Interlayer repair with porcine small intestinal submucosa versus internal repair with tragus cartilage in endoscopic tympanoplasty

Objective Endoscopic tympanoplasty includes various surgical methods,such as internal repair,interlayer repair,and external overlay.This technique requires autologous materials,allografts,and xenografts,which are used to repair tympanic membrane(TM)perforation.To obtain good results,appropriate surgical methods and repair materials should be selected.This study aims to assess the efficacy of repairing refractory TM perforations in the porcine small intestinal submucosa(SIS)during transcanal endoscopic type I tympanoplasty.Method A retrospective chart review was performed on patients who underwent TM perforation repair with porcine SIS and tragus cartilage between January 2022 and September 2022 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Perforation size,tympanic status,pre-and postoperative symptoms,follow-up data,wound healing rates,and hearing improvement were analysed.Results Of the 115 patients included in the study,56 underwent interlayer repair with porcine SIS of the TM,and 59 patients underwent internal repair with tragus cartilage.No significant difference was found between the two groups at baseline in terms of age,sex,disease course,perforation side,tympanic status,underlying disease,or preoperative infection.The total postoperative effective rate of interlayer implantation with porcine SIS was 91.07%(51 patients),and that of internal implantation with tragus cartilage was 88.14%(52 patients).No significant difference was found in terms of the graft success rate between the two surgical methods(p=0.887).Postoperative pure tone auditory(PTA)and air-bone gap(ABG)density significantly increased in both groups compared with before surgery(p<0.05).However,the postoperative PTA and ABG density were not significantly different 3 months post-surgery between the two groups(p>0.05).Compared to those in the internal implantation group,the patients in the interlayer group had a shorter operation duration(51.36±6.76 min vs.59.71±7.45 min,t=6.298,p<0.001)and less blood loss(11.91±2.61 mL vs.15.27±2.57 mL,t=7.019,p<0.001).Conclusions Our study suggests that the porcine SIS,as well as the tragus cartilage,has a high success rate in repairing irreversible TM perforation.Endoscopic tympanoplasty via interlayer implantation with porcine SIS offers distinct advantages,including the absence of donor-site incision and scar formation,and ease of graft modification and manipulation.

Efficacy of mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection

BACKGROUND We recently developed a new endoscopic closure technique using only conventional endo-clips for colorectal lesions.Little is known about the feasibility of the endoscopic mucosa-submucosa clip closure method for gastric lesions.AIM To elucidate the efficacy of the endoscopic mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection(ESD).METHODS Twenty-two patients who underwent gastric ESD and mucosa-submucosa clip closure were included in this study.In this method,endo-clips are placed at the edges of a mucosal defect.Additional endo-clips are then applied in the same way to facilitate reduction of the defect size.Additional endo-clips are applied to both sides of the mucosal defect.Complete closure can be achieved.We have also developed a“location score”and“closure difficulty index”for assessment purposes.RESULTS Complete closure was achieved in 68.2%of the patients(15/22).The location score in the failure group was significantly larger than that in the complete closure group(P=0.023).The closure difficulty index in the failure group was significantly higher than that in the complete closure group(P=0.007).When the cutoff value of the closure difficulty index was set at 99,the high closure difficulty index predicted failure with a sensitivity of 57.1%,specificity of 100%,and accuracy of 86.3%.CONCLUSION The endoscopic mucosa-submucosa clip closure method was unreliable after gastric ESD,especially in cases with a high closure difficulty index.

Gastric Submucosa Is Inferior to the Liver as Transplant Site for Autologous Islet Transplantation in Pancreatectomized Diabetic Beagles

Intraportal transplantation of islets is no longer considered to be an ideal procedure and finding the extrahepatic alternative site is becoming a subject of high priority. Herein, in this study, we would introduce our initial outcomes of using gastric submucosa（GS） and liver as sites of islet autotransplantation in pancreatectomized diabetic Beagles. Total pancreatectomy was performed in Beagles and then their own islets extracted from the excised pancreas were transplanted into GS（GS group, n=8） or intrahepatic via portal vein（PV group, n=5）. Forty-eight hours post transplantation, graft containing tissue harvested from the recipients revealed the presence of insulin-positive cells. All recipients in GS group achieved euglycemia within 1 day, but returned to a diabetic state at 6 to 8 days post-transplantation（mean survival time, 7.16±0.69 days）. However, all of the animals kept normoglycemic until 85 to 155 days post-transplantation in PV group（mean survival time, 120±28.58 days; P〈0.01 vs. GS group）. The results of intravenous glucose tolerance test（IVGTT） confirmed that the marked improvement in glycometabolism was obtained in intrahepatic islet autotransplantation. Thus, our findings indicate that the liver is still superior to the GS as the site of islet transplantation, at least in our islet autotransplant model in pancreatectomized diabetic Beagles.

Small intestinal submucosa improves islet survival and function during in vitro culture

AIM： To evaluate the recovery and function of isolated rat pancreatic islets during in vitro culture with small intestinal submucosa （SIS）. METHODS： Pancreatic islets were isolated from Wistar rats by standard surgical procurement followed by intraductal collagenase distension, mechanical dissociation and Euroficoll purification. Purified islets were cultured in plates coated with multilayer SIS （SIS-treated group） or without multilayer SIS （standard cultured group） for 7 and 14 d in standard islet culture media of RPMI 1640. After isolation and culture, islets from both experimental groups were stained with dithizone and counted. Recovery of islets was determined by the ratio of counts after the culture to the yield of islets immediately following islet isolation. Viability of islets after the culture was assessed by the glucose challenge best with low （2.7 mmol/L） and high glucose （16.7 mmol/L） solution supplemented with 50 mmol/L 3-isobutyl-1- methylxanthine （IBMX） solution. Apoptosis of islet cells after the culture was measured by relative quantification of histone-complexed DNA fragments using ELISA. RESULTS： After 7 or 14 d of in vitro tissue culture, the recovery of islets in SIS-treated group was significantly higher than that cultured in plates without SIS coating. The recovery of islets in SIS-treated group was about twice more than that of in the control group. In SIS treated group, there was no significant difference in the recovery of islets between short- and long-term periods of culture （95.8±1.0% vs 90.8±1.5%, P〉0.05）. When incubated with high glucose （16.7 mmol/L） solution, insulin secretion in SIS-treated group showed a higher increase than that in control group after 14 d of culture （20.7±1.1 mU/L vs 11.8±1.1 mU/L, P〈0.05）. When islets were placed in high glucose solution containing IBMX, stimulated insulin secretion was higher in SlS-treated group than in control group. Calculated stimulation index of SlS-treated group was about 23 times of control group. In addition, the stimulation index of SlS-treated group remained constant regardless of short- and long- term periods of culture （9.5±0.2 vs 10.2±1.2, P〉0.05）. Much less apoptosis of islet cells occurred in SlS-treated group than in control group after the culture. CONCLUSION： Co-culture of isolated rat islets with native sheet-like SIS might build an extracellular matrix for islets and provide possible biotrophic and growth factors that promote the recovery and subsequent function of islets.

Effect of small intestinal submucosa on islet recovery and function in vitro culture

BACKGROUND: The ability to maintain isolated human islet preparation in tissue culture has recently been adopted by most islet transplant centers to improve the safety and practicality of islet transplantation. However, maintaining islet viability and recovery remains a challenge in clinical setting. Extracellular matrix (ECM) is one of the most important components of islet microenvironment. The reconstruction of the cell-matrix relationship seems to be effective in improving the loss of differentiated islet structure and function. Small intestinal submucosa ( SIS ) , a naturally occurring ECM, has been investigated to be able to promote wound healing, tissue remodeling, and cell growth. The purpose of this study was to evaluate the recovery and function of isolated rat pancreatic islets after in vitro culture with SIS. METHODS: Pancreatic islets were isolated from Wistar rats by using standard surgical procurement followed by intra-ductal collagenase distension, mechanical dissociation, and EuroFicoll purification. Groups of purified islets were cultured in plates which were coated with multilayer SIS (SIS-treated group) or without ( standard cultured group) for 7 days and 14 days in standard islet culture conditions of RP-MI 1640 tissue culture media in humidified atmosphere containing 95% air and 5% CO2 at 37 ℃. The mean recovery of islets after the culture period was determined by sizing duplicate counts of a known volume and their viability was assessed by static incubation with low glucose (2.7 mmol) , high glucose (16.7 mmol) and high glucose solution supplemented with 50 μm 3-isobutyl-1-methylxanthine (IB-MX) solution. RESULTS: After 7 days and 14 days of in vitro tissue culture, the SIS-treated group showed a significantly higher recovery compared with those cultured under standard conditions. The recovery in the SIS-treated group was about two times of the control group cultured in standard conditions after 14 days culture. In the SIS-treated group, there was no statistically difference between the short and long periods of culture ( 95. 8 ± 1.0% vs. 90. 8±1. 5% , P 】 0.05). During incubation in high glucose (16.7 mmol) solution, there was a 2-3 fold increase in insulin secretion from both groups, but the SIS-treated group showed a higher increase than the standard cultured group after 14-day culture (20.7 ±1.1 mU/L vs. 11. 8 ±1.1 mU/L, P 【 0. 05). When islets were placed in the high glucose solution supplemented with IBMX, the stimulated insulin response in the SIS-treated group was higher than that in the standard cultured group in spite of the duration of the culture. The stimulation index of the SIS-treated group was about 2-3 times of the standard cultured group. In addition , after a long period of culture, the stimulation index of the SIS-treated group was statistically equivalent with that of the short period of culture (9.5 ±0.2 vs. 10.2 ±1.2, P】0.05). CONCLUSIONS: The co-culture of isolated rat islets with native sheet-like SIS can provide an excellent extracellular matrix, possible biotrophic and growth factors that promote the recovery and subsequent function of islets after in vitro tissue culture. In view of results of this study and rapid degradation of SIS in vitro, future studies will investigate the extended duration of culture and the effect of SIS on islets in vitro.

Abnormal Change in Arterial Blood Pressure after Adrenaline-Containing in Lidocaine Infiltrated into Oral Submucosa during General Anesthesia

Sudden severe hypotension also occurs in an otherwise stable surgery when adrenaline-containing in lidocaine is infiltrated and care must be taken when using adrenaline-containing in lidocaine because it occasionally induces several adverse reactions. We report the case of a 16-year-old man who scheduled for oral surgery in which abnormal arterial blood pressure changes occurred after adrenaline-containing in lidocaine infiltrated into oral submucosa.

Use of small intestinal submucosa graft for repair of anterior urethral strictures

Objective To investigate the feasibility of using small intestinal submucosa ( SIS) graft for repair of anterior urethral strictures. Methods From June 2009 to August 2010,18 men ( mean age,38 yrs) with anterior urethral strictures underwent urethroplasty using a four layer SIS as an onlay patch graft. SIS was used to

Bioactive mineralized small intestinal submucosa acellular matrix/PMMA bone cement for vertebral bone regeneration

Polymethylmethacrylate(PMMA)bone cement extensively utilized for the treatment of osteoporotic vertebral compression fractures due to its exceptional handleability and mechanical properties.Nevertheless,the clinical application of PMMA bone cement is restricted by its poor bioactivity and excessively high modulus of elasticity.Herein,mineralized small intestinal submucosa(mSIS)was incorporated into PMMA to prepare a partially degradable bone cement(mSIS-PMMA)that provided suitable compressive strength and reduced elastic modulus compared to pure PMMA.The ability of mSIS-PMMA bone cement to promote the attachment,proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells was shown through cellular experiments carried out in vitro,and an animal osteoporosis model validated its potential to improve osseointegration.Considering these benefits,mSIS-PMMA bone cement shows promising potential as an injectable biomaterial for orthopedic procedures that require bone augmentation.

超声评估心力衰竭患者胃肠壁淤血程度的应用价值

目的探讨超声评估心力衰竭患者胃肠壁淤血程度的应用价值。方法招募2023年8月至10月首都医科大学附属北京安贞医院收治的心力衰竭患者32例作为心衰组,另选择同期无心脏疾病的健康人群33名作为对照组。通过胃肠超声及腹部超声测量两组的胃壁、胃壁黏膜下层、肠壁厚度,以及下腔静脉内径、肝静脉内径、门静脉内径、肠系膜上静脉内径。对心衰组进行超声心动图检查,测量左心室射血分数(LVEF)、右室三尖瓣环收缩期位移(TAPSE)及肺动脉收缩压。比较两组临床资料,分析心衰组患者胃肠壁厚度与腹部静脉内径、心脏功能指标间的相关性。结果心衰组患者胃壁厚度、胃壁黏膜下层厚度、肠壁厚度较对照组增厚,下腔静脉内径、肝静脉内径、门静脉内径、肠系膜上静脉内径较对照组增宽,差异有统计学意义(P<0.05)。心衰组患者LVEF为45.5(25.0,57.7)%,TAPSE为16.0(11.0,18.0)mm,肺动脉收缩压为43.5(28.5,59.0)mmHg。心衰组患者胃壁厚度与TAPSE呈负相关(P<0.05),与门静脉内径呈正相关(P<0.05);胃壁黏膜下层厚度与TAPSE呈负相关(P<0.05),与肺动脉收缩压、下腔静脉内径、肝静脉内径、门静脉内径呈正相关(P<0.05);肠壁厚度与TAPSE呈负相关(P<0.05),与下腔静脉内径、肝静脉内径、门静脉内径呈正相关(P<0.05)。心衰组患者胃壁厚度、胃壁黏膜下层厚度、肠壁厚度与LVEF相关性不显著(P>0.05)。结论超声可以实时监测心衰患者胃肠壁及胃壁黏膜下层厚度指标,可作为评估心衰患者胃肠壁淤血程度的影像学方法。

不同种类聚合物对猪小肠黏膜下层支架仿生矿化的影响

目的:探究不同种类的聚合物对脱细胞猪小肠黏膜下层(small intestinal submucosa,SIS)支架体外仿生矿化的影响,并基于理化性能和生物相容性指标评价各组SIS矿化支架。方法:将冷冻干燥法制备而成的SIS支架分别浸泡在模拟体液(simulated body fluid,SBF)、含聚丙烯酸(polyacrylic acid,PAA)的矿化液和同时含PAA和聚天冬氨酸(polyaspartic acid,PASP)的矿化液中持续2周,隔天换液,依次得到SBF@SIS、PAA@SIS、PAA/PASP@SIS支架,以未矿化的SIS支架为对照组,评价上述支架的理化性能及生物相容性。结果:环境扫描电子显微镜(environment scanning electron microscopy,ESEM)下各组支架均呈适宜孔径的三维多孔结构,各组矿化支架均可见晶体附着,其中以PAA/PASP@SIS支架晶体沉积更为规则,同时可见胶原纤维增粗。能谱分析显示,3组矿化支架均可见钙、磷元素的特征峰,以PAA/PASP@SIS支架峰值最高;傅里叶变换红外光谱分析证实,3组矿化支架均实现了羟基磷灰石与SIS结合;各组支架均具有良好的亲水性;3组矿化支架压缩强度均高于对照组,以PAA/PASP@SIS支架压缩强度最优;各组支架均能有效吸附蛋白,以PAA/PASP@SIS组吸附能力最佳。CCK-8细胞增殖实验(周期为1、3、5、7、9 d)中,PAA/PASP@SIS组展现出最佳的促细胞增殖能力。结论:经同时含PAA和PASP的矿化液制备的PAA/PASP@SIS支架与其他矿化支架相比具有更优的理化性能和生物相容性,具有骨组织工程应用的潜能。

Porcine Small Intestinal Submucosa Mesh for Treatment of Pelvic Organ Prolapsed

Background：Pelvic organ prolapse （POP） is a major health concern that affects women.Surgeons have increasingly used prosthetic meshes to correct POP.However,the most common used is synthetic mesh,and absorbable mesh is less reported.This research aimed to evaluate the clinical effectiveness of porcine small intestinal submucosa （SIS）.Methods：Consecutive forty POP patients who met the inclusion criteria underwent pelvic reconstruction surgery with SIS between March 2012 and December 2013.The patients＆#39; clinical characteristics were recorded preoperatively.Surgical outcomes,measured by objective and subjective success rates,were investigated.We evaluated the quality of life （QOL） using the Pelvic Floor Distress Inventory-20 （PFDI-20） and the Pelvic Floor Impact Questionnaire-7 （PFIQ-7）.Sexual QOL was assessed by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 （P1SQ-12）.Results：At postoperative 12 months,the subjective recurrence rate （7.5%） was much lower than the objective recurrence rate （40.0%）.Postoperatively,no erosion was identified.One underwent a graft release procedure because of urinary retention,and one had anus sphincter reconstruction surgery due to defecation urgency.Another experienced posterior vaginal wall infection where the mesh was implanted,accompanied by severe vaginal pain.Estrogen cream relieved the pain.One patient with recurrence underwent a secondary surgery with Bard Mesh because of stage 3 anterior vaginal wall prolapse.Scoring system of PFDI-20 was from 59.150 ± 13.143 preoperatively to 8.400 ± 4.749 postoperatively and PFIQ-7 was from 73.350 ± 32.281 to 7.150 ± 3.110,while PISQ-12 was from 15.825 ± 4.050 to 12.725 ± 3.471.Conclusions：QOL and the degree of subjective satisfaction were significantly improved postoperatively.Anterior repair deserves more attention because of the higher recurrence rate.The long-term follow-up of the patient is warranted to draw firm conclusion.

Use of porcine small intestinal submucosa for pediatric endoscopic tympanic membrane repair

Tympanic membrane perforationsoccur frequently in children,and can result in hearing loss,otorrhea,pain,and cholesteatoma.Due to the narrower ear canal in children,a postauricular incision is often needed to access the tympanic membrane for surgical repair.Endoscopic approaches are increasingly being used for tympanic membrane repair,reducing the need for postauricular incisions.As the need for a postauricular incision decreases,the demand for non-autologous grafting material has increased.Acellular porcine small intestinal submucosa (SIS) has been described in the literature as an alternative to commonly used autologous grafts,and is well suited for use with transcanal endoscopic ear surgery as a minimally invasive approach.This paper describes techniques for use of SIS in endoscopic tympanic membrane repair in children.

Tissue engineered esophagus by copper——small intestinal submucosa graft for esophageal repair in a canine model

Acellular porcine small intestinal submucosa(SIS)has been used for esophagoplasty with success in a canine model.However,it did not lead to complete epithelialization.For better reconstruction,a cellular component is required.Moreover,promotion of angiogenesis with copper has been widely recognized by basic research as well as clinical studies.In this study,we have evaluated the feasibility and effectiveness of combined Cu and SIS(SIS-Cu patch)for the esophageal repair using a canine model.Eighteen male beagle dogs were subjected to surgical resection to produce cervical esophageal defects(5 cm in length,180°in range).SIS with Cu(5 or 25μmol L 1copper)or without Cu was patched on the esophageal defects.Barium esophagram and histology exam were carried out to evaluate the effectiveness of the therapy.As shown,the SIS-Cu graft promoted re-epithelialization,re-vascularization and muscular regeneration.SIS-Cu patch is more effective than SIS alone for esophageal repair,and the SIS+25μmol L 1Cu group demonstrated additional advantages over the SIS+5μmol L 1Cu.

Surface modification of small intestine submucosa in tissue engineering

With the development of tissue engineering,the required biomaterials need to have the ability to promote cell adhesion and proliferation in vitro and in vivo.Especially,surface modification of the scaffold material has a great influence on biocompatibility and functionality of materials.The small intestine submucosa(SIS)is an extracellular matrix isolated from the submucosal layer of porcine jejunum,which has good tissue mechanical properties and regenerative activity,and is suitable for cell adhesion,proliferation and differentiation.In recent years,SIS is widely used in different areas of tissue reconstruction,such as blood vessels,bone,cartilage,bladder and ureter,etc.This paper discusses the main methods for surface modification of SIS to improve and optimize the performance of SIS bioscaffolds,including functional group bonding,protein adsorption,mineral coating,topography and formatting modification and drug combination.In addition,the reasonable combination of these methods also offers great improvement on SIS surface modification.This article makes a shallow review of the surface modification of SIS and its application in tissue engineering.

Procyanidins-crosslinked small intestine submucosa: A bladder patch promotes smooth muscle regeneration and bladder function restoration in a rabbit model

Currently the standard surgical treatment for bladder defects is augmentation cystoplasty with autologous tissues,which has many side effects.Biomaterials such as small intestine submucosa(SIS)can provide an alternative scaffold for the repair as bladder patches.Previous studies have shown that SIS could enhance the capacity and compliance of the bladder,but its application is hindered by issues like limited smooth muscle regeneration and stone formation since the fast degradation and poor mechanical properties of the SIS.Procyanidins(PC),a natural bio-crosslinking agent,has shown anti-calcification,anti-inflammatory and anti-oxidation properties.More importantly,PC and SIS can crosslink through hydrogen bonds,which may endow the material with enhanced mechanical property and stabilized functionalities.In this study,various concentrations of PC-crosslinked SIS(PC-SIS)were prepared to repair the full-thickness bladder defects,with an aim to reduce complications and enhance bladder functions.In vitro assays showed that the crosslinking has conferred the biomaterial with superior mechanical property and anti-calcification property,ability to promote smooth muscle cell adhesion and upregulate functional genes expression.Using a rabbit model with bladder defects,we demonstrated that the PC-SIS scaffold can rapidly promote in situ tissue regrowth and regeneration,in particular smooth muscle remodeling and improvement of urinary functions.The PC-SIS scaffold has therefore provided a promising material for the reconstruction of a functional bladder.

Co-administration of platelet-rich plasma and small intestinal submucosa is more beneficial than their individual use in promoting acute skin wound healing

Background:Acute skin wounds may compromise the skin barrier,posing a risk of infection.Small intestinal submucosa(SIS)is widely used to treat acute and chronic wounds.However,the efficacy of SIS to accelerate wound healing still needs to be improved to meet clinical demands.To tackle this problem,platelet-rich plasma(PRP)is used due to its potency to promote proliferation,migration and adhesion of target cells.In this study,we applied PRP and SIS to skin wounds to explore their effects on wound healing by evaluating re-epithelialization,collagen production,angiogenesis and the inflammatory response.Methods:A1×1-cm full-thickness skin defectwas established in mice.Sixty mice were divided into four treatment groups:PRP+SIS,PRP,SIS and control.On days 3,5,7,10 and 14 post-surgery,tissue specimens were harvested.Haematoxylin and eosin,Masson’s trichrome,immunohistochemical and immunofluorescence double staining were used to visualize epidermal thickness,collagen and vascular regeneration and inflammation.Results:Wound contraction in the PRP and PRP+SIS groups was significantly greater,compared with the other groups,on days 3 and 5 post-surgery.A histological analysis showed higher collagen expression in the PRP and PRP+SIS groups on day 7,whichwas associated with a thicker epidermal layer on day 14.In addition,immunohistochemical staining showed that CD31-positive blood vessels and vascular endothelial growth factor expression in the PRP+SIS and PRP groups were significantly higher,compared with the control group.Furthermore,immunofluorescence double staining showed that the number of M1 and M2 macrophages in the PRP+SIS and PRP groups was higher,compared with the control and SIS groups alone,on day 3.However,on day 7,the number of M1 macrophages dramatically decreased in the PRP+SIS and PRP groups.The ratio of M2 to M1 macrophages in the PRP+SIS and PRP groups was 3.97 and 2.93 times that of the control group and 4.56 and 3.37 times that of the SIS group,respectively.Conclusion:Co-administration of SIS and PRP has a better effect on promoting angiogenesis,reepithelialization and collagen regeneration in managing acute wound healing than either agent alone.

Accelerating ESD-induced gastric ulcer healing using a pH-responsive polyurethane/small intestinal submucosa hydrogel delivered by endoscopic catheter

Endoscopic submucosal dissection(ESD)is the standard treatment for early-stage gastric cancer,but the large post-operative ulcers caused by ESD often lead to serious side effects.Post-ESD mu-cosal repair materials provide a new option for the treatment of post-ESD ulcers.In this study,we developed a polyurethane/small intestinal submucosa(PU/SIS)hydrogel and investigated its effi-cacy for accelerating ESD-induced ulcer healing in a canine model.PU/SIS hydrogel possessed great biocompatibility and distinctive pH-sensitive swelling properties and protected GES-1 cells from acid attack through forming a dense film in acidic conditions in vitro.Besides,PU/SIS gels present a strong bio-adhesion to gastric tissues under acidic conditions,thus ensuring the reten-tion time of PU/SIS gels in vivo.In a canine model,PU/SIS hydrogel was easily delivered via endoscopy and adhered to the ulcer sites.PU/SIS hydrogel accelerated gastric ulcer healing at an early stage with more epithelium regeneration and slight inflammation.Our findings reveal PU/SIS hydrogel is a promising and attractive candidate for ESD-induced ulcer repair.

Decellularized small intestine submucosa/polylactic-co-glycolic acid composite scaffold for potential application in hypopharyngeal and cervical esophageal tissue repair

There has been an increase in the incidence of hypopharyngeal and cervical esophageal cancer worldwide,and hence growing needs for hypopharyngeal and cervical esophageal tissue repair.This work produced a bi-layer composite scaffold with decellularized small intestine submucosa and polylactic-co-glycolic acid,which resembled the layered architectures of its intended tissues.The decellularized small intestine submucosa contained minimal residual DNA(52.5±61.2 ng/mg)and the composite scaffold exhibited satisfactory mechanical properties(a tensile modulus of 21.1±64.8 MPa,an ultimate tensile strength of 14.0±62.9MPa and a failure strain of 26.9±65.1%).The interactions between cells and the respective layers of the scaffold were characterized by CCK-8 assays,immunostaining and Western blotting.Desirable cell proliferation and phenotypic behaviors were observed.These results have provided an important basis for the next-step in vivo studies of the scaffold,and bode well for its future clinical applications.

小肠黏膜下层可吸收生物膜在牙槽骨缺损修复中的应用效果评价

目的:探讨小肠黏膜下层(small intestinal submucosa,SIS)可吸收生物膜在牙槽骨缺损修复的临床疗效。方法:选择2020年1月—2022年1月接受引导骨再生术(guided bone regeneration,GBR)的102例牙槽骨缺损患者,采用计算机随机数字生成器分为Bio-Gide组(51例,采用Bio-Gide可吸收生物膜)和SIS组(51例,采用SIS可吸收生物膜)。比较2组围术期相关指标、血钙、血磷、生物相容性、牙周附着丧失(periodontal attachment loss,PAL)长度、牙髓敏感度、牙松动度、牙槽骨骨量及不良事件。采用SPSS 24.0软件包对数据进行统计学分析。结果:2组手术时间、术中出血量、术后第1天疼痛视觉模拟量表(VAS)评分、术后第5天VAS评分,术前、术后1 d、术后12 d血钙、血磷水平,术前、术后3个月、术后6个月、术后12个月PAL长度,术后3、6、12个月牙髓敏感度及牙松动度1级、2级百分率,术后12个月骨宽度增加量、骨高度增加量,不良事件发生率相比,差异均无统计学意义(P>0.05)。与Bio-Gide组相比,SIS组创口愈合时间、生物膜吸收时间显著缩短(P<0.05),术后12 d排异反应发生率显著降低(P<0.05)。结论:SIS可吸收生物膜、Bio-Gide可吸收生物膜在牙槽骨缺损修复GBR中的效果及安全性相当,但前者生物相容性更佳,后者可提供更长时间的屏障功能。

小肠黏膜下层复合纳米羟基磷灰石海绵组织工程材料制备及其性能评价

目的制备一种新型猪小肠黏膜下层(small intestinal submucosal,SIS)复合纳米羟基磷灰石(nano-hydroxyapatite,nHA)海绵材料并对其性能进行初步评价,为骨组织工程修复骨缺损提供支架选择。方法采用冷冻干燥法,根据SIS与nHA比重(1:0、1:1、1:2和1:4)制备4种支架分为SIS组、SIS:nHA=1:1组、SIS:nHA=1:2组和SIS:nHA=1:4组。对其进行理化性能和生物相容性评价。结果制备出的4组支架材料均为疏松多孔的海绵状支架材料。SIS组、SIS:nHA=1:1组、SIS:nHA=1:2组和SIS:nHA=1:4组材料孔隙率分别为(93.01±3.14)%、(86.35±12.19)%、(81.28±3.07)%和(68.12±4.22)%,且随着nHA比重增加孔隙率逐渐降低(P<0.05);吸水膨胀率分别为(864.88±235.70)%、(1029.68%±268.40)%、(1169.76±104.15)%和(1023.38±68.99)%,4组比较差异无统计学意义(P>0.05);弹性模量分别为(77.67±22.94)kPa、(132.67±21.83)kPa、(159.33±18.01)kPa和(301.33±76.43)kPa,随着nHA比重增加材料压缩模量逐渐增加,SIS:nHA各组压缩模量显著高于SIS组(P<0.05)。SIS组、SIS:nHA=1:1组和SIS:nHA=1:2组细胞毒性较低,SIS:nHA=1:4组具有一定的细胞毒性。结论SIS海绵中增加nHA可显著提高支架材料强度,SIS:nHA=1:2可作为骨组织工程中较为合适的支架选择。