High density porous polyethylene material (Medpor) as an unwrapped orbital implant

Objective: To introduce the clinical effect among patients who received an unwrapped orbital implant with high density porous polyethylene material (Medpor) after enucleation or evisceration. Methods: Retrospective analysis of a series of 302 patients with anophthalmia who underwent placement of an unwrapped high density porous polyethylene orbital implant. We compared the patients (n=180) who accepted primary implant placement with those (n=122) who accepted secondary implant placement. Parameters evaluated included: age at time of surgery, date of surgery, sex, implant type and size, surgery type, the surgical procedure and technique performed, and complications. Results: The time of follow-up ranged from 2.0 to 58.0 months (mean 32.5 months). A total of 5 of 302 (1.66%) cases had documented postoperative complications. The following problems were noted after surgery: implant exposure, 3 patients (0.99%); implant removed due to orbital infection, 1 patient (0.34%); ptosis, 1 patient (0.34%). There were no significant complications observed in other 297 cases and all implants showed good orbital mo- tility. The clinical effect of primary implant placement is better than that of secondary placement. Conclusion: High density porous polyethylene material can be used successfully as an unwrapped orbital implant in anopthalmic socket surgery with minimal complications. The material is well tolerated, nonantigenic and has low rate of infection and migration.

PREPARATION OF HIGH DENSITY POLYETHYLENE/POLYETHYLENE-BLOCK-POLY(ETHYLENE GLYCOL)COPOLYMER BLEND POROUS MEMBRANES VIA THERMALLY INDUCED PHASE SEPARATION PROCESS AND THEIR PROPERTIES

High density polyethylene （HDPE）/polyethylene-block-poly（ethylene glycol） （PE-b-PEG） blend porous membranes were prepared via thermally induced phase separation （TIPS） process using diphenyl ether （DPE） as diluent. The phase diagrams of HDPE/PE-b-PEG/DPE systems were determined by optical microscopy and differential scanning calorimetry （DSC）. By varying the content of PE-b-PEG, the effects of PE-b-PEG copolymer on morphology and crystalline structure of membranes were studied by scanning electron microscopy （SEM） and wide angle X-ray diffraction （WAXD）. The chemical compositions of whole membranes and surface layers were characterized by elementary analysis, Fourier transform infrared spectroscopy-attenuated total reflection （FTIR-ATR） and X-ray photoelectron spectroscopy （XPS）. Water contact angle, static protein adsorption and water flux experiments were used to evaluate the hydrophilicity, antifouling and water permeation properties of the membranes. It was found that the addition of PE-b-PEG increased the pore size of the obtained blend membranes. In the investigated range of PE-b-PEG content, the PEG blocks could not aggregate into obviously separated domains in membrane matrix. More importantly, PE-b-PEG could not only be retained stably in the membrane matrix during membrane formation, but also enrich at the membrane surface layer. Such stability and surface enrichment of PE-b-PEG endowed the blend membranes with improved hydrophilicity, protein absorption resistance and water permeation properties, which would be substantially beneficial to HDPE membranes for water treatment application.

Effects and complications of placement of motility coupling post in porous polyethylene orbital implants

Objective： To investigate the effects and complications of primary and secondary placements of motility coupling post （MCP） in the unwrapped porous polyethylene orbital implant （PPOI） following enucleation. Methods： We investigated 198 patients who received PPOI implantation following the standard enucleation procedure in the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, from 2002 to 2004. These patients were subgrouped into PPOI-only patients （112 cases, received PPOI following enucleation）, primary MCP patients （46 cases, received primary placement of MCP during PPOI operation）, and secondary MCP patients （40 cases, received secondary placement ofMCP 6 months after the initial surgery）. Effects and complications among these three groups were compared. Results： The PPOI-only patients took shorter treatment course when compared with other two MCP groups （P〈0.001）, without significant difference noted between the two MCP groups. However, the two MCP groups had better prosthetic motility than PPOI-only group （P〈0.001）, without significant difference between the two MCP groups. In the early stage, 2 eyes in the PPOI-only group and l eye in the primary MCP group had PPOI infection. In PPOI-only group, 3 （2.68%） eyes had PPOI exposure, which occurred after fitting the prostheses; 4 eyes （8.70%） in primary MCP group and 1 eye （2.50%） in secondary MCP had PPOI exposure, which occurred before fitting the prostheses. After prosthesis was fit successfully, the excessive discharge and granuloma were 33.9% and 1.79% in PPOI group-only, 53.3% and 8.9% in primary MCP group, and 52.5% and 7.5% in secondary MCP group, respectively. Conclusion： Both primary and secondary placements of MCP into the PPOI following enucleation can help patients to obtain desirable prosthetic motility, but may be associated with more complications. The primary placement of MCP with skilled operation in selected patients is more recommendable than secondary placement.

应用Medpor支架行全耳再造术病儿的护理

目的探讨对Medpor支架全耳再造术儿童的护理方法,促进Medpor支架全耳再造术患儿身心的康复。方法对12例Medpor支架全耳再造术患儿,重视心理护理,术前进行睡姿的适应性训练,术后密切观察病情变化,识别并及时对症处理相关护理问题。结果Medpor支架全耳再造术患儿的常见护理问题均得到及时有效的处理,12例患儿无1例发生医源性护理并发症,其身心均得到完全康复。结论重视术前术后护理及病情观察,及时处理常见护理问题是取得良好护理效果的重要因素。

CAD/CAM技术辅助下使用Medpor~精确修复下颌轮廓凹陷

目的报导一种通过个体化Medpor来重塑下颌骨轮廓的方法,评价其治疗效果并讨论适应证。方法选取四川大学华西口腔医院下颌骨轮廓凹陷病例17例,采集其CT数据,运用CAD/CAM、镜像反求、快速成型及3D打印技术设计并精确制作出手术模板,雕刻塑形出个性化Medpor,并指导准确植入体内,修复下颌凹陷畸形。结果除1例植入体因迟发性感染取出外,其余患者恢复良好,复查定位照相对比示:患者下颌轮廓凹陷均得到较好修复,对称性得到明显改善,医患均对手术效果感到满意。结论在CAD/CAM技术辅助下,运用Medpor可以精确修复下颌骨轮廓凹陷,是一种值得推广的方法。

MEDPOR在肋软骨已钙化患者耳廓再造术中的应用

目的探讨对于肋软骨已发生钙化的先天性小耳或后天性耳缺损患者,以MEDPOR作为再造耳廓支架的可行性。方法手术分为2期,1期是在残耳后埋置皮肤软组织扩张器,扩张皮瓣或瘢痕瓣。2期是以扩张皮瓣、耳后乳突区皮下筋膜瓣、残耳、MEDPOR支架、中厚皮片移植行耳廓再造术。自2009年1月---2014年1月,以此种方法行耳廓再造术34例,男性23例,女性11例,年龄32岁-61岁,均为单侧耳廓再造。结果 34例耳均顺利完成二期耳廓再造手术。术后随访时间,最短2年,最长5年7个月,形态令人满意,支架无外露发生。结论对于肋软骨已发生钙化的先天性小耳或后天性耳缺损患者,MEDPOR支架是较为适合的再造耳廓支架材料。

Structure and Oxygen Sensing Properties of TiO_2 Porous Semiconductor Thin Films

Semiconductor-type TiO2 oxygen sensing thin films were synthesized using tetrabutyl titanate （Ti （OBu）4） as precursor and diethanolamine （DEA） as complexing agent by the sol-get process. The porous and oxygen sensing TiO2 films were obtained by the addition of polyethylene glycol （PEG）. The micrographs of scanning electron microscope （SEM） show that the pores of the sample about 400-600 nm in size with PEG（2 000 g/mol） are larger than those about 300 nm in size with PEG（ 1 000 g/mol）, while the density of pores is lower. The results also indicate that increasing the content of PEG properly is beneficial to the formation of porous structure. With the increasing content of PEG from 0 g to 2.5 g, the oxygen sensitivity increases from 330 to more than 1 000 at 800 ℃, from 170 to more than 1 000 at 900℃, and the response time to O2 and H2 are about 1.5 s and less than 1s, respectively.

Medpor®Acts on Stem Cells Derived from Peripheral Blood

Porous polyethylene (PP or Medpor?) is an alloplastic material used worldwide for craniofacial reconstruction. Although several clinical studies are available, how this material alters osteoblast activity to promote bone formation is poorly understood. To study how PP can induce osteoblast differentiation in mesenchymal stem cells, the expression levels of bone related genes and mesenchymal stem cells marker were analyzed, using real time Reverse Transcription-Polymerase Chain Reaction. PP causes induction of osteoblast transcriptional factor RUNX2 and of the bone related genes osteocalcin (BGLAP) and alkaline phosphatase (ALPL). In contrast the expression of ENG was decreased in stem cells treated with PP respect to untreated cells, indicating the differentiation effect of this biomaterial on stem cells. The obtained results can be relevant to better understand the molecular mechanism of bone regeneration and as a model for comparing other materials with similar clinical effects.

Biological porous carbon encapsulated polyethylene glycol-based phase change composites for integrated electromagnetic interference shielding and thermal management capabilities

The development of functional composites with excellent thermal management capabilities and electro-magnetic interference(EMI)shielding has become extremely urgent for keeping up with the continuous improvement of the operating speed and efficiency for electronic equipment.In this study,the biolog-ical wood-derived porous carbon(WPC)was determined as the supporting material to encapsulating polyethylene glycol(PEG),and a series of WPC/PEG/Fe_(3)O_(4) phase change composites(PCCs)with excel-lent shape stability,EMI shielding and thermal management capabilities were prepared via a simple vac-uum impregnation method.The Fe_(3)O_(4) magnetic particles modified PCCs have greatly improved the EMI shielding effectiveness(SE).The EMI SE of WP-4(7.5 wt.% Fe_(3)O_(4) in PEG)can be up to 55.08 dB between 8.2−12.4 GHz,however,the WP-0 without Fe_(3)O_(4) addition is only 40.08 dB.Meanwhile,the absorption ratio of electromagnetic waves(EMW)has also increased from 75.02%(WP-0)to 85.56%(WP-4),which effectively prevents secondary pollution.In addition,after wrapping a thin layer of polydimethylsiloxane resin(PDMS),the obtained WP-4 can maintain a high heat storage capacity(109.52 J/g)and good wa-ter stability.In short,the prepared WPC/PEG/Fe_(3)O_(4) PCCs have great potential application value in the thermal management and electromagnetic shielding requirements for electronic devices.

高密度聚乙烯多孔材料在颅骨缺损整复中的应用观察

目的:观察高密度聚乙烯多孔材料Medpor在颅骨缺损整复中的临床应用,分析其改善情况。方法:对6例去骨瓣减压术后因颅骨缺损患者行高密度聚乙烯多孔材料修复术治疗。结果:术后切口均Ⅰ期愈合。随访2个月,外形恢复满意,无不良并发症。结论:研究表明高密度聚乙烯多孔材料操作容易,可塑性高,材料在体内可促进自体组织长入,不易感染及外露,具有较好的修复效果,对颅骨缺损修复具有一定的指导意义。

人造耳支架植入在先天性小耳畸形中的应用——18年临床经验总结

目的 观察并探讨高分子聚乙烯人造耳支架植入行全耳廓再造术的临床效果与经验。方法 收集2003年5月—2021年6月诊治的小耳畸形患者1 057例(1 063耳),分别对其手术方式、手术成功率、耳廓的对称度、耳廓精细结构显示、患者的满意度、并发症发生情况及听力恢复情况进行评估。结果 术后随访6个月至16年。1 063耳手术均成功,耳廓形态随着时间的延长而逐渐显露。对耳廓的7个对称度指标进行评分,均在5分以上;对耳廓的14个精细结构进行评分,945耳(88.90%)≥10分。患者的总满意率为92.00%(978/1 063耳)。同期行听力重建的患者术后得到不同程度的听力改善。结论 先天性小耳畸形高密度聚乙烯人造耳支架植入全耳廓再造术在临床上安全可行,可以作为耳再造的方法之一;并可以同期行听力重建术,在再造耳廓的同时取得较好的听力康复效果,也可以使再造耳廓在形态上更加逼真,提高患者的满意率。

MEDPOR在眼及眶部整形中的应用

目的 :研究MEDPOR在眼部及眶部整形美容中的应用。方法 :应用MEDPOR治疗 3 6例 (3 6眼 )眼部及眶部整形患者。结果 :术后所有患者效果满意 ,眼球正位 ,复视消失。一例眶修复术后 ,又经两次斜视手术 ,复视得到矫正。结论 :在眼部及眶部整形美容术中 ,MEDPOR是一种良好的、现代的线状高密度多孔网状生物材料。

Medpor支架在耳廓再造中的应用进展

1引言先天性外中耳畸形、外伤、烧伤及肿瘤切除术后和感染后耳缺损等患者需要进行耳廓再造,临床上以先天性外中耳畸形最为常见,其发病率世界各地报道不尽相同,西班牙人、亚洲人及美洲土著人发病率较高[1,2]。我国发病率约为5.18/10000[3]。先天性外中耳畸形不仅给患者带来容貌的缺陷,同时也伴随着听觉功能障碍和心理障碍,特别是双侧外中耳畸形患者,由于双耳听力障碍,

硅胶与Medpor假体用于隆颏的Meta分析

目的对固体硅胶假体与多孔高密度聚乙烯（Medpor）假体用于隆颏进行系统评价。方法计算机检索Pubmed文献数据库、中国知网中文数据库、万方数据库。收集所有相关使用生物材料隆颏术的临床报道，行Meta分析，以进行系统评价。结果（1）硅胶感染率合并值为0．00，95％可信区间为[0．00；0．01]，Medpor的感染率合并值为0．00，95％可信区间为[0．00；0．01]，差异无统计学意义（P〉0．05）。（2）硅胶假体位置偏移率合并值为0．03，95％可信区间为[0．00；0．08]，Medpor假体位置偏移率合并值为0．00，95％可信区间为[0．00；0．01]，差异有统计学意义（P〈0．01）。（3）硅胶假体取出率合并值为0．17，95％可信区间为[0．00；0．34]，Medpor的假体取出率合并值为0．01，95％可信区间为[0．00；0．02]，差异有统计学意义（P〈0．01）。（4）硅胶假体骨质吸收发生率合并值为0．15，95％可信区间为[0．04；0．26]，Medpor假体的骨质吸收发生率合并值为0．00，95％可信区间为[0．00；0．01]，差异有统计学意义（P〈0．01）。结论生物材料为隆颏术的发展带来了新进展，而Medpor与硅胶假体各有优缺点，应当根据患者不同需求及情况作出合适的选择。

Medpor整复爆裂性眼眶骨折的临床研究

目的研究人体整形的新型高分子材料．Medpor（多孔高密度聚乙烯）整复眼眶爆裂性骨折的临床效果及其特点。方法对31例患者均行高分辨率眼眶CT扫描和三维重建、了解眼眶骨折的部位、大小；用Hertel突眼计测量眼球内陷度数；Lancaster红绿灯测量法分析复视情况。以Medpor作为手术整复材料，并进行6--22个月随访。结果术前31例患者随访6个月及以上，其中：26例患者眼球内陷，20例患者眼球内陷完全矫正（76．92％），6例患者好转（23．08％）；术前23例伴有复视患者，18例复视完全矫正（78．26％），5例复视好转（21．74％）；术前20例患者眼球运动受限，12例恢复正常（60％），8例好转（40％）。结论Medpor作为近年来用于临床的新型整形材料，具有生物相容性好、术后支撑能力强、稳定性高、易于固定、填充量可选的特点，并可以根据骨折范围、眼球内陷程度对材料进行热处理后修剪成型，用于眼眶骨折的整复，能有效的矫正中重度眼球内陷，复视明显的患者。

Preparation and properties of gel membrane containing porous PVDF-HFP matrix and cross-linked PEG for lithium ion conduction

Lithium ion conducting membranes are the key materials for lithium batteries.The lithium ion conducting gel polymer electrolyte membrane(Li-GPEM)based on porous poly(vinylidene fluoride-co-hexafluoropropylene)(PVDF-HFP)matrix and cross-linked PEG network is pre-pared by a typical phase inversion process.By immersing theporousPVDF-HFPmembraneinliquidelectrolytecon-taining poly(ethylene glycol)diacrylate(PEGDA)and an initiator to absorb the liquid electrolyte at 25℃,and then thermally cross-linking at 60℃,the Li-GPEM is fabricated successfully.The measurements on its weight loss,mech-anical and electrochemical properties reveal that the obtained Li-GPEM has better overall performance than the liquid and blend gel systems used as conductive media in lithium batteries.The ionic conductivity of the fabricated Li-GPEM can reach as high as 2.25×10^(-3) S/cm at 25℃.

多孔高密度聚乙烯置入联合耳甲软骨移植鼻尖成形术

目的探讨多孔高密度聚乙烯（poroushigh-density polyethylene，Medpor）置入联合自体耳甲软骨移植行鼻尖成形术的操作方法及适应证。方法采用8．5mm厚的Medpor薄片置入支撑鼻尖，并联合应用自体耳甲软骨移植以优化鼻尖形态。结果36例术后鼻尖部形态良好，无感染、置入体外露等并发症发生。结论Medpor能为鼻尖部提供强有力的支撑，安全、有效，适应于纠正鼻尖部上旋、抬高和延长鼻尖部的成形术，联合自体耳甲软骨移植可进一步提高鼻外形效果。

多孔高密度聚乙烯支架在皮肤破溃感染的全耳廓再造术中的应用

目的对于先天性小耳患者，在应用扩张法行外耳再造术的过程中，当耳后皮肤软组织在扩张阶段发生扩张皮肤破溃，以致继发感染后，探索一种较为可行的外耳再造方法。方法对26例耳后扩张皮肤发生破溃感染的先天性小耳患者，经过积极的全身抗感染和适宜的局部换药处理，在感染得到有效控制后，应用多孔高密度聚乙烯（porous high density polyethylene，Medpor）材料做支架，外包蒂在前的耳后乳突区皮下组织筋膜瓣、扩张皮肤及移植皮片，行外耳再造术。结果26例外耳再造手术均获成功，耳形态令人满意，轮廓清晰。结论在耳后皮肤软组织扩张阶段，当扩张皮肤发生破溃继发感染后，用Medpor支架代替自体肋软骨支架行外耳再造术，是一种较为安全可行的手术方法。

高密度多孔聚乙烯假体置入隆颏在面下1／3轮廓成形术中的应用

目的探讨高密度多孔聚乙烯（porous high-density polyethylene，Medpor）假体置入隆颏在面下1／3轮廓成形术中的应用效果。方法149例同时行口内入路Medpor假体置入隆颏及面下1／3轮廓整形，其中行双侧下颌角截骨成形术121例，行双侧下颌角截骨成形术及双侧颧骨截骨降低术28例，并进行术前术后照相对比，观察判断临床效果。结果术后145例（97．3％）颏部外形及面下1／3轮廓改善满意。2例（1．3％）感觉颏部突度改善欠佳，其中1例再次行Medpor假体取出及颏部截骨前移颏成形术。1例（0．7％）感觉颏部假体偏大，行二次手术将假体修小；1例（0．7％）术后6个月因假体偏斜改行颏部截骨颏成形术。20例（13．4％）术后短期感觉下唇麻木，1～3个月后基本消失。随访期间没有发现伤口血肿、感染及假体外露、断裂等并发症。结论Medpor假体组织相容性好，同时经口内入路置入隆颏及下颌角截骨成形术在面下1／3轮廓整形中效果良好。

121例多孔聚乙烯义眼座眶内植入的临床分析

目的评价高密度多孔聚乙烯义眼座（Medpor）眶内植入的疗效及其并发症。方法回顾分析2003年3月至2006年3月期间眶内植入多孔聚乙烯义眼座121例，男性91例，女性30例，平均年龄29岁（6～53岁）。其中眼球摘除术后Ⅰ期植入20例，眼球内容剜除术后Ⅰ期植入54例，Ⅱ期植入47例。结果随诊时间6～36个月，平均随访时间18个月。121例均取得满意效果，结膜创口愈合好，义眼座无脱出，无暴露及感染。义眼座植入眼眶后活动度较好，所配带的义眼外观满意。结论Medpor义眼座眶内植入可明显地矫正眼窝凹陷，可采用自体巩膜包裹或者直接眶内植入，术后义眼座活动度好，并发症少。是一种理想的眶内植入物材料。