Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue.Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment.Microbes have evolved n...Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue.Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment.Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host,such as drug-resistant bacteria,biofilms,persister cells,intracellular bacteria,and small colony variants(SCVs).Moreover,microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process,leading to impaired bone defect repair.Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade,challenges remain in clinical management.The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections,but a comprehensive review of their research progress is lacking.This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration,and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections.It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.展开更多
The biodegradable substitution materials for bone tissue engineering have been a research hotspot.As is known to all,the biodegradability,biocompatibility,mechanical properties and plasticity of the substitution mater...The biodegradable substitution materials for bone tissue engineering have been a research hotspot.As is known to all,the biodegradability,biocompatibility,mechanical properties and plasticity of the substitution materials are the important indicators for the application of implantation materials.In this article,we reported a novel binary substitution material by blending the poly(lactic-acid)-co-(trimethylenecarbonate)and poly(glycolic-acid)-co-(trimethylene-carbonate),which are both biodegradable polymers with the same segment of flexible trimethylene-carbonate in order to accelerate the degradation rate of poly(lactic-acid)-co-(trimethylene carbonate)substrate and improve its mechanical properties.Besides,we further fabricate the porous poly(lactic-acid)-co-(trimethylene-carbonate)/poly(glycolic-acid)-co-(trimethylene-carbonate)scaffolds with uniform microstructure by the 3D extrusion printing technology in a mild printing condition.The physicochemical properties of the poly(lactic-acid)-co-(trimethylenecarbonate)/poly(glycolic-acid)-co-(trimethylene-carbonate)and the 3D printing scaffolds were investigated by universal tensile dynamometer,fourier transform infrared reflection(FTIR),scanning electron microscope(SEM)and differential scanning calorimeter(DSC).Meanwhile,the degradability of the PLLATMC/GA-TMC was performed in vitro degradation assays.Compared with PLLA-TMC group,PLLA-TMC/GATMC groups maintained the decreasing Tg,higher degradation rate and initial mechanical performance.Furthermore,the PLLA-TMC/GA-TMC 3D printing scaffolds provided shape-memory ability at 37℃.In summary,the PLLA-TMC/GA-TMC can be regarded as an alternative substitution material for bone tissue engineering.展开更多
Objective Open microsurgery,often with bypass techniques,is indispensable for complex aneurysms.To date,it remains unknown whether arterial anatomy or quantitative blood flow measurements can predict insufficient flow...Objective Open microsurgery,often with bypass techniques,is indispensable for complex aneurysms.To date,it remains unknown whether arterial anatomy or quantitative blood flow measurements can predict insufficient flow-related stroke(IRS).The present study aimed to evaluate the risk factors for IRS in patients treated with open microsurgery with bypass procedures for complex internal carotid artery aneurysms.Methods Patients with complex aneurysms undergoing bypass surgery were retrospectively reviewed.The recipient/donor flow index(RDFI)was preoperatively evaluated using colour-coding angiography.RDFI was defined as the ratio of the cerebral blood volume of the recipient and donor arteries.The sizes of the recipient and donor arteries were measured.The recipient/donor diameter index(RDDI)was then calculated.IRS was defined as the presence of new postoperative neurological deficits and infarction on postoperative CT scans.We assessed the association between RDFI and other variables and the IRS.Results Twenty patients(38±12 years)were analysed.IRS was observed in 12 patients(60%).Patients with postoperative IRS had a higher RDFI than those without postoperative IRS(p<0.001).RDDI was not significantly different between patients with and without IRS(p=0.905).Patients with RDFI>2.3 were more likely to develop IRS(p<0.001).Conclusion Quantitative digital subtraction angiography enables preoperative evaluation of cerebral blood volume.RDFI>2.3,rather than RDDI,was significantly associated with postoperative IRS.This preoperative evaluation allows appropriate decisions regarding the treatment strategy for preventing postoperative IRS.展开更多
文摘Osteomyelitis is a devastating disease caused by microbial infection in deep bone tissue.Its high recurrence rate and impaired restoration of bone deficiencies are major challenges in treatment.Microbes have evolved numerous mechanisms to effectively evade host intrinsic and adaptive immune attacks to persistently localize in the host,such as drug-resistant bacteria,biofilms,persister cells,intracellular bacteria,and small colony variants(SCVs).Moreover,microbial-mediated dysregulation of the bone immune microenvironment impedes the bone regeneration process,leading to impaired bone defect repair.Despite advances in surgical strategies and drug applications for the treatment of bone infections within the last decade,challenges remain in clinical management.The development and application of tissue engineering materials have provided new strategies for the treatment of bone infections,but a comprehensive review of their research progress is lacking.This review discusses the critical pathogenic mechanisms of microbes in the skeletal system and their immunomodulatory effects on bone regeneration,and highlights the prospects and challenges for the application of tissue engineering technologies in the treatment of bone infections.It will inform the development and translation of antimicrobial and bone repair tissue engineering materials for the management of bone infections.
基金the sub project of the national major project generation method and application verification of personalized rehabilitation prescription for patients with balance(No.2019YFB1311403)。
文摘The biodegradable substitution materials for bone tissue engineering have been a research hotspot.As is known to all,the biodegradability,biocompatibility,mechanical properties and plasticity of the substitution materials are the important indicators for the application of implantation materials.In this article,we reported a novel binary substitution material by blending the poly(lactic-acid)-co-(trimethylenecarbonate)and poly(glycolic-acid)-co-(trimethylene-carbonate),which are both biodegradable polymers with the same segment of flexible trimethylene-carbonate in order to accelerate the degradation rate of poly(lactic-acid)-co-(trimethylene carbonate)substrate and improve its mechanical properties.Besides,we further fabricate the porous poly(lactic-acid)-co-(trimethylene-carbonate)/poly(glycolic-acid)-co-(trimethylene-carbonate)scaffolds with uniform microstructure by the 3D extrusion printing technology in a mild printing condition.The physicochemical properties of the poly(lactic-acid)-co-(trimethylenecarbonate)/poly(glycolic-acid)-co-(trimethylene-carbonate)and the 3D printing scaffolds were investigated by universal tensile dynamometer,fourier transform infrared reflection(FTIR),scanning electron microscope(SEM)and differential scanning calorimeter(DSC).Meanwhile,the degradability of the PLLATMC/GA-TMC was performed in vitro degradation assays.Compared with PLLA-TMC group,PLLA-TMC/GATMC groups maintained the decreasing Tg,higher degradation rate and initial mechanical performance.Furthermore,the PLLA-TMC/GA-TMC 3D printing scaffolds provided shape-memory ability at 37℃.In summary,the PLLA-TMC/GA-TMC can be regarded as an alternative substitution material for bone tissue engineering.
基金supported by the National Key Technology Research and Development Program of the Ministry of Science and Technology of China(2015BAI12B04)Beijing Science and Technology Supporting Plan(D16110000381605)+2 种基金Beijing Municipal Administration of Hospitals’Mission Plan(SML20150501)Beijing Municipal Administration of Hospitals Incubating Program(PX2016034)National Natural Science Foundation of China(81571110,81771234).
文摘Objective Open microsurgery,often with bypass techniques,is indispensable for complex aneurysms.To date,it remains unknown whether arterial anatomy or quantitative blood flow measurements can predict insufficient flow-related stroke(IRS).The present study aimed to evaluate the risk factors for IRS in patients treated with open microsurgery with bypass procedures for complex internal carotid artery aneurysms.Methods Patients with complex aneurysms undergoing bypass surgery were retrospectively reviewed.The recipient/donor flow index(RDFI)was preoperatively evaluated using colour-coding angiography.RDFI was defined as the ratio of the cerebral blood volume of the recipient and donor arteries.The sizes of the recipient and donor arteries were measured.The recipient/donor diameter index(RDDI)was then calculated.IRS was defined as the presence of new postoperative neurological deficits and infarction on postoperative CT scans.We assessed the association between RDFI and other variables and the IRS.Results Twenty patients(38±12 years)were analysed.IRS was observed in 12 patients(60%).Patients with postoperative IRS had a higher RDFI than those without postoperative IRS(p<0.001).RDDI was not significantly different between patients with and without IRS(p=0.905).Patients with RDFI>2.3 were more likely to develop IRS(p<0.001).Conclusion Quantitative digital subtraction angiography enables preoperative evaluation of cerebral blood volume.RDFI>2.3,rather than RDDI,was significantly associated with postoperative IRS.This preoperative evaluation allows appropriate decisions regarding the treatment strategy for preventing postoperative IRS.
