)(1 mg/mL)into female C57/BL mice,followed by WYHZ treatment for 3 weeks to evaluate its effects on embryo implantation.Mechanistic studies were further conducted using the MCT-1 inhibitor AZD3965 and adeno-associated virus-mediated HIF-1αknockdown.In vitro,an in vitro CE model consisting of M1 macrophages and Ishikawa,as well as an in vitro embryo implantation model mediated by JAR cells,were constructed using Transwell,and the therapeutic mechanisms of WYHZ was validated using AZD3965 and lentiviral sh HIF-1αintervention.Metabolic enzyme activity assays,protein antibody microarrays,immunofluorescence,Western blotting,Seahorse analysis,and ELISA were employed.Results:WYHZ improved the immune-inflammatory microenvironment at the maternal-fetal interface by reducing pro-inflammatory cytokines and increasing anti-inflammatory factors.In parallel,WYHZ reprogrammed endometrial metabolism by enhancing glycolysis and suppressing mitochondrial oxidative phosphorylation,thereby improving endometrial receptivity and embryo implantation.Mechanistically,WYHZ activated the MCT/HIF-1α/LDHA pathway in endometrial epithelial cells,alleviating inflammatory stress and restoring receptivity.Both AZD3965 intervention and HIF-1αknockdown impaired endometrial receptivity and implantation,effects that were reversed by WYHZ.Conclusion:WYHZ modulates the immunometabolic microenvironment of the endometrium in the context of CE by targeting the activation of the MCT/HIF-1α/LDHA pathway,which improves endometrial receptivity and promotes embryo implantation.展开更多
Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability t...Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.展开更多
Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic ...Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.展开更多
Objective:To assess whether personalized embryo transfer guided by endometrial receptivity array(ERA)improves implantation and pregnancy rates in women with implantation failure.Methods:This retrospective case-control...Objective:To assess whether personalized embryo transfer guided by endometrial receptivity array(ERA)improves implantation and pregnancy rates in women with implantation failure.Methods:This retrospective case-control study was conducted on women with previous implantation failure.The women were divided into two groups,i.e,women who underwent ERA and those who underwent embryo transfer without ERA testing.ERA was performed using Igenomix.ERA results were interpreted as receptive or non-receptive.Women underwent frozen embryo transfer on the 6th day of progesterone(P+5).The primary outcomes were implantation rate,clinical pregnancy rate,abortion rate,and negative pregnancy rate.Results:This study included 229 women with previous implantation failure,with 154 in the ERA group and 75 in the no ERA group.The mean age of the women of the ERA group was(32.2±4.1)years,and that of the no ERA group was(31.5±4.8)years.Women in the ERA group had a higher implantation rate(60.4%)and clinical pregnancy rate(57.1%)compared to those in the no ERA group(48.0%and 46.7%,respectively).In addition,implantation rate of the nonreceptive ERA group was higher than the no ERA group(65%vs.48%),and clinical pregnancy rate was also higher in the non-receptive ERA group than the no ERA group(65%vs.47%).The abortion rate of the no ERA group was 9%and that of the non-receptive ERA group was 10%.52%no ERA group women and 35%non-receptive ERA group women had negative pregnancy results.Conclusions:Women who have undergone personalised embryo transfer guided by ERA have a higher clinical pregnancy rate than women who have not after previous implantation failure.展开更多
Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow ...Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.展开更多
Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,m...Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,management and outcomes of these patients and to describe predictors of length of hospital stay(LoS)in this context.Methods Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge(January 2018-December 2022).A TAVI program was implemented in may 2021.Baseline clinical characteristics,management and in-hospital complications were registered.Predictors of long hospital stay(>7 day)were assessed by binary logistic regression.Results We included 614 patients,with mean age 80.5 years.Most patients(438/614,71.2%)presented conditions that precluded an early discharge.Mean hospital stay was 7.6 days.Patients admitted after the implementation of the program had a significantly lower burden of comorbidities.The rate of conduction disturbances after TAVI remained stable around 60%.However,permanent pacemaker requirement declined from 30.3%to 22.5%(P=0.028).LoS was reduced after the implementation of the program both in patients suitable for an early discharge(from 6.5 day to 4 day,P<0.001)and unsuitable patients(from 9.4 day to 7.7 day,P=0.014).The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases,day of the week,emergent procedures,and conduction disturbances and other complications as independent predictors of long stay after TAVI.Conclusions Most patients undergoing TAVI present conditions that preclude an early hospital discharge.The implementation of a TAVI program improved selection of patients,with a lower burden of comorbidities,a lower rate of complications and a marked reduction of hospital stay.展开更多
To promote early rapid osteogenesis and prevent late implant-related infection,it is critical to develop ef-fective and reliable surface treatment technologies for enhancing both osteogenic and antibacterial prop-erti...To promote early rapid osteogenesis and prevent late implant-related infection,it is critical to develop ef-fective and reliable surface treatment technologies for enhancing both osteogenic and antibacterial prop-erties of titanium alloy implants.Reduced graphene oxide(rGO)is considered a promising modification candidate.However,whether rGO retains its osteogenic and antibacterial functions after being applied to modify titanium alloy surfaces depends on the surface treatment technology employed.In this study,rGO was integrated onto the surface of Ti-35Nb-2Ta-3Zr(TNTZ)alloy through friction stir processing(FSP),yielding a consolidated TNTZ/F-rGO composite.The incorporation of rGO not only significantly im-proved the microhardness and hydrophilicity of the material,but also exhibited positive biological effects in vitro experiments:it effectively promoted the proliferation,osteogenic differentiation,alkaline phos-phatase(ALP)production and extracellular matrix mineralization of BMSCs.Furthermore,TNTZ/F-rGO ex-hibited potent antibacterial activity via surface-contact mechanisms.In summary,the rGO-modified in-tegrated titanium alloy has excellent osteogenic properties and high-efficiency antibacterial ability.This study provides new insights and strategies for the design of graphene-based biomaterials and implant surface modification technologies.展开更多
Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAV...Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.展开更多
This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent author...This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria.A meta-analysis was performed to evaluate the weighted mean differences in survival rate(SR)and changes in pocket probing depth(PPD),bone level(BL),and clinical attachment level(CAL).The study cohorts were defined as antibiotic and control groups with subgroups for analysis.Seven studies including 309 patients(390 implants)were considered.Within the limitations of this review,patients in the antibiotic groups exhibited significant improvements in PPD.Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL.It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis,whether through surgical or non-surgical approaches,and also shows moderate performance regarding BL and CAL.Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics,careful clinical judgment is still necessary.展开更多
Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial pr...Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial properties,and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis.Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque.However,it is particularly important to prevent the occurrence of peri-implantitis rather than treatment.Therefore,the current research spot has focused on improving the antibacterial properties of dental implants,such as the construction of specific micro-nano surface texture,the introduction of diverse functional coatings,or the application of materials with intrinsic antibacterial properties.The aforementioned antibacterial surfaces can be incorporated with bioactive molecules,metallic nanoparticles,or other functional components to further enhance the osteogenic properties and accelerate the healing process.In this review,we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration.Furthermore,we summarized the obstacles existing in the process of laboratory research to reach the clinic products,and propose corresponding directions for future developments and research perspectives,so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy,biological safety,and osteogenic property.展开更多
The bioinert nature of polyether ether ketone(PEEK)material limits the widespread clinical application of PEEK implants.Although the porous structure is considered to improve osseointegration of PEEK implants,it is ha...The bioinert nature of polyether ether ketone(PEEK)material limits the widespread clinical application of PEEK implants.Although the porous structure is considered to improve osseointegration of PEEK implants,it is hardly used due to its mechanical properties.This study investigated the combined influence of the porous structure and in vivo mechanical stimulation on implantation safety and bone growth based on finite element analysis of the biomechanical behavior of the implantation system.The combined control of pore size and screw preloads allows the porous PEEK implant to achieve good osseointegration while maintaining a relatively high safety level.A pore size of 600μm and a preload of 0.05 N·m are the optimal combination for the long-term stability of the implant,with which the safety factor of the implant is>2,and the predicted percentage of effective bone growth area of the bone-implant interface reaches 97%.For further clinical application,PEEK implants were fabricated with fused filament fabrication(FFF)three-dimensional(3D)printing,and clinical outcomes demonstrated better bone repair efficacy and long-term stability of porous PEEK implants compared to solid PEEK implants.Moreover,good osteointegration performance of 3D-printed porous PEEK implants was observed,with an average bone volume fraction>40%three months after implantation.In conclusion,3D-printed porous PEEK implants have great potential for clinical application,with validated implantation safety and good osseointegration.展开更多
To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elas...To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.展开更多
基金Financial support from National University of Singapore (NUS)(AcRF A-8000-126-00-00)。
文摘Next-generation craniomaxillofacial implants(CMFIs) are redefining personalized bone reconstruction by balancing and optimizing biomechanics,biocompatibility,and bioactivity—the "3Bs".This review highlights recent progress in implant design,material development,additive manufacturing,and preclinical evaluation.Emerging biomaterials,including bioresorbable polymers,magnesium alloys,and composites with bioactive ceramics,enable patient-specific solutions with improved safety and functionality.Triply periodic minimal surface(TPMS) architectures exemplify how structural design can enhance both mechanical performance and biological integration.Additive manufacturing technologies further allow the fabrication of geometrically complex,customized impla nts that meet individual anatomical and pathological needs.In parallel,multiscale evaluation techniques—from mechanical testing to in vitro and in vivo models—provide comprehensive insights into implant performance and safety.Looking ahead,the field is poised to benefit from several transformative trends:the development of smart and multifunctional biomaterials;Al-driven design frameworks that leverage patient-specific data and computational modeling;predictive additive manufacturing with real-time quality control;and advanced biological testing platforms for preclinical evaluation.Together,these advances form the foundation of a data-informed,translational pipeline from bench to bedside.Realizing the full potential of nextgene ration CMFIs will require close interdisciplina ry collaboration across mate rials science,computational engineering,and clinical medicine.
文摘Objective:To explore the application effect of digital intraoral scanning impression technique in oral implant restoration for periodontitis patients and analyze its impact on patients’Visual Analogue Scale(VAS)scores.Methods:A total of 80 periodontitis patients who received implant restoration in our hospital from May 2023 to May 2025 were selected as research subjects.They were randomly divided into an observation group and a control group using a random number table method,with 40 cases in each group.The observation group used the digital intraoral scanning impression technique to obtain impressions,while the control group used the traditional silicone rubber impression technique.The impression-taking time,the number of prostheses try-ins,implant survival rate,periodontal health indicators(probing depth,gingival index,bleeding index),and VAS scores(pain during treatment and comfort after restoration)were compared between the two groups.Results:The observation group was superior to the control group in terms of impression-taking time,the number of prostheses try-ins,and implant survival rate(p<0.05).Six months after restoration,the improvement in periodontal health indicators in the observation group was significantly better than that in the control group(p<0.05).In addition,the pain VAS score of the observation group during treatment was lower than that of the control group,and the comfort VAS score after restoration was higher than that of the control group(p<0.05).Conclusion:Digital intraoral scanning impression technology can effectively enhance the efficiency and success rate of implant restoration in periodontitis patients,improve periodontal health,alleviate patients’discomfort during treatment,and increase post-restoration comfort,demonstrating high clinical application value.
基金supported by PT.Catur Dakwah Crane Pharmacy,an Indonesian pharmaceutical company.The funding was granted through a mutual agreement between the research team and the company,under the coordination of the National Population and Family Planning Board(BKKBN Indonesia).The funder provided financial support only and had no role in the study design,data collection,analysis,interpretation of data,or the decision to submit the manuscript for publication.
文摘Objective:To compare the effectiveness,safety,acceptability,and confounding factors of the two-rod levonorgestrel implants between the Indoplant and Sinoplant implant brands.Methods:The study was a double-blind,randomized controlled trial at three different centers in Indonesia.A total of 531 participants that met inclusion and exclusion criteria were randomized into two groups,with 264 participants in the Sinoplant group and 267 participants in the Indoplant group.At each center,participants were divided into two groups for Sinoplant and Indoplant.The participants were followed up for 36 months.Four parameters were evaluated:implant effectiveness,safety,acceptability,and confounding factors.Results:A total of 531 eligible participants were enrolled in this study.Both Sinoplant and Indoplant showed 100%efficacy in preventing pregnancy,with no significant differences in side effects.24.22%of the Sinoplant group and 22.18%of the Indoplant group reported weight changes.8.60%of the Sinoplant group and 9.73%of the Indoplant group reported menstrual changes,and 1.17%of the both groups experienced intermenstrual bleeding.Implant acceptability was 96.61%,with 3.39%dropout rates.Confounding factors such as age,parity,and contraceptive history did not significantly differ between the two groups.Conclusions:Sinoplant and Indoplant did not differ significantly in contraceptive effectiveness,safety,acceptability,and confounding factors.
文摘Objective:To investigate the spatial gradient of intraoperative impedance across the cochlear electrode array in pediatric cochlear implant recipients and assess its potential as a physiological indicator for the electrode-neural interface.Methods:A prospective observational study involving 56 pediatric patients underwent cochlear implantation with Cochlear Nucleus devices.Intraoperative polarized impedance and electrically evoked compound action potential(ECAP)threshold were recorded across all 1232 electrodes using AutoNRT software.Eight electrodes with open-or short-circuit were excluded,leaving 1,224 for analysis.Impedance values were categorized by cochlear region(basal,middle,apical),and electrodes with elevated impedance(10-20 kΩ)were analyzed for regional distribution and clinical relevance.Data were analyzed for spatial patterns and correlation with the ECAP threshold profiles.Results:A consistent basal-to-apical increase in impedance was observed(7.7±1.9,9.2±1.4,10.8±1.5 kΩ;p<0.001).Impedance and ECAP threshold were weakly correlated(ρ=-0.20,p<0.001;β=-1.26,p<0.001),with a positive association in the apical region(ρ=0.12,p=0.048).Electrodes with higher impedance(1020 kΩ)were less likely to show elevated or absent TNRT(OR=0.175,p=0.02).The impedance gradient persisted across age groups and was significantly correlated with ECAP threshold patterns.Conclusion:Intraoperative impedance monitoring reveals a strong and physiologically consistent gradient,with higher values in apical electrodes.This gradient reflects anatomical and tissue interface variations,which may offer a valuable physiological indicator for intraoperative electrode positioning and neural interface integrity.
文摘Background:Inflatable Penile Prosthesis(IPP)is the treatment for erectile dysfunction(ED)refractory to pharmacological therapies.Long-term data on factors associated with prosthesis survival remain unclear.This study aimed to analyze the long-term survival of penile prostheses and identify risk factors associated with survival without reintervention.Methods:This is a retrospective,single-center study of patients who underwent IPP implantation between January 2014 and December 2022.Preoperative data related to the patient and the etiology of ED,as well as perioperative data,were collected.The primary outcome was survival without reintervention,defined as prosthesis revision or explantation due to mechanical dysfunction or infection.We conducted survival analyses without reintervention and searched for risk factors using a multivariate Cox model.Results:In total,33 out of 137 patients underwent reintervention(24.1%),including 24(17.5%)prosthesis revisions and 9(6.6%)had explantations.Median follow-up was 39 months with an interquartile range(IQR)of 9.00 to 62.00.Median survival without reintervention was 7 years.In univariate analysis,downsizing(p=0.046)was associated with reintervention.Smoking(p=0.003)and age(p=0.034)were associated with prosthesis explantation.The number of implantations(p=0.009)was associated with prosthesis revision.Multivariate analysis by the Cox model did not identify any independent predictive factors for reintervention.Conclusion:Smoking may play a role in infection post-IPP implantation.Primary implantations seem to be associated with better survival.Adjusting cylinder size,known as downsizing,is likely to be a proxy for the complexity of the procedure and thus linked to earlier reintervention.
文摘AIM:To compare the anatomical and functional outcomes of combined phacoemulsification with intravitreal dexamethasone implant(DEX-I)versus anti-vascular endothelial growth factor(VEGF)injections in patients with diabetic macular edema(DME)and visually significant cataract.METHODS:This nonrandomized,retrospective analysis included 54 eyes undergoing phacoemulsification with DEX-I(DEX-I group)and 47 eyes receiving anti-VEGF injections(anti-VEGF group).Best-corrected visual acuity(BCVA)and central macular thickness(CMT)were measured preoperatively and postoperatively at 1 and 3mo.RESULTS:The two groups had comparable baseline characteristics,with similar age(DEX-I:66.83±7.27y;anti-VEGF:66.81±6.79y)and gender distribution(51.9%vs 59.6%males).Both groups showed significant BCVA improvement at 1 and 3mo,with no significant intergroup differences.CMT reduction was significantly greater in the DEX-I group at 3mo(25.03%vs 14.07%;P=0.049),particularly in recalcitrant eyes(25.09%vs 11.10%;P=0.007).Postoperative intraocular pressure(IOP)>21 mm Hg was observed in 14.8%of DEX-I eyes and 4.25%of anti-VEGF eyes(P=0.08),normalizing by 3mo.DEX-I required no reinjection,while 29.79%of anti-VEGF eyes needed a fourth dose at 3mo.Complications were minimal,with one posterior capsular injury in the DEX-I group.CONCLUSION:Combined phacoemulsification with intravitreal DEX-I offers superior CMT reduction and comparable visual acuity improvement to anti-VEGF injections in DME,with fewer required treatments.It is an effective strategy for managing cataract with DME,offering benefits,especially for recalcitrant cases.Both therapies have favourable safety profiles,but further long-term studies are needed for clinical guidance.
基金supported by the National Key Research and Development Program of China(grant no.2022YFC2402705)National Municipal Natural Science Foundation(grant no.82471161)Beijing Municipal Natural Science Foundation(grant no.7244308).
文摘Objectives:To investigate the imaging characteristics,surgical approaches,and outcomes of cochlear implantation(CI)in patients with special inner ear malformations(IEMs)that show transitional forms between cochlear hypoplasia(CH)and common cavity(CC).Methods:Twelve children(eight males,four females),aged 10 to 43 months,with special IEMs were enrolled,and their inner ear structures were analyzed using detailed segmentation.Two surgical approaches were employed:the transmastoid slot labyrinthotomy approach(TSLA)for cases requiring customized electrodes,and the round window or cochleostomy approach for the remaining cases.Outcomes were evaluated using Categories of Auditory Performance(CAP),Speech Intelligibility Rating(SIR),and Meaningful Auditory Integration Scale(MAIS/IT-MAIS)at 12 months post-implantation.Results:Two main types of malformed cochleae were identified:common cavity-like and primitive CH types.All patients exhibited cochlear nerve deficiency and significant bilateral differences in their inner ear structures.Four patients underwent TSLA with customized electrodes,while the remaining patients received lateral wall electrodes via the round window or cochleostomy approach.Most patients showed improvement in auditory and speech capabilities following implantation.Conclusion:Inner ear malformations with transitional forms between CH and CC present unique challenges,requiring detailed preoperative evaluation and customized surgical plans.Even in severe cases,carefully planned surgery can lead to meaningful auditory rehabilitation.
文摘AIM:To compare the visual outcomes between bilateral implantation of Tecnis ZXR00 extended depth-of-focus(EDOF)intraocular lenses(IOLs)and mixed implantation of Tecnis ZXR00(EDOF)with Tecnis ZMB00(bifocal)IOLs.METHODS:This postoperative cross-sectional study enrolled patients who underwent phacoemulsification combined with IOL implantation.Patients were divided into two groups:the bilateral ZXR00 group(ZXR00-only group)and the mixed IOL group(ZXR00+ZMB00 group).Primary outcome measures included uncorrected and corrected distance visual acuity(UDVA,CDVA),uncorrected and distance-corrected near visual acuity(UNVA,DCNVA),uncorrected and distance-corrected intermediate visual acuity(UIVA,DCIVA),and defocus curves.Secondary outcome measures were visual quality,spectacle independence,patient satisfaction,photic phenomena,and stereopsis.RESULTS:A total of 47 patients(94 eyes)were included,with 26 patients(11 males,15 females)in the ZXR00-only group(mean age:62.73±7.24y)and 21 patients(7 males,14 females)in the mixed group(mean age:65.71±9.16y).There was no statistically significant difference in age between the two groups(P=0.218).The mixed group showed significantly better binocular DCNVA compared to the ZXR00-only group(P=0.002).Defocus curve analysis revealed that the mixed group exhibited superior performance at−2.5 to−4.0 D but inferior performance at−0.5 and−1.5 D.Near stereoacuity was significantly poorer in the mixed group(Randot:5.589±0.744 vs 6.240±0.394 ln arcsec;Contour:4.966±0.973 vs 5.740±0.833 ln arcsec;both P<0.01).Both groups achieved high levels of spectacle independence and patient satisfaction,with no significant differences in photic phenomena or questionnaire scores.CONCLUSION:Mixed implantation of EDOF and bifocal IOLs improve near visual acuity but may compromise near stereopsis.This approach provides a viable option for patients prioritizing near vision;however,caution is recommended for individuals requiring fine stereoscopic vision for daily or professional tasks.
基金supported by the National Natural Science Foundation of China(grant number:82205172,82274570).
文摘Background:Chronic endometritis(CE)is an important pathological factor contributing to female infertility and recurrent pregnancy loss.Although antibiotics are the primary clinical treatment for CE,they do not effectively improve pregnancy outcomes.Wen Yang Hua Zhuo(WYHZ)is a clinically employed classical formula known for its effects in warming yang,tonifying the spleen and kidneys,and resolving dampness.However,its underlying mechanisms remain unclear.This study aimed to elucidate how WYHZ modulates the immunometabolic microenvironment at the maternal-fetal interface in CE by targeting the MCT/HIF-1α/LDHA pathway to promote embryo implantation.Methods:In vivo,the model of CE was established by intrauterine injection of lipopolysaccharide(LPS)(1 mg/mL)into female C57/BL mice,followed by WYHZ treatment for 3 weeks to evaluate its effects on embryo implantation.Mechanistic studies were further conducted using the MCT-1 inhibitor AZD3965 and adeno-associated virus-mediated HIF-1αknockdown.In vitro,an in vitro CE model consisting of M1 macrophages and Ishikawa,as well as an in vitro embryo implantation model mediated by JAR cells,were constructed using Transwell,and the therapeutic mechanisms of WYHZ was validated using AZD3965 and lentiviral sh HIF-1αintervention.Metabolic enzyme activity assays,protein antibody microarrays,immunofluorescence,Western blotting,Seahorse analysis,and ELISA were employed.Results:WYHZ improved the immune-inflammatory microenvironment at the maternal-fetal interface by reducing pro-inflammatory cytokines and increasing anti-inflammatory factors.In parallel,WYHZ reprogrammed endometrial metabolism by enhancing glycolysis and suppressing mitochondrial oxidative phosphorylation,thereby improving endometrial receptivity and embryo implantation.Mechanistically,WYHZ activated the MCT/HIF-1α/LDHA pathway in endometrial epithelial cells,alleviating inflammatory stress and restoring receptivity.Both AZD3965 intervention and HIF-1αknockdown impaired endometrial receptivity and implantation,effects that were reversed by WYHZ.Conclusion:WYHZ modulates the immunometabolic microenvironment of the endometrium in the context of CE by targeting the activation of the MCT/HIF-1α/LDHA pathway,which improves endometrial receptivity and promotes embryo implantation.
基金supported by National Institutes of Health R03DE027492 to Shareef Dabdoubsupported by National Institutes of Health,project number 7R01DE027857-06supported by National Institutes of Health R56DE033913 awarded to Purnima Kumar.
文摘Dental implants have restored masticatory function to over 100000000 individuals,yet almost 1000000 implants fail each year due to peri-implantitis,a disease triggered by peri-implant microbial dysbiosis.Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis.Therefore,we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing,finescale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus.We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies.Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement.These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation.Unlike the periodontal microbiome,recruitment of new members to the peri-implant community occurs on nepotistic principles.Maturation is accompanied by a progressive increase in anaerobiosis,however,the predominant functionalities are oxygen-dependent over the 12-weeks.The peri-implant community is easily perturbed following crown placement,but demonstrates remarkable resilience;returning to pre-perturbation states within three weeks.This study highlights important differences in the development of the periodontal and peri-implant ecosystems,and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.
文摘Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.
文摘Objective:To assess whether personalized embryo transfer guided by endometrial receptivity array(ERA)improves implantation and pregnancy rates in women with implantation failure.Methods:This retrospective case-control study was conducted on women with previous implantation failure.The women were divided into two groups,i.e,women who underwent ERA and those who underwent embryo transfer without ERA testing.ERA was performed using Igenomix.ERA results were interpreted as receptive or non-receptive.Women underwent frozen embryo transfer on the 6th day of progesterone(P+5).The primary outcomes were implantation rate,clinical pregnancy rate,abortion rate,and negative pregnancy rate.Results:This study included 229 women with previous implantation failure,with 154 in the ERA group and 75 in the no ERA group.The mean age of the women of the ERA group was(32.2±4.1)years,and that of the no ERA group was(31.5±4.8)years.Women in the ERA group had a higher implantation rate(60.4%)and clinical pregnancy rate(57.1%)compared to those in the no ERA group(48.0%and 46.7%,respectively).In addition,implantation rate of the nonreceptive ERA group was higher than the no ERA group(65%vs.48%),and clinical pregnancy rate was also higher in the non-receptive ERA group than the no ERA group(65%vs.47%).The abortion rate of the no ERA group was 9%and that of the non-receptive ERA group was 10%.52%no ERA group women and 35%non-receptive ERA group women had negative pregnancy results.Conclusions:Women who have undergone personalised embryo transfer guided by ERA have a higher clinical pregnancy rate than women who have not after previous implantation failure.
基金Supported by the National Key Research and Development Program(No.2019YFC1710200)the Shandong Province Pharmaceutical Technology Development Project(No.202107020970).
文摘Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.
文摘Background The number of transcatheter aortic valve implantation(TAVI)procedures in patients with severe aortic stenosis(AS)is increasing worldwide.We aimed to assess the impact of a TAVI program on clinical profile,management and outcomes of these patients and to describe predictors of length of hospital stay(LoS)in this context.Methods Retrospective single center study enrolling consecutive AS patients undergoing TAVI and surviving to discharge(January 2018-December 2022).A TAVI program was implemented in may 2021.Baseline clinical characteristics,management and in-hospital complications were registered.Predictors of long hospital stay(>7 day)were assessed by binary logistic regression.Results We included 614 patients,with mean age 80.5 years.Most patients(438/614,71.2%)presented conditions that precluded an early discharge.Mean hospital stay was 7.6 days.Patients admitted after the implementation of the program had a significantly lower burden of comorbidities.The rate of conduction disturbances after TAVI remained stable around 60%.However,permanent pacemaker requirement declined from 30.3%to 22.5%(P=0.028).LoS was reduced after the implementation of the program both in patients suitable for an early discharge(from 6.5 day to 4 day,P<0.001)and unsuitable patients(from 9.4 day to 7.7 day,P=0.014).The final predictive model for LoS included prior pacemaker and availability of TAVI program as protectors and other valvular diseases,day of the week,emergent procedures,and conduction disturbances and other complications as independent predictors of long stay after TAVI.Conclusions Most patients undergoing TAVI present conditions that preclude an early hospital discharge.The implementation of a TAVI program improved selection of patients,with a lower burden of comorbidities,a lower rate of complications and a marked reduction of hospital stay.
基金financially supported by the National Natural Science Foundation of China(Nos.52272283,52311530772,and 52274387)the Science and Technology Commission of Shanghai Municipality(No.22S31902900)+4 种基金the Shanghai Medical Key Specialty(No.2024ZDXK0048)the Medical Key Subject of Xuhui District(No.SHXHZDXK202302)the National Key Research and Development Program of China(No.2024YFE0109000)the Medical-Engineering Cross Foundation of Shanghai Jiao Tong University(No.YG2024LC04)the Institute-level Research Project of Xuhui District Dental Center(No.SHXYF202212).
文摘To promote early rapid osteogenesis and prevent late implant-related infection,it is critical to develop ef-fective and reliable surface treatment technologies for enhancing both osteogenic and antibacterial prop-erties of titanium alloy implants.Reduced graphene oxide(rGO)is considered a promising modification candidate.However,whether rGO retains its osteogenic and antibacterial functions after being applied to modify titanium alloy surfaces depends on the surface treatment technology employed.In this study,rGO was integrated onto the surface of Ti-35Nb-2Ta-3Zr(TNTZ)alloy through friction stir processing(FSP),yielding a consolidated TNTZ/F-rGO composite.The incorporation of rGO not only significantly im-proved the microhardness and hydrophilicity of the material,but also exhibited positive biological effects in vitro experiments:it effectively promoted the proliferation,osteogenic differentiation,alkaline phos-phatase(ALP)production and extracellular matrix mineralization of BMSCs.Furthermore,TNTZ/F-rGO ex-hibited potent antibacterial activity via surface-contact mechanisms.In summary,the rGO-modified in-tegrated titanium alloy has excellent osteogenic properties and high-efficiency antibacterial ability.This study provides new insights and strategies for the design of graphene-based biomaterials and implant surface modification technologies.
文摘Particularly commendable is the important work of Calvo,et al.[1]in comparing geriatric assessment tools to predict mortality and readmissions in elderly patients undergoing transcatheter aortic valve implantation(TAVI).Their efforts underscore the growing importance of frailty assessment in cardiovascular risk stratification.We would like to respectfully highlight several areas that,if addressed in future studies(Figure 1),could further enhance the utility and inclusivity of these assessments.
基金supported by the Fundamental Research Funds for the Central Universities(No.2023QZJH59/226-2023-00155)the National Natural Science Foundation of China(Nos.82370990 and 82201051)+1 种基金the Medical Health Science and Technology Project of Zhejiang Provincial Health Commis-sion(No.WKJ-ZJ-2335)the Innovative Talent of Zhejiang Provincial Health Commission,the Zhejiang“Xinmiao”Tal-ents Program(No.2023R401211),China.
文摘This systematic review and meta-analysis considered the results of randomized controlled clinical trials(RCTs)to evaluate the efficacy of systemic or local antibiotic therapy in peri-implantitis.Two independent authors screened publications from three electronic databases to include RCTs meeting all the inclusion and exclusion criteria.A meta-analysis was performed to evaluate the weighted mean differences in survival rate(SR)and changes in pocket probing depth(PPD),bone level(BL),and clinical attachment level(CAL).The study cohorts were defined as antibiotic and control groups with subgroups for analysis.Seven studies including 309 patients(390 implants)were considered.Within the limitations of this review,patients in the antibiotic groups exhibited significant improvements in PPD.Subgroup analysis indicated that the administration of systemic antibiotics or the use of antibiotics in non-surgical treatments did not result in a significant alteration in BL.It was established that the addition of antibiotics can ameliorate PPD and SR in the treatment of peri-implantitis,whether through surgical or non-surgical approaches,and also shows moderate performance regarding BL and CAL.Considering the lack of application of new technologies in the control group and the hardship of assessing the potential risks of antibiotics,careful clinical judgment is still necessary.
基金supported by the National Key Research and Development Program of China(2023YFC2412600)the National Natural Science Foundation of China(52271243,52171233,82370924,82170929)+3 种基金the Beijing Natural Science Foundation(L212014)the Beijing Nova Program(20230484459)the National Clinical Key Discipline Construction Project(PKUSSNKP-T202103)the Research Foundation of Peking University School and Hospital of Stomatology(PKSS20230104).
文摘Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption,ultimately resulting in implant failure.Dental implants for clinical use barely have antibacterial properties,and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis.Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque.However,it is particularly important to prevent the occurrence of peri-implantitis rather than treatment.Therefore,the current research spot has focused on improving the antibacterial properties of dental implants,such as the construction of specific micro-nano surface texture,the introduction of diverse functional coatings,or the application of materials with intrinsic antibacterial properties.The aforementioned antibacterial surfaces can be incorporated with bioactive molecules,metallic nanoparticles,or other functional components to further enhance the osteogenic properties and accelerate the healing process.In this review,we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration.Furthermore,we summarized the obstacles existing in the process of laboratory research to reach the clinic products,and propose corresponding directions for future developments and research perspectives,so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy,biological safety,and osteogenic property.
基金supported by the National Key R&D Program of China(No.2023YFB4603500)the Program for Innovation Team of Shaanxi Province(No.2023-CX-TD-17)+1 种基金the Fundamental Research Funds for the Central Universitiesthe Shaanxi Province Qinchuangyuan“Scientist+Engineer”Team Construction Project(No.2022KXJ-106).
文摘The bioinert nature of polyether ether ketone(PEEK)material limits the widespread clinical application of PEEK implants.Although the porous structure is considered to improve osseointegration of PEEK implants,it is hardly used due to its mechanical properties.This study investigated the combined influence of the porous structure and in vivo mechanical stimulation on implantation safety and bone growth based on finite element analysis of the biomechanical behavior of the implantation system.The combined control of pore size and screw preloads allows the porous PEEK implant to achieve good osseointegration while maintaining a relatively high safety level.A pore size of 600μm and a preload of 0.05 N·m are the optimal combination for the long-term stability of the implant,with which the safety factor of the implant is>2,and the predicted percentage of effective bone growth area of the bone-implant interface reaches 97%.For further clinical application,PEEK implants were fabricated with fused filament fabrication(FFF)three-dimensional(3D)printing,and clinical outcomes demonstrated better bone repair efficacy and long-term stability of porous PEEK implants compared to solid PEEK implants.Moreover,good osteointegration performance of 3D-printed porous PEEK implants was observed,with an average bone volume fraction>40%three months after implantation.In conclusion,3D-printed porous PEEK implants have great potential for clinical application,with validated implantation safety and good osseointegration.
基金supported by National Natural Science Foundation of China(52271117)Educational Commission of Hunan Province of China(23A0107)High Technology Research and Development Program of Hunan Province of China(2022GK4038).
文摘To improve the corrosion resistance of biodegradable Mg alloys,WE43 alloys were implanted with Fe,Ti,Zn and Zr ions at the same implantation dose.The surface morphology,valence state of elements,nano-hardness(NH),elastic modulus(EM),degradation rate and in vitro cell experiments of the modified WE43 alloys were systematically studied.A modified layer composed of Mg,MgO,the implanted elements and their oxides was formed on the modified alloys.Since high-speed metal ions caused severe surface lattice damage,the surface hardness of the substrate considerable increased.Electrochemical tests demonstrated a substantial enhancement in the corrosion resistance of the modified alloys via the implantation of Ti and Zr ions,resulting in a reduction of the corrosion current density to 88.1±9.9 and 15.6±11.4μA cm^(−2),respectively,compared with the implantation of Fe and Zn ions.Biocompatibility tests showed that the implantation of Fe,Ti,Zn and Zr ions enhanced the anticoagulant and hemolytic resistance of the WE43 alloy.All surface-modified samples showed negligible cytotoxicity(0-1)at 12.5%extract concentration.Moreover,the alloys implanted with Fe,Ti and Zn ions significantly promoted proliferation of human umbilical vein endothelial cells(HUVEC)compared with the unmodified alloy.The results demonstrate that Ti ion implantation is the best choice for WE43 alloy modification to achieve outstanding corrosion resistance and biocompatibility.
