加速康复外科(enhanced recovery after surgery,ERAS)旨在通过采用一系列有循证医学证据的围手术期优化处理措施,减少手术患者生理和心理的应激,从而使患者从疾患和手术应激状态快速恢复。近年来,ERAS理念在国内外发展迅速,多项研究表...加速康复外科(enhanced recovery after surgery,ERAS)旨在通过采用一系列有循证医学证据的围手术期优化处理措施,减少手术患者生理和心理的应激,从而使患者从疾患和手术应激状态快速恢复。近年来,ERAS理念在国内外发展迅速,多项研究表明,ERAS理念的实施可以缩短患者的住院时间,降低并发症发生率和再入院率,减少医疗费用。目前,在"白求恩公益基金会创伤骨科专业委员会"的组织下,已有一系列ERAS理念下创伤骨科常见骨折诊疗方案优化的专家共识发表,为指导和规范ERAS理念下骨折的治疗发挥了重要作用。该专家共识为此系列共识之一。胫骨平台骨折是创伤骨科比较常见且治疗困难的骨折之一,通过长期临床实践和研究,国内外医生、学者对于胫骨平台骨折的诊治取得了很多的成果和方法。ERAS理念的引入,可以为胫骨平台骨折的诊治提供更全面的平台,也为诊疗方法的选择和优化提供了更为明确的导向和标准。因此,经全国创伤骨科专家代表讨论,在循证医学基础上,以ERAS理念为指导,特制定本共识。该共识适用于成年人新鲜闭合性胫骨平台骨折(手术距伤后3周内)患者。展开更多
Background The initial osteoblastic adhesion to materials characterizes the first phase of cell-material interactions and influences all the events leading to the formation of new bone. In a previous work, we develope...Background The initial osteoblastic adhesion to materials characterizes the first phase of cell-material interactions and influences all the events leading to the formation of new bone. In a previous work, we developed a novel amorphous calcium phosphate （ACP）/poly（L-lactic acid） （PLLA） material that demonstrated morphologic variations in its microstructure. The aim of this study was to investigate the initial interaction between this material and osteoblastic cells. Cellular attachment and the corresponding signal transduction pathways were investigated. Methods A porous ACP/PLLA composite and PLLA scaffold （as a control） were incubated in fetal bovine serum （FBS） containing phosphate-buffered saline （PBS）, and the protein adsorption was determined. Osteoblastic MG63 cells were seeded on the materials and cultured for 1, 4, 8, or 24 hours. Cell attachment was evaluated using the MTS method. Cell morphology was examined using scanning electron microscopy （SEM）. The expression levels of the genes encoding integrin subunits αl, α5, αv, β1, focal adhesion kinase （FAK）, and glyceraldehyde-3-phosphate dehydrogenase （GAPDH） were determined using real-time reverse transcription polymerase chain reaction （RT-PCR）. Results The ACP/PLLA material significantly increased the protein adsorption by 6.4-fold at 1 hour and 2.4-fold at 24 hours, compared with the pure PLLA scaffold. The attachment of osteoblastic cells to the ACP/PLLA was significantly higher than that on the PLLA scaffold. The SEM observation revealed a polygonal spread shape of cells on the ACP/ PLLA, with the filopodia adhered to the scaffold surface. In contrast, the cells on the PLLA scaffold exhibited a spherical or polygonal morphology. Additionally, real-time RT-PCR showed that the genes encoding the integrin subunits αl, αv, β1, and FAK were expressed at higher levels on the ACP/PLLA composite. Conclusions The ACP/PLLA composite promoted protein adsorption and osteoblastic adhesion. The enhanced cell adhesion may be mediated by the binding of integrin subunits αl, αv, and β1, and subsequently may be regulated through the FAK signal transduction pathways.展开更多
文摘加速康复外科(enhanced recovery after surgery,ERAS)旨在通过采用一系列有循证医学证据的围手术期优化处理措施,减少手术患者生理和心理的应激,从而使患者从疾患和手术应激状态快速恢复。近年来,ERAS理念在国内外发展迅速,多项研究表明,ERAS理念的实施可以缩短患者的住院时间,降低并发症发生率和再入院率,减少医疗费用。目前,在"白求恩公益基金会创伤骨科专业委员会"的组织下,已有一系列ERAS理念下创伤骨科常见骨折诊疗方案优化的专家共识发表,为指导和规范ERAS理念下骨折的治疗发挥了重要作用。该专家共识为此系列共识之一。胫骨平台骨折是创伤骨科比较常见且治疗困难的骨折之一,通过长期临床实践和研究,国内外医生、学者对于胫骨平台骨折的诊治取得了很多的成果和方法。ERAS理念的引入,可以为胫骨平台骨折的诊治提供更全面的平台,也为诊疗方法的选择和优化提供了更为明确的导向和标准。因此,经全国创伤骨科专家代表讨论,在循证医学基础上,以ERAS理念为指导,特制定本共识。该共识适用于成年人新鲜闭合性胫骨平台骨折(手术距伤后3周内)患者。
基金The present study was supported by grants from the Natural Science Foundation of China （No. 81201414 and No. 81101377）, the Doctoral Fund of the Ministry of Education of China （No. 20100101120132）, and the Natural Science Grants of the Zhejiang Province （No. LQ14H060001）.
文摘Background The initial osteoblastic adhesion to materials characterizes the first phase of cell-material interactions and influences all the events leading to the formation of new bone. In a previous work, we developed a novel amorphous calcium phosphate （ACP）/poly（L-lactic acid） （PLLA） material that demonstrated morphologic variations in its microstructure. The aim of this study was to investigate the initial interaction between this material and osteoblastic cells. Cellular attachment and the corresponding signal transduction pathways were investigated. Methods A porous ACP/PLLA composite and PLLA scaffold （as a control） were incubated in fetal bovine serum （FBS） containing phosphate-buffered saline （PBS）, and the protein adsorption was determined. Osteoblastic MG63 cells were seeded on the materials and cultured for 1, 4, 8, or 24 hours. Cell attachment was evaluated using the MTS method. Cell morphology was examined using scanning electron microscopy （SEM）. The expression levels of the genes encoding integrin subunits αl, α5, αv, β1, focal adhesion kinase （FAK）, and glyceraldehyde-3-phosphate dehydrogenase （GAPDH） were determined using real-time reverse transcription polymerase chain reaction （RT-PCR）. Results The ACP/PLLA material significantly increased the protein adsorption by 6.4-fold at 1 hour and 2.4-fold at 24 hours, compared with the pure PLLA scaffold. The attachment of osteoblastic cells to the ACP/PLLA was significantly higher than that on the PLLA scaffold. The SEM observation revealed a polygonal spread shape of cells on the ACP/ PLLA, with the filopodia adhered to the scaffold surface. In contrast, the cells on the PLLA scaffold exhibited a spherical or polygonal morphology. Additionally, real-time RT-PCR showed that the genes encoding the integrin subunits αl, αv, β1, and FAK were expressed at higher levels on the ACP/PLLA composite. Conclusions The ACP/PLLA composite promoted protein adsorption and osteoblastic adhesion. The enhanced cell adhesion may be mediated by the binding of integrin subunits αl, αv, and β1, and subsequently may be regulated through the FAK signal transduction pathways.
