BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of th...BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect,which was filled with a large allogeneic cortical bone graft from a bone bank.Complete bony union was achieved after 14 months of follow-up.Previous studies have used autogenous bone as the primary bone source for the Masquelet technique;in our case,the exclusive use of allografts is as successful as the use of autologous bone grafts.With the advent of bone banks,it is possible to obtain an unlimited amount of allograft,and the Masquelet technique may be further improved based on this new way of bone grafting.CASE SUMMARY In this study,we reported a case of repair of a long bone defect in a 40-year-old male patient,which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm.The patient's results of functional recovery of the forearm were surprising,which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.CONCLUSION Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.展开更多
Hemorrhagic cystitis is a common and in its severe form potentially life threatening complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis is defined as a diffuse inflammatory condition of the ...Hemorrhagic cystitis is a common and in its severe form potentially life threatening complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis is defined as a diffuse inflammatory condition of the urinary bladder due to an infectious or noninfectious etiology resulting in bleeding from the bladder mucosa. Hemorrhagic cystitis is characterized by lower urinary tract symptoms including dysuria, hematuria and hemorrhage. The most common cause is a bacterial infection that usually responds promptly to treatment. But chronic and recurrent hemorrhagic cystitis often arises from anticancer chemotherapy or radiotherapy for the treatment of pelvic malignancies. Infectious etiologies are less common causes of chronic hemorrhagic cystitis except in immunocompromised hosts like bone marrow transplant recipients. Hemorrhagic cystitis is a significant complication of bone marrow transplantation which influences economic and survival outcome. Hemorrhagic cystitis can be divided into two classes according to onset time;early and late onset time. Earlyonset hemorrhagic cystitis is commonly associated used with chemo-radiotherapy protocols in some of the preparatory regimens. More than one factor is accused in the etiology of late onset hemorrhagic cystitis. Here, we present a patient whose hematuria started after 54 days from allogeneic stem cell transplantation.展开更多
We hypothesized that a chemically extracted acellular allogeneic nerve graft used in combination with bone marrow mesenchymal stem cell transplantation would be an effective treatment for long-segment sciatic nerve de...We hypothesized that a chemically extracted acellular allogeneic nerve graft used in combination with bone marrow mesenchymal stem cell transplantation would be an effective treatment for long-segment sciatic nerve defects.To test this,we established rabbit models of 30 mm sciatic nerve defects,and treated them using either an autograft or a chemically decellularized allogeneic nerve graft with or without simultaneous transplantation of bone marrow mesenchymal stem cells.We compared the tensile properties,electrophysiological function and morphology of the damaged nerve in each group.Sciatic nerves repaired by the allogeneic nerve graft combined with stem cell transplantation showed better recovery than those repaired by the acellular allogeneic nerve graft alone,and produced similar results to those observed with the autograft.These findings confirm that a chemically extracted acellular allogeneic nerve graft combined with transplantation of bone marrow mesenchymal stem cells is an effective method of repairing long-segment sciatic nerve defects.展开更多
A new method for filling bone cavity with a graft of frozen-decalcified-defatted-driedallogeneic (FDDDA) cancellous bone was described.This method was used for the treatment of cavi-ties after the enucleation of jaw c...A new method for filling bone cavity with a graft of frozen-decalcified-defatted-driedallogeneic (FDDDA) cancellous bone was described.This method was used for the treatment of cavi-ties after the enucleation of jaw cysts in 10 patients from December 1985 to February 1990.Thewounds of 9 patients healed by first intension,but wound infection occurred in one case postopera-tively.The 9 patients,besides the patient who suffered from wound infection,were followed up for5 to 56 months,with an average of 41.1 months.Evidence of recurrence with jaw cyst.was not ob-served.展开更多
Bone biomaterials have been increasingly used to reconstruct maxillary atrophic ridges.Thus,the aim of this study was to evaluate bone reconstruction in the maxilla using a homologous cortico-cancellous FFB(lyophilize...Bone biomaterials have been increasingly used to reconstruct maxillary atrophic ridges.Thus,the aim of this study was to evaluate bone reconstruction in the maxilla using a homologous cortico-cancellous FFB(lyophilized)graft and verify its reliability.Eight individuals were included from 2014 to 2018.The first surgery was performed to install homologous bone blocks in the maxilla.The period of the second intervention varied between 5 months and 15 days to 11 months(≈7.93 months).The biopsies were taken from the central region of the matured graft during the surgery for implant placement.All patients presented clinical and radiographic conditions for the installation of dental implants.There was a 100%of survival rate.The histological assessment showed that the homologous block bone graft was an osteoconductive biomaterial,with connective tissue present,and newly formed bone juxtaposed on its surface.There were bone trabeculae with osteocytes and active osteoblasts with connective tissue in the mineralization process;the remodeling process can be found through the reverse lines.A limited focus of necrosis with fibrosis was detected,with small resorption and areas of inflammatory infiltrate,but without clinical significance.The homologous block bone graft can be considered a feasible option to substitute the autogenous bone graft(gold standard),with predictable clinical and favorable histological results.The patients had a shorter surgical period,low morbidity,and an unlimited amount of biomaterial available at an accessible cost.展开更多
The removal of a failed implant with high torque causes significant damage to the surrounding tissue,compromising bone regeneration and subsequent osseointegration in the defect area.Here,we report a case of carrier s...The removal of a failed implant with high torque causes significant damage to the surrounding tissue,compromising bone regeneration and subsequent osseointegration in the defect area.Here,we report a case of carrier screw fracture followed by immediate implant removal,bone grafting and delayed reimplantation.A dental implant with a fractured central carrier screw was removed using the bur-forceps technique.The resulting three-wall bone defect was filled with granular surface demineralized freeze-dried bone allograft(SD-FDBA).Cone-beam computerized tomography was performed at 1week,6months and 15months postoperatively and standardized for quantitative evaluation.The alveolar bone width and height at 15months post-surgery were about 91%of the original values,with a slightly lower bone density,calculated using the gray value ratio.The graft site was reopened and was found to be completely healed with dense and vascularized bone along with some residual bone graft.Reimplantation followed by restoration was performed 8months later.The quality of regenerated bone following SD-FDBA grafting was adequate for osseointegration and longterm implant success.The excellent osteogenic properties of SD-FDBA are attributed to its human origin,cortical bone-like structure,partly demineralized surfaces and bone morphogenetic protein-2-containing nature.Further investigation with more cases and longer follow-up was required to confirm the final clinical effect.展开更多
Amniotic membrane of human placenta is a source of abundant mesenchymal stem cell (hAMSC) which makes it a potential source of allogeneic multipotent cell for bone healing. However, much has to be explored about its i...Amniotic membrane of human placenta is a source of abundant mesenchymal stem cell (hAMSC) which makes it a potential source of allogeneic multipotent cell for bone healing. However, much has to be explored about its isolation procedure and the osteogenic differentiation potential. The aims of this study are to establish the procurement procedure of human amniotic membrane, the isolation and culture of hAMSC, the MSC phenotypic characterization, and the in vitro osteogenic differentiation of hAMSC. Results of the study are as follows. The quality of human amniotic membrane would be best if procured from Caesarean operation under highly aseptic condition to avoid fungal and bacterial contamination on the culture. Isolation procedure using modified Soncini protocol yielded large amount of MSC with high proliferative capacity in culture medium. Characterization of hAMSC showed that the majority of the target cells exhibited specific MSC markers (CD105 and CD90) with a small number of these cells expressing CD45, the marker of hematopoeitic cells. The in vitro osteogenic differentiation of hAMSC followed by Alizarin Red staining showed that osteoblastic differentiation was detected in a significantly high number of cells. This study concludes that hAMSCs isolated from human amniotic membrane have the capacity for in vitro osteogenesis which makes them be one of the potential allogeneic stem cells for application in maxillofacial bone reconstruction.展开更多
In order to explore a new special and effective way to prevent graft versus host disease (GVHD) after allogenic bone marrow transplantation (allo-BMT), the stem cell antigen-1 (Sca-1) + early hematopoietic cells (EHC...In order to explore a new special and effective way to prevent graft versus host disease (GVHD) after allogenic bone marrow transplantation (allo-BMT), the stem cell antigen-1 (Sca-1) + early hematopoietic cells (EHC) from BALB/c mouse (H-2 d) were introduced with exogenous mouse Fas ligand (mFasL) cDNA gene by the retrovirus-mediated gene transfer and expanded for one week, and then they were co-cultured with the spleen mononuclear cells (SMNC) from BAC mouse (H-2 d×b) as one way mixed lymphocyte reaction (OWMLR). The cytotoxicity of treated BAC mouse SMNC against Na 2 51CrO 4 labeling SMNC from BALB/c mouse was observed. The bone marrow mononuclear cells (BMMNC) from BAC mouse treated by the above methods were transplanted into lethally-irradiated congenic BALB/c mice to observe the occurrence of GVHD. The results showed that the SMNC from BAC mouse after OWMLR with exogenous mFasL cDNA gene-transduced hematopoietic cells (HC) from BALB/c mouse in a ratio of 1 to 5 exhibited an obvious inhibition of the cytotoxicity against the BALB/c mouse spleen cells at different effector/target ratios as compared to the control group (P<0.01). The gradeⅠ GVHD or no GVHD and the 80 % survival rate at day 60 post-BMT were observed in the BALB/c mouse receiving BAC mouse BMMNC treated with similar way, while the grade Ⅱ-Ⅲ GVHD and the 20 % survival rate were noted in the control group (P<0.01). It is suggested that the attenuation of GVHD in allo-BMT recipient could be successfully achieved through FasL-Fas pathway in an H-2 haplotype disparate mouse combination.展开更多
Purpose: Autogenous bone was still considered as the gold standard in bone augmentations prior to implants insertion at the atrophic ridges. However if large bone grafts are needed to augment multiple edentulous atrop...Purpose: Autogenous bone was still considered as the gold standard in bone augmentations prior to implants insertion at the atrophic ridges. However if large bone grafts are needed to augment multiple edentulous atrophic segments, extraoral donor sites may be mandatory. The aim of this report is to introduce the Fares Wedge Technique, as a new bone augmentation method that can augment multiple edentulous ridges with intraoral cortical bone grafts. Methods: This report includes patients with moderate to severe ridge atrophy in different regions of the both jaws who were treated over 6-years period (2009-215) with wedge Technique (WT). Patients received panorex immediately after the surgery, and they were examined clinically and radiographically (periapical) every 2 weeks. At 4 months, computed tomography was performed to evaluate the bone gain. Reentry was performed after 4 to 5 months to evaluate the new bone volume and quality and to insert implants. At this stage specimens for histologic examination were also obtained. Results: 39 augmentation sites in 22 patients (15 women, 7 men: mean age 47 years) were followed 12 to 52 months. The healing process was uneventful, with minimal morbidity. The success rate was 95%, and the bone gain average was 3 - 6 mm vertically and 3 - 9 mm horizontally. In two patients the graft was partially exposed and treated with shaving and rounding the exposed wedges, but the augmentations were saved. In one case the majority of the bone graft was lost. At 38 sites the patients had successfully received 114 implants. Conclusions: wedge technique can augment multiple segments of atrophic ridges with small amount of autogenic graft. The bone volume that achieved was satisfying, especially that the majority of the augmented areas were at posterior mandibular defects.展开更多
Filgrastim is used to accelerate hematopoietic recovery after ABMT （allogeneic bone marrow transplantation）. Its impact on the total cost of patient care remains to be explored. We therefore undertook a cost effecti...Filgrastim is used to accelerate hematopoietic recovery after ABMT （allogeneic bone marrow transplantation）. Its impact on the total cost of patient care remains to be explored. We therefore undertook a cost effectiveness analysis in the context of a randomized single blinded clinical trial of Filgrastim versus placebo in post ABMT. A primary endpoint, duration of myelosuppression, and three secondary end points （number of days of fever, length of hospital stay, survival at one hundred days） were used to assess efficacy. Direct costs were evaluated and allowed the calculation of the ICER （incremental cost-effectiveness ratios） for the major endpoint of the trial. Sixteen patients were included in the study. The duration of myelosuppression was significantly decreased in the Filgrastim arm with medians of 15 days vs. 19 days in the placebo arm （p = 0.023）. Cost analysis showed no statistically significant difference between the two arms. According to the calculation of ICER, Filgrastim was more costly and more effective than placebo for the number of days of aplasia avoided and the number of days with fever avoided. Placebo strictly dominated filgrastim for days of hospitalization avoided. Filgrastim has proven effective in reducing the duration of aplasia without increasing costs.展开更多
背景:体外淋巴细胞增殖实验常用于检测医疗器械潜在的免疫原性,但在相关标准中均未给出详尽的浸提条件及作用剂量。目的:考察供试品不同浸提条件及作用剂量对体外人淋巴细胞增殖的影响,思考在选择体外淋巴细胞增殖实验条件时需考虑的因...背景:体外淋巴细胞增殖实验常用于检测医疗器械潜在的免疫原性,但在相关标准中均未给出详尽的浸提条件及作用剂量。目的:考察供试品不同浸提条件及作用剂量对体外人淋巴细胞增殖的影响,思考在选择体外淋巴细胞增殖实验条件时需考虑的因素。方法:实验检测同种骨修复材料与肝素修饰人工晶状体两种供试品,均分为以下12组:①实验组1:供试品24 h完全培养基(含体积分数10%胎牛血清的RPMI改良培养基)浸提液200μL+淋巴细胞悬液50μL;②阴性对照组1:24 h完全培养基200μL+淋巴细胞悬液50μL;③实验组2:供试品24 h完全培养基浸提液100μL+淋巴细胞悬液100μL;④阴性对照组2:24 h完全培养基100μL+淋巴细胞悬液100μL;⑤实验组3:供试品72 h RPMI改良培养基浸提液(实验前加体积分数10%胎牛血清)200μL+淋巴细胞悬液50μL;⑥阴性对照组3:72 h RPMI改良培养基(实验前加体积分数10%胎牛血清)200μL+淋巴细胞悬液50μL;⑦实验组4:供试品72 h RPMI改良培养基浸提液(实验前加体积分数10%胎牛血清)100μL+淋巴细胞悬液100μL;⑧阴性对照组4:72 h RPMI改良培养基(实验前加体积分数10%胎牛血清)100μL+淋巴细胞悬液100μL;⑨阳性对照组1:含10μg/mL植物血凝素M的完全培养基200μL+淋巴细胞悬液50μL;⑩阳性对照组2:含10μg/mL植物血凝素M的完全培养基100μL+淋巴细胞悬液100μL;⑪空白对照组1:250μL完全培养基;⑫空白对照组2:200μL完全培养基。培养3 d后,采用CCK-8法检测淋巴细胞增殖。结果与结论:①不同实验条件下,同种骨修复材料浸提液均可增强人淋巴细胞的活性,以RPMI改良培养基浸提72 h、浸提液与淋巴细胞悬液的体积比为4∶1的实验条件最为显著;肝素修饰人工晶状体在该条件下对淋巴细胞活性有明显的抑制作用,可能与浸提液中的肝素有关,但在完全培养基浸提24 h、浸提液与淋巴细胞悬液的体积比为4∶1的实验条件下对淋巴细胞活性有轻微的增强作用;②供试品不同浸提条件及作用剂量下,人体外淋巴细胞增殖实验结果可能会有较大差异,实验条件的选择需结合产品临床应用情况,也需考虑产品的固有特性。展开更多
Rheumatoid arthritis （RA） etiology and amelioration remains a challenge in modern therapeutics. Herein, we explored the synergistic effect of allogenic bone marrow stem cell （BMSC） translation and photodynamic tre...Rheumatoid arthritis （RA） etiology and amelioration remains a challenge in modern therapeutics. Herein, we explored the synergistic effect of allogenic bone marrow stem cell （BMSC） translation and photodynamic treatment of RA with tetra sulfonatophenyl porphyrin （TSPP） and TiO2 nanocomposites as a new strategy for RA theranostics. The translation of BMSCs with miRNAs into infected joints in long bones post-photodynamic therapy is helpful for treating and understanding RA pathophysiology. We observed that allogenic BMSC translation combined with TSPP-TiO2 nanocomposites can significantly （p 〈 0.01） lower the concentrations of serum biomarkers （tumor necrosis factor-α and interleukin-17） in a collagen induced arthritis （CIA） murine model, both in vitro and in vivo, as well as improve other parameters such as arthritis score, BMSC count, complete blood count, and numbers of platelets, red blood cells, and white blood cells. Moreover, a fluorescent TSPP in the feet or long bones and X-ray bioimaging of RA joints revealed the clinical efficacy of BMSCs combined with TSPP-TiO2 nanocomposites. Microarray data analysis illustrated that rnomir-375-3p and rno-mir-196b-3p were up-regulated by approximately 100-fold in the BMSCs of ameliorated RA post-photodynamic therapy with TSPP-TiO2 nanocomposites. Our study not only suggests a new approach for RA theranostics, but also helps in understanding RA pathophysiology.展开更多
目的:探究人工骨浆联合同种异体骨治疗对四肢骨缺损患者愈合情况及生活质量的影响。方法:选取102例于2021年5月—2023年12月在赣南医科大学第二附属医院进行治疗的四肢骨缺损患者作为研究对象,进行回顾性分析。根据治疗方式的不同将患...目的:探究人工骨浆联合同种异体骨治疗对四肢骨缺损患者愈合情况及生活质量的影响。方法:选取102例于2021年5月—2023年12月在赣南医科大学第二附属医院进行治疗的四肢骨缺损患者作为研究对象,进行回顾性分析。根据治疗方式的不同将患者分为异体骨组(n=46,给予单纯同种异体骨治疗)、联合组(n=56,给予人工骨浆联合同种异体骨治疗)。比较两组愈合情况、愈合效果及生活质量。结果:联合组愈合时间早于异体骨组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。联合组和异体骨组术前VAS评分比较,差异无统计学意义(P>0.05);联合组和异体骨组术后24 h VAS评分较术前均降低,且联合组术后24 h VAS评分低于异体骨组,差异均有统计学意义(P<0.05)。联合组术后3个月X射线评分高于异体骨组,差异有统计学意义(P<0.05)。联合组和异体骨组术前健康调查量表36(SF-36)评分比较,差异均无统计学意义(P>0.05);联合组和异体骨组术后3个月SF-36评分均较术前升高,且联合组术后3个月SF-36评分均高于异体骨组,差异均有统计学意义(P<0.05)。结论:与单纯同种异体骨治疗相比,人工骨浆联合同种异体骨治疗四肢骨缺损,患者愈合时间短、术后疼痛感轻,有助于生活质量提高,且安全性高。展开更多
文摘BACKGROUND The induced-membrane technique was initially described by Masquelet as an effective treatment for large bone defects,especially those caused by infection.Here,we report a case of chronic osteomyelitis of the radius associated with a 9 cm bone defect,which was filled with a large allogeneic cortical bone graft from a bone bank.Complete bony union was achieved after 14 months of follow-up.Previous studies have used autogenous bone as the primary bone source for the Masquelet technique;in our case,the exclusive use of allografts is as successful as the use of autologous bone grafts.With the advent of bone banks,it is possible to obtain an unlimited amount of allograft,and the Masquelet technique may be further improved based on this new way of bone grafting.CASE SUMMARY In this study,we reported a case of repair of a long bone defect in a 40-year-old male patient,which was characterized by the utilization of allograft cortical bone combined with the Masquelet technique for the treatment of the patient's long bone defect in the forearm.The patient's results of functional recovery of the forearm were surprising,which further deepens the scope of application of Masquelet technique and helps to strengthen the efficacy of Masquelet technique in the treatment of long bones indeed.CONCLUSION Allograft cortical bone combined with the Masquelet technique provides a new method of treatment to large bone defect.
文摘Hemorrhagic cystitis is a common and in its severe form potentially life threatening complication of hematopoietic stem cell transplantation. Hemorrhagic cystitis is defined as a diffuse inflammatory condition of the urinary bladder due to an infectious or noninfectious etiology resulting in bleeding from the bladder mucosa. Hemorrhagic cystitis is characterized by lower urinary tract symptoms including dysuria, hematuria and hemorrhage. The most common cause is a bacterial infection that usually responds promptly to treatment. But chronic and recurrent hemorrhagic cystitis often arises from anticancer chemotherapy or radiotherapy for the treatment of pelvic malignancies. Infectious etiologies are less common causes of chronic hemorrhagic cystitis except in immunocompromised hosts like bone marrow transplant recipients. Hemorrhagic cystitis is a significant complication of bone marrow transplantation which influences economic and survival outcome. Hemorrhagic cystitis can be divided into two classes according to onset time;early and late onset time. Earlyonset hemorrhagic cystitis is commonly associated used with chemo-radiotherapy protocols in some of the preparatory regimens. More than one factor is accused in the etiology of late onset hemorrhagic cystitis. Here, we present a patient whose hematuria started after 54 days from allogeneic stem cell transplantation.
基金supported by the Science and Technology Development Plan Project Fund of Jilin Province in China,No.20110492
文摘We hypothesized that a chemically extracted acellular allogeneic nerve graft used in combination with bone marrow mesenchymal stem cell transplantation would be an effective treatment for long-segment sciatic nerve defects.To test this,we established rabbit models of 30 mm sciatic nerve defects,and treated them using either an autograft or a chemically decellularized allogeneic nerve graft with or without simultaneous transplantation of bone marrow mesenchymal stem cells.We compared the tensile properties,electrophysiological function and morphology of the damaged nerve in each group.Sciatic nerves repaired by the allogeneic nerve graft combined with stem cell transplantation showed better recovery than those repaired by the acellular allogeneic nerve graft alone,and produced similar results to those observed with the autograft.These findings confirm that a chemically extracted acellular allogeneic nerve graft combined with transplantation of bone marrow mesenchymal stem cells is an effective method of repairing long-segment sciatic nerve defects.
文摘A new method for filling bone cavity with a graft of frozen-decalcified-defatted-driedallogeneic (FDDDA) cancellous bone was described.This method was used for the treatment of cavi-ties after the enucleation of jaw cysts in 10 patients from December 1985 to February 1990.Thewounds of 9 patients healed by first intension,but wound infection occurred in one case postopera-tively.The 9 patients,besides the patient who suffered from wound infection,were followed up for5 to 56 months,with an average of 41.1 months.Evidence of recurrence with jaw cyst.was not ob-served.
文摘Bone biomaterials have been increasingly used to reconstruct maxillary atrophic ridges.Thus,the aim of this study was to evaluate bone reconstruction in the maxilla using a homologous cortico-cancellous FFB(lyophilized)graft and verify its reliability.Eight individuals were included from 2014 to 2018.The first surgery was performed to install homologous bone blocks in the maxilla.The period of the second intervention varied between 5 months and 15 days to 11 months(≈7.93 months).The biopsies were taken from the central region of the matured graft during the surgery for implant placement.All patients presented clinical and radiographic conditions for the installation of dental implants.There was a 100%of survival rate.The histological assessment showed that the homologous block bone graft was an osteoconductive biomaterial,with connective tissue present,and newly formed bone juxtaposed on its surface.There were bone trabeculae with osteocytes and active osteoblasts with connective tissue in the mineralization process;the remodeling process can be found through the reverse lines.A limited focus of necrosis with fibrosis was detected,with small resorption and areas of inflammatory infiltrate,but without clinical significance.The homologous block bone graft can be considered a feasible option to substitute the autogenous bone graft(gold standard),with predictable clinical and favorable histological results.The patients had a shorter surgical period,low morbidity,and an unlimited amount of biomaterial available at an accessible cost.
基金supported by grants from the Natural Science Foundation of Jiangsu Province(Grant number BK20211249)the Beijing Science Nova Program(Grant number 20220484155)+2 种基金the Haidian Frontier Project of Beijing Natural Science Foundation(Grant number L212067)the Jiangsu Province Capability Improvement Project through Science,Technology and Education-Jiangsu Provincial Research Hospital Cultivation Unit(Grant number YJXYYJSDW4)the Jiangsu Provincial Medical Innovation Center(Grant number CXZX202227).
文摘The removal of a failed implant with high torque causes significant damage to the surrounding tissue,compromising bone regeneration and subsequent osseointegration in the defect area.Here,we report a case of carrier screw fracture followed by immediate implant removal,bone grafting and delayed reimplantation.A dental implant with a fractured central carrier screw was removed using the bur-forceps technique.The resulting three-wall bone defect was filled with granular surface demineralized freeze-dried bone allograft(SD-FDBA).Cone-beam computerized tomography was performed at 1week,6months and 15months postoperatively and standardized for quantitative evaluation.The alveolar bone width and height at 15months post-surgery were about 91%of the original values,with a slightly lower bone density,calculated using the gray value ratio.The graft site was reopened and was found to be completely healed with dense and vascularized bone along with some residual bone graft.Reimplantation followed by restoration was performed 8months later.The quality of regenerated bone following SD-FDBA grafting was adequate for osseointegration and longterm implant success.The excellent osteogenic properties of SD-FDBA are attributed to its human origin,cortical bone-like structure,partly demineralized surfaces and bone morphogenetic protein-2-containing nature.Further investigation with more cases and longer follow-up was required to confirm the final clinical effect.
文摘Amniotic membrane of human placenta is a source of abundant mesenchymal stem cell (hAMSC) which makes it a potential source of allogeneic multipotent cell for bone healing. However, much has to be explored about its isolation procedure and the osteogenic differentiation potential. The aims of this study are to establish the procurement procedure of human amniotic membrane, the isolation and culture of hAMSC, the MSC phenotypic characterization, and the in vitro osteogenic differentiation of hAMSC. Results of the study are as follows. The quality of human amniotic membrane would be best if procured from Caesarean operation under highly aseptic condition to avoid fungal and bacterial contamination on the culture. Isolation procedure using modified Soncini protocol yielded large amount of MSC with high proliferative capacity in culture medium. Characterization of hAMSC showed that the majority of the target cells exhibited specific MSC markers (CD105 and CD90) with a small number of these cells expressing CD45, the marker of hematopoeitic cells. The in vitro osteogenic differentiation of hAMSC followed by Alizarin Red staining showed that osteoblastic differentiation was detected in a significantly high number of cells. This study concludes that hAMSCs isolated from human amniotic membrane have the capacity for in vitro osteogenesis which makes them be one of the potential allogeneic stem cells for application in maxillofacial bone reconstruction.
基金ThisprojectwassupportedbyagrantfromNationalNaturalSciencesFoundationofChina (No .39770 76 7)
文摘In order to explore a new special and effective way to prevent graft versus host disease (GVHD) after allogenic bone marrow transplantation (allo-BMT), the stem cell antigen-1 (Sca-1) + early hematopoietic cells (EHC) from BALB/c mouse (H-2 d) were introduced with exogenous mouse Fas ligand (mFasL) cDNA gene by the retrovirus-mediated gene transfer and expanded for one week, and then they were co-cultured with the spleen mononuclear cells (SMNC) from BAC mouse (H-2 d×b) as one way mixed lymphocyte reaction (OWMLR). The cytotoxicity of treated BAC mouse SMNC against Na 2 51CrO 4 labeling SMNC from BALB/c mouse was observed. The bone marrow mononuclear cells (BMMNC) from BAC mouse treated by the above methods were transplanted into lethally-irradiated congenic BALB/c mice to observe the occurrence of GVHD. The results showed that the SMNC from BAC mouse after OWMLR with exogenous mFasL cDNA gene-transduced hematopoietic cells (HC) from BALB/c mouse in a ratio of 1 to 5 exhibited an obvious inhibition of the cytotoxicity against the BALB/c mouse spleen cells at different effector/target ratios as compared to the control group (P<0.01). The gradeⅠ GVHD or no GVHD and the 80 % survival rate at day 60 post-BMT were observed in the BALB/c mouse receiving BAC mouse BMMNC treated with similar way, while the grade Ⅱ-Ⅲ GVHD and the 20 % survival rate were noted in the control group (P<0.01). It is suggested that the attenuation of GVHD in allo-BMT recipient could be successfully achieved through FasL-Fas pathway in an H-2 haplotype disparate mouse combination.
文摘Purpose: Autogenous bone was still considered as the gold standard in bone augmentations prior to implants insertion at the atrophic ridges. However if large bone grafts are needed to augment multiple edentulous atrophic segments, extraoral donor sites may be mandatory. The aim of this report is to introduce the Fares Wedge Technique, as a new bone augmentation method that can augment multiple edentulous ridges with intraoral cortical bone grafts. Methods: This report includes patients with moderate to severe ridge atrophy in different regions of the both jaws who were treated over 6-years period (2009-215) with wedge Technique (WT). Patients received panorex immediately after the surgery, and they were examined clinically and radiographically (periapical) every 2 weeks. At 4 months, computed tomography was performed to evaluate the bone gain. Reentry was performed after 4 to 5 months to evaluate the new bone volume and quality and to insert implants. At this stage specimens for histologic examination were also obtained. Results: 39 augmentation sites in 22 patients (15 women, 7 men: mean age 47 years) were followed 12 to 52 months. The healing process was uneventful, with minimal morbidity. The success rate was 95%, and the bone gain average was 3 - 6 mm vertically and 3 - 9 mm horizontally. In two patients the graft was partially exposed and treated with shaving and rounding the exposed wedges, but the augmentations were saved. In one case the majority of the bone graft was lost. At 38 sites the patients had successfully received 114 implants. Conclusions: wedge technique can augment multiple segments of atrophic ridges with small amount of autogenic graft. The bone volume that achieved was satisfying, especially that the majority of the augmented areas were at posterior mandibular defects.
文摘Filgrastim is used to accelerate hematopoietic recovery after ABMT （allogeneic bone marrow transplantation）. Its impact on the total cost of patient care remains to be explored. We therefore undertook a cost effectiveness analysis in the context of a randomized single blinded clinical trial of Filgrastim versus placebo in post ABMT. A primary endpoint, duration of myelosuppression, and three secondary end points （number of days of fever, length of hospital stay, survival at one hundred days） were used to assess efficacy. Direct costs were evaluated and allowed the calculation of the ICER （incremental cost-effectiveness ratios） for the major endpoint of the trial. Sixteen patients were included in the study. The duration of myelosuppression was significantly decreased in the Filgrastim arm with medians of 15 days vs. 19 days in the placebo arm （p = 0.023）. Cost analysis showed no statistically significant difference between the two arms. According to the calculation of ICER, Filgrastim was more costly and more effective than placebo for the number of days of aplasia avoided and the number of days with fever avoided. Placebo strictly dominated filgrastim for days of hospitalization avoided. Filgrastim has proven effective in reducing the duration of aplasia without increasing costs.
文摘背景:体外淋巴细胞增殖实验常用于检测医疗器械潜在的免疫原性,但在相关标准中均未给出详尽的浸提条件及作用剂量。目的:考察供试品不同浸提条件及作用剂量对体外人淋巴细胞增殖的影响,思考在选择体外淋巴细胞增殖实验条件时需考虑的因素。方法:实验检测同种骨修复材料与肝素修饰人工晶状体两种供试品,均分为以下12组:①实验组1:供试品24 h完全培养基(含体积分数10%胎牛血清的RPMI改良培养基)浸提液200μL+淋巴细胞悬液50μL;②阴性对照组1:24 h完全培养基200μL+淋巴细胞悬液50μL;③实验组2:供试品24 h完全培养基浸提液100μL+淋巴细胞悬液100μL;④阴性对照组2:24 h完全培养基100μL+淋巴细胞悬液100μL;⑤实验组3:供试品72 h RPMI改良培养基浸提液(实验前加体积分数10%胎牛血清)200μL+淋巴细胞悬液50μL;⑥阴性对照组3:72 h RPMI改良培养基(实验前加体积分数10%胎牛血清)200μL+淋巴细胞悬液50μL;⑦实验组4:供试品72 h RPMI改良培养基浸提液(实验前加体积分数10%胎牛血清)100μL+淋巴细胞悬液100μL;⑧阴性对照组4:72 h RPMI改良培养基(实验前加体积分数10%胎牛血清)100μL+淋巴细胞悬液100μL;⑨阳性对照组1:含10μg/mL植物血凝素M的完全培养基200μL+淋巴细胞悬液50μL;⑩阳性对照组2:含10μg/mL植物血凝素M的完全培养基100μL+淋巴细胞悬液100μL;⑪空白对照组1:250μL完全培养基;⑫空白对照组2:200μL完全培养基。培养3 d后,采用CCK-8法检测淋巴细胞增殖。结果与结论:①不同实验条件下,同种骨修复材料浸提液均可增强人淋巴细胞的活性,以RPMI改良培养基浸提72 h、浸提液与淋巴细胞悬液的体积比为4∶1的实验条件最为显著;肝素修饰人工晶状体在该条件下对淋巴细胞活性有明显的抑制作用,可能与浸提液中的肝素有关,但在完全培养基浸提24 h、浸提液与淋巴细胞悬液的体积比为4∶1的实验条件下对淋巴细胞活性有轻微的增强作用;②供试品不同浸提条件及作用剂量下,人体外淋巴细胞增殖实验结果可能会有较大差异,实验条件的选择需结合产品临床应用情况,也需考虑产品的固有特性。
基金This work is supported by National High-tech R＆D Program of China （No. 2015AA020502） and the National Natural Science Foundation of China （Nos. 81325011, 21327902 and 21175020）. M. S. acknowledges support from the NSF-PREM program （NSF Award DRM- 1523588）. H. J. acknowledges support from the Fundamental Research Funds for the Central Universities （No. 2242016K41023）, China.
文摘Rheumatoid arthritis （RA） etiology and amelioration remains a challenge in modern therapeutics. Herein, we explored the synergistic effect of allogenic bone marrow stem cell （BMSC） translation and photodynamic treatment of RA with tetra sulfonatophenyl porphyrin （TSPP） and TiO2 nanocomposites as a new strategy for RA theranostics. The translation of BMSCs with miRNAs into infected joints in long bones post-photodynamic therapy is helpful for treating and understanding RA pathophysiology. We observed that allogenic BMSC translation combined with TSPP-TiO2 nanocomposites can significantly （p 〈 0.01） lower the concentrations of serum biomarkers （tumor necrosis factor-α and interleukin-17） in a collagen induced arthritis （CIA） murine model, both in vitro and in vivo, as well as improve other parameters such as arthritis score, BMSC count, complete blood count, and numbers of platelets, red blood cells, and white blood cells. Moreover, a fluorescent TSPP in the feet or long bones and X-ray bioimaging of RA joints revealed the clinical efficacy of BMSCs combined with TSPP-TiO2 nanocomposites. Microarray data analysis illustrated that rnomir-375-3p and rno-mir-196b-3p were up-regulated by approximately 100-fold in the BMSCs of ameliorated RA post-photodynamic therapy with TSPP-TiO2 nanocomposites. Our study not only suggests a new approach for RA theranostics, but also helps in understanding RA pathophysiology.
文摘目的:探究人工骨浆联合同种异体骨治疗对四肢骨缺损患者愈合情况及生活质量的影响。方法:选取102例于2021年5月—2023年12月在赣南医科大学第二附属医院进行治疗的四肢骨缺损患者作为研究对象,进行回顾性分析。根据治疗方式的不同将患者分为异体骨组(n=46,给予单纯同种异体骨治疗)、联合组(n=56,给予人工骨浆联合同种异体骨治疗)。比较两组愈合情况、愈合效果及生活质量。结果:联合组愈合时间早于异体骨组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。联合组和异体骨组术前VAS评分比较,差异无统计学意义(P>0.05);联合组和异体骨组术后24 h VAS评分较术前均降低,且联合组术后24 h VAS评分低于异体骨组,差异均有统计学意义(P<0.05)。联合组术后3个月X射线评分高于异体骨组,差异有统计学意义(P<0.05)。联合组和异体骨组术前健康调查量表36(SF-36)评分比较,差异均无统计学意义(P>0.05);联合组和异体骨组术后3个月SF-36评分均较术前升高,且联合组术后3个月SF-36评分均高于异体骨组,差异均有统计学意义(P<0.05)。结论:与单纯同种异体骨治疗相比,人工骨浆联合同种异体骨治疗四肢骨缺损,患者愈合时间短、术后疼痛感轻,有助于生活质量提高,且安全性高。
