BACKGROUND Postoperative chylothorax is usually regarded as a complication associated with cardiothoracic surgery;however,it is one of the rare complications in orthopedic surgery.This case report describes a female p...BACKGROUND Postoperative chylothorax is usually regarded as a complication associated with cardiothoracic surgery;however,it is one of the rare complications in orthopedic surgery.This case report describes a female patient who developed chylothorax after a successful L4-S1 transforaminal lumbar interbody fusion surgery.The etiology,diagnosis,and treatment were analyzed and discussed.CASE SUMMARY A 50-year-old woman was admitted with repeated back and leg pain.She was diagnosed with L4 degenerative spondylolisthesis,L4/L5 and L5/S1 intervertebral disc herniation and L5 instability,and underwent successful posterior L4-S1 instrumentation and fusion surgery.Unfortunately,thoracic effusion was identified 2 d after operation.The thoracic effusion was finally confirmed to be chylous based on twice positive chyle qualitative tests.The patient was discharged after 12-d persisting drainage,3-d total parenteral nutrition and fasting,and other supportive treatments.No recurring symptoms were observed within 12 mo follow-up.CONCLUSION Differential diagnosis is crucial for unusual thoracic effusion.Comprehensive diagnosis and treatment of chylothorax are necessary.Thorough intraoperative protection to relieve high thoracic pressure caused by the prone position is important.展开更多
Mimicking the complex structure of natural bone remains a challenge for bone tissue scaffolds.In this study,a novel processing strategy was developed to prepare the bone-like scaffolds that are featured by highly orie...Mimicking the complex structure of natural bone remains a challenge for bone tissue scaffolds.In this study,a novel processing strategy was developed to prepare the bone-like scaffolds that are featured by highly oriented and fully interconnected pores.This type of biomimetic scaffolds was evolved from solid phase stretching of immiscible polycaprolactone(PCL)/poly(ethylene oxide)(PEO)blends with cocontinuous structure and the pore morphology was inherited from selective extraction of water soluble PEO phase.The pore anisotropy was readily tuned by varying the stretching strain without loss of interconnectivity.Significant promotion in preosteoblast proliferation,alkaline phosphatase activity and osteogenic gene expression was observed in the oriented porous scaffolds compared to the isotropic porous counterpart.The oriented architecture provided a topographical cue for aligned growth of preosteoblasts,which activated the Wnt/β-catenin signaling pathway.The proposed strategy enriches the toolbox for the scaffold design and fabrication for bone tissue engineering.展开更多
基金Supported by National Natural Science Foundation of China,No.81874027.
文摘BACKGROUND Postoperative chylothorax is usually regarded as a complication associated with cardiothoracic surgery;however,it is one of the rare complications in orthopedic surgery.This case report describes a female patient who developed chylothorax after a successful L4-S1 transforaminal lumbar interbody fusion surgery.The etiology,diagnosis,and treatment were analyzed and discussed.CASE SUMMARY A 50-year-old woman was admitted with repeated back and leg pain.She was diagnosed with L4 degenerative spondylolisthesis,L4/L5 and L5/S1 intervertebral disc herniation and L5 instability,and underwent successful posterior L4-S1 instrumentation and fusion surgery.Unfortunately,thoracic effusion was identified 2 d after operation.The thoracic effusion was finally confirmed to be chylous based on twice positive chyle qualitative tests.The patient was discharged after 12-d persisting drainage,3-d total parenteral nutrition and fasting,and other supportive treatments.No recurring symptoms were observed within 12 mo follow-up.CONCLUSION Differential diagnosis is crucial for unusual thoracic effusion.Comprehensive diagnosis and treatment of chylothorax are necessary.Thorough intraoperative protection to relieve high thoracic pressure caused by the prone position is important.
基金The authors gratefully acknowledge the flnancial support from the National Key R&D Program of China(No.2018YFB0704200)the National Natural Science Foundation of China(Nos.51803139,52022061,52033005 and 52003169).
文摘Mimicking the complex structure of natural bone remains a challenge for bone tissue scaffolds.In this study,a novel processing strategy was developed to prepare the bone-like scaffolds that are featured by highly oriented and fully interconnected pores.This type of biomimetic scaffolds was evolved from solid phase stretching of immiscible polycaprolactone(PCL)/poly(ethylene oxide)(PEO)blends with cocontinuous structure and the pore morphology was inherited from selective extraction of water soluble PEO phase.The pore anisotropy was readily tuned by varying the stretching strain without loss of interconnectivity.Significant promotion in preosteoblast proliferation,alkaline phosphatase activity and osteogenic gene expression was observed in the oriented porous scaffolds compared to the isotropic porous counterpart.The oriented architecture provided a topographical cue for aligned growth of preosteoblasts,which activated the Wnt/β-catenin signaling pathway.The proposed strategy enriches the toolbox for the scaffold design and fabrication for bone tissue engineering.
