Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surge...Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.展开更多
AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet con...AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet concentrate to treat full-thickness macular holes, and to describe different anatomical outcome. METHODS: A retrospective case series of 8 eyes of 8 patients was described. RESULTS: In all cases investigated, the plateletassisted closure of macular holes was associated with a rapid resolution of cystic cavities in the foveal walls. In two patients, there was a regular regeneration of the foveal morphology after hole closure;the regenerated central fovea had a regular structure with a foveola and photoreceptors. In three other patients, there was an irregular regeneration of the fovea;a foveola was not formed, photoreceptor cells were absent from the foveal center, and the center was composed of Müller and retinal pigment epithelial(RPE) cells. The foveal regeneration after hole closure may proceed with or without a temporary detachment of the foveal center from the RPE, and with or without a direct contact between the central outer nuclear layer(ONL) and the RPE. Contacts between the ONL and RPE were observed only in patients with an irregular foveal regeneration after hole closure.CONCLUSION: The data show that there are different modes of foveal regeneration after closure of macular holes with(re)vitrectomy and platelet concentrate. It is suggested that the regular regeneration of the foveal morphology proceeds by Müller cell-mediated tissue movements without cell proliferation, whereas the irregular foveal regeneration proceeds in part by proliferation of Müller and RPE cells.展开更多
Administration of platelet rich plasma(PRP) and bone marrow aspirate concentrate(BMAC) has shown some promise in the treatment of neurological conditions;however, there is limited information on combined administratio...Administration of platelet rich plasma(PRP) and bone marrow aspirate concentrate(BMAC) has shown some promise in the treatment of neurological conditions;however, there is limited information on combined administration. As such, the purpose of this study was to assess safety and functional outcomes for patients administered combined autologous PRP and BMAC for spinal cord injury(SCI). This retrospective case series included seven patients who received combined treatment of autologous PRP and BMAC via intravenous and intrathecal administration as salvage therapy for SCI. Patients were reviewed for adverse reactions and clinical outcomes using the Oswestry Disability Index(ODI) for up to 1 year, as permitted by availability of follow-up data. Injury levels ranged from C3 through T11, and elapsed time between injury and salvage therapy ranged from 2.4 months to 6.2 years. Post-procedure complications were mild and rare, consisting only of self-limited headache and subjective memory impairment in one patient. Four patients experienced severe disability prior to PRP combined with BMAC injection, as evidenced by high(> 48/100) Oswestry Disability Index scores. Longitudinal Oswestry Disability Index scores for two patients with incomplete SCI at C6 and C7, both of whom had cervical spine injuries, demonstrated a decrease of 28–40% following salvage therapy, representing an improvement from severe to minimal disability. In conclusion, intrathecal/intravenous co-administration of PRP and BMAC resulted in no significant complications and may have had some clinical benefits. Larger clinical studies are needed to further test this method of treatment for patients with SCI who otherwise have limited meaningful treatment options. This study was reviewed and approved by the Ohio Health Institutional Review Board(IRB No. 1204946) on May 16, 2018.展开更多
High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of ...High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of this study were to evaluate the prognostic significance of plasma fibrinogen concentration and platelet count, as well as to determine the overall survival of NSCLC patients with brain metastases. A total of 275 NSCLC patients with brain metastasis were enrolled into this study. Univariate analysis showed that high plasma fibrinogen concentration was associated with age ≥ 65 years(P = 0.011), smoking status(P = 0.009), intracranial symptoms(P = 0.022), clinical T category(P = 0.010), clinical N category(P = 0.003), increased partial thromboplastin time(P < 0.001), and platelet count(P < 0.001). Patients with low plasma fibrinogen concentration demonstrated longer overall survival compared with those with high plasma fibrinogen concentration(median, 17.3 months versus 11.1 months; P ≤ 0.001). A similar result was observed for platelet counts(median, 16.3 months versus 11.4 months; P = 0.004). Multivariate analysis showed that both plasma fibrinogen concentration and platelet count were independent prognostic factors for NSCLC with brain metastases(R2 = 1.698, P < 0.001 and R2 = 1.699, P < 0.001, respectively). Our results suggest that high plasma fibrinogen concentration and platelet count indicate poor prognosis for NSCLC patients with brain metastases. Thus, these two biomarkers might be independent prognostic predictors for this subgroup of NSCLC patients.展开更多
Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparat...Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparative(microfracture) or replacement(autologous osteochondral graft) strategies and demonstrate good clinical outcomes at the short and medium term follow-up. Radiological findings and second-look arthroscopy however, indicate possible poor cartilage repair with evidence of fibrous infill and fissuring of the regenerative tissue following microfracture. Longer-term follow-up echoes these findings as it demonstrates a decline in clinical outcome. The nature of the cartilage repair that occurs for an osteochondral graft to become integrated with the native surround tissue is also of concern. Studies have shown evidence of poor cartilage integration,with chondrocyte death at the periphery of the graft, possibly causing cyst formation due to synovial fluid ingress. Biological adjuncts, in the form of platelet-rich plasma(PRP) and bone marrow aspirate concentrate(BMAC), have been investigated with regard to their potential in improving cartilage repair in both in vitro and in vitro settings. The in vitro literature indicates that these biological adjuncts may increase chondrocyte proliferation as well as synthetic capability, while limiting the catabolic effects of an inflammatory joint environment. These findings have been extrapolated to in vitro animal models, with results showing that both PRP and BMAC improve cartilage repair. The basic science literature therefore establishes the proof of concept that biological adjuncts may improve cartilage repair when used in conjunction with reparative and replacement treatment strategies for osteochondral lesions of the talus.展开更多
Platelet concentration near the blood vessel wall is one of the major factors in the adhesion of platelets to the wall.In our previous studies,it was found that swirling flows could suppress platelet adhesion in small...Platelet concentration near the blood vessel wall is one of the major factors in the adhesion of platelets to the wall.In our previous studies,it was found that swirling flows could suppress platelet adhesion in small-caliber artificial grafts and end-to-end anastomoses.In order to better understand the beneficial effect of the swirling flow,we numerically analyzed the near-wall concentration distribution of platelets in a straight tube and a sudden tubular expansion tube under both swirling flow and normal flow conditions.The numerical models were created based on our previous experimental studies.The simulation results revealed that when compared with the normal flow,the swirling flow could significantly reduce the near-wall concentration of platelets in both the straight tube and the expansion tube.The present numerical study therefore indicates that the reduction in platelet adhesion under swirling flow conditions in small-caliber arterial grafts,or in end-to-end anastomoses as observed in our previous experimental study,was possibly through a mechanism of platelet transport,in which the swirling flow reduced the near-wall concentration of platelets.展开更多
Objective By hybridization in situ and biomech anical approach of platelet-derive d growth fator mRNA(PDGFmRNA)and in-sulin-like growth factor mRNA(IGFmRNA),we discussed the influence of the platelet concentrated liqu...Objective By hybridization in situ and biomech anical approach of platelet-derive d growth fator mRNA(PDGFmRNA)and in-sulin-like growth factor mRNA(IGFmRNA),we discussed the influence of the platelet concentrated liquid on the healing of rabbit ulna frac-ture.Method We selected 24New Zealand rabbits,divided them into 4groups randomly(blank group,serum-control group,g roup with platelet concentrated liquid and group with b one graft and platelet concentrated liquid),and then made the fracture model on t he middle of ulna which was fixed by finger armor plate.Before t he operation,we drew out 6ml blood fr om femoral artery,performed anti-c oagulation with the Sodium Citrate and centrifugated by low and the followed high speed.We purified the white blood plate and injected it into the fracture position.The rabbits were killed at 1st,2nd,4th and 6th week.Q ualitative analysis by hybridizati on in situ of PDGFmRNAand IGFmRNAand biomechanical measurement on the 6th week sample were made.Result Bone callus could be seen on the radiu s specimen in various degrees when th e rabbits were killed at 1st,2nd,4th and 6th week,particularly i n the last week.The average maximum d estructive load on the fracture tip i s higher to the control,and there is significant difference(P <0.01).Conclusion The local application of platelet co ncentration on the fracture tip can a ccelerate its healing.展开更多
目的建立一种自主研发的针对细菌16 S r DNA基因的实时荧光定量PCR(Real-time PCR)方法并评价该方法对浓缩血小板制品中细菌污染检测的效果。方法设计16S r DNA基因保守区引物,构建SYBR Green Real-time PCR反应体系;然后分别将大肠杆...目的建立一种自主研发的针对细菌16 S r DNA基因的实时荧光定量PCR(Real-time PCR)方法并评价该方法对浓缩血小板制品中细菌污染检测的效果。方法设计16S r DNA基因保守区引物,构建SYBR Green Real-time PCR反应体系;然后分别将大肠杆菌、金黄色葡萄球菌、表皮葡萄球菌、蜡样芽孢杆菌和绿脓杆菌以初始浓度为1CFU/m L、10 CFU/m L和100 CFU/m L接种到浓缩血小板中,经22℃保存7 d后,用实时定量荧光PCR方法进行细菌检测。结果细菌污染后的血小板在常规保存条件下,最长保存期<7 d,不同接种浓度的细菌生长情况的变化趋势基本一致,所有种类的细菌均在d 1、2表现出迅猛的增殖高峰,d 3以后增殖趋于平缓。结论该Real-time PCR检测体系可定量地检测出血小板的细菌污染的情况,可适用于血小板输注前的快速细菌污染检测。展开更多
文摘Platelet concentrates(PC) [platelet-rich plasma(PRP) and platelet-rich fibrin(PRF)] are frequently used for surgical procedures in medical and dental fields,particularly in oral and maxillofacial surgery,plastic surgery and sports medicine.The objective of all these technologies is to extract all the elements from a blood sample that could be used to improve healing and promote tissue regeneration.Although leukocyte rich and leukocyte poor PRP's have their own place in literature,the importance of non-platelet components in a platelet concentrate remains a mystery.PC have come a long way since its first appearance in 1954 to the T-PRF,A-PRF and i-PRF introduced recently.These PC find varied applications successfully in periodontics and implant dentistry as well.However,the technique of preparation,standing time,transfer process,temperature of centrifuge,vibration,etc.,are the various factors for the mixed results reported in the literature.Until the introduction of a proper classification of terminologies,the PC were known by different names in different countries and by different commercial companies which also created a lot of confusion.This review intends to clarify all these confusion by briefing the exact evolution of PC,their preparation techniques,recent advances and their various clinical and technical aspects and applications.
文摘AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet concentrate to treat full-thickness macular holes, and to describe different anatomical outcome. METHODS: A retrospective case series of 8 eyes of 8 patients was described. RESULTS: In all cases investigated, the plateletassisted closure of macular holes was associated with a rapid resolution of cystic cavities in the foveal walls. In two patients, there was a regular regeneration of the foveal morphology after hole closure;the regenerated central fovea had a regular structure with a foveola and photoreceptors. In three other patients, there was an irregular regeneration of the fovea;a foveola was not formed, photoreceptor cells were absent from the foveal center, and the center was composed of Müller and retinal pigment epithelial(RPE) cells. The foveal regeneration after hole closure may proceed with or without a temporary detachment of the foveal center from the RPE, and with or without a direct contact between the central outer nuclear layer(ONL) and the RPE. Contacts between the ONL and RPE were observed only in patients with an irregular foveal regeneration after hole closure.CONCLUSION: The data show that there are different modes of foveal regeneration after closure of macular holes with(re)vitrectomy and platelet concentrate. It is suggested that the regular regeneration of the foveal morphology proceeds by Müller cell-mediated tissue movements without cell proliferation, whereas the irregular foveal regeneration proceeds in part by proliferation of Müller and RPE cells.
文摘Administration of platelet rich plasma(PRP) and bone marrow aspirate concentrate(BMAC) has shown some promise in the treatment of neurological conditions;however, there is limited information on combined administration. As such, the purpose of this study was to assess safety and functional outcomes for patients administered combined autologous PRP and BMAC for spinal cord injury(SCI). This retrospective case series included seven patients who received combined treatment of autologous PRP and BMAC via intravenous and intrathecal administration as salvage therapy for SCI. Patients were reviewed for adverse reactions and clinical outcomes using the Oswestry Disability Index(ODI) for up to 1 year, as permitted by availability of follow-up data. Injury levels ranged from C3 through T11, and elapsed time between injury and salvage therapy ranged from 2.4 months to 6.2 years. Post-procedure complications were mild and rare, consisting only of self-limited headache and subjective memory impairment in one patient. Four patients experienced severe disability prior to PRP combined with BMAC injection, as evidenced by high(> 48/100) Oswestry Disability Index scores. Longitudinal Oswestry Disability Index scores for two patients with incomplete SCI at C6 and C7, both of whom had cervical spine injuries, demonstrated a decrease of 28–40% following salvage therapy, representing an improvement from severe to minimal disability. In conclusion, intrathecal/intravenous co-administration of PRP and BMAC resulted in no significant complications and may have had some clinical benefits. Larger clinical studies are needed to further test this method of treatment for patients with SCI who otherwise have limited meaningful treatment options. This study was reviewed and approved by the Ohio Health Institutional Review Board(IRB No. 1204946) on May 16, 2018.
基金supported by grants from Ministry of Science and Technology Projects of China(No.2012AA021502)Provincial Science and Technology Projects of Guangdong(No.2012B031800295)
文摘High expression of fibrinogen and platelets are often observed in non–small cell lung cancer(NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of this study were to evaluate the prognostic significance of plasma fibrinogen concentration and platelet count, as well as to determine the overall survival of NSCLC patients with brain metastases. A total of 275 NSCLC patients with brain metastasis were enrolled into this study. Univariate analysis showed that high plasma fibrinogen concentration was associated with age ≥ 65 years(P = 0.011), smoking status(P = 0.009), intracranial symptoms(P = 0.022), clinical T category(P = 0.010), clinical N category(P = 0.003), increased partial thromboplastin time(P < 0.001), and platelet count(P < 0.001). Patients with low plasma fibrinogen concentration demonstrated longer overall survival compared with those with high plasma fibrinogen concentration(median, 17.3 months versus 11.1 months; P ≤ 0.001). A similar result was observed for platelet counts(median, 16.3 months versus 11.4 months; P = 0.004). Multivariate analysis showed that both plasma fibrinogen concentration and platelet count were independent prognostic factors for NSCLC with brain metastases(R2 = 1.698, P < 0.001 and R2 = 1.699, P < 0.001, respectively). Our results suggest that high plasma fibrinogen concentration and platelet count indicate poor prognosis for NSCLC patients with brain metastases. Thus, these two biomarkers might be independent prognostic predictors for this subgroup of NSCLC patients.
文摘Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparative(microfracture) or replacement(autologous osteochondral graft) strategies and demonstrate good clinical outcomes at the short and medium term follow-up. Radiological findings and second-look arthroscopy however, indicate possible poor cartilage repair with evidence of fibrous infill and fissuring of the regenerative tissue following microfracture. Longer-term follow-up echoes these findings as it demonstrates a decline in clinical outcome. The nature of the cartilage repair that occurs for an osteochondral graft to become integrated with the native surround tissue is also of concern. Studies have shown evidence of poor cartilage integration,with chondrocyte death at the periphery of the graft, possibly causing cyst formation due to synovial fluid ingress. Biological adjuncts, in the form of platelet-rich plasma(PRP) and bone marrow aspirate concentrate(BMAC), have been investigated with regard to their potential in improving cartilage repair in both in vitro and in vitro settings. The in vitro literature indicates that these biological adjuncts may increase chondrocyte proliferation as well as synthetic capability, while limiting the catabolic effects of an inflammatory joint environment. These findings have been extrapolated to in vitro animal models, with results showing that both PRP and BMAC improve cartilage repair. The basic science literature therefore establishes the proof of concept that biological adjuncts may improve cartilage repair when used in conjunction with reparative and replacement treatment strategies for osteochondral lesions of the talus.
基金supported by Grant-in-Aid from the National Natural Science Foundation of China (10632010,11072023)
文摘Platelet concentration near the blood vessel wall is one of the major factors in the adhesion of platelets to the wall.In our previous studies,it was found that swirling flows could suppress platelet adhesion in small-caliber artificial grafts and end-to-end anastomoses.In order to better understand the beneficial effect of the swirling flow,we numerically analyzed the near-wall concentration distribution of platelets in a straight tube and a sudden tubular expansion tube under both swirling flow and normal flow conditions.The numerical models were created based on our previous experimental studies.The simulation results revealed that when compared with the normal flow,the swirling flow could significantly reduce the near-wall concentration of platelets in both the straight tube and the expansion tube.The present numerical study therefore indicates that the reduction in platelet adhesion under swirling flow conditions in small-caliber arterial grafts,or in end-to-end anastomoses as observed in our previous experimental study,was possibly through a mechanism of platelet transport,in which the swirling flow reduced the near-wall concentration of platelets.
文摘Objective By hybridization in situ and biomech anical approach of platelet-derive d growth fator mRNA(PDGFmRNA)and in-sulin-like growth factor mRNA(IGFmRNA),we discussed the influence of the platelet concentrated liquid on the healing of rabbit ulna frac-ture.Method We selected 24New Zealand rabbits,divided them into 4groups randomly(blank group,serum-control group,g roup with platelet concentrated liquid and group with b one graft and platelet concentrated liquid),and then made the fracture model on t he middle of ulna which was fixed by finger armor plate.Before t he operation,we drew out 6ml blood fr om femoral artery,performed anti-c oagulation with the Sodium Citrate and centrifugated by low and the followed high speed.We purified the white blood plate and injected it into the fracture position.The rabbits were killed at 1st,2nd,4th and 6th week.Q ualitative analysis by hybridizati on in situ of PDGFmRNAand IGFmRNAand biomechanical measurement on the 6th week sample were made.Result Bone callus could be seen on the radiu s specimen in various degrees when th e rabbits were killed at 1st,2nd,4th and 6th week,particularly i n the last week.The average maximum d estructive load on the fracture tip i s higher to the control,and there is significant difference(P <0.01).Conclusion The local application of platelet co ncentration on the fracture tip can a ccelerate its healing.
文摘目的建立一种自主研发的针对细菌16 S r DNA基因的实时荧光定量PCR(Real-time PCR)方法并评价该方法对浓缩血小板制品中细菌污染检测的效果。方法设计16S r DNA基因保守区引物,构建SYBR Green Real-time PCR反应体系;然后分别将大肠杆菌、金黄色葡萄球菌、表皮葡萄球菌、蜡样芽孢杆菌和绿脓杆菌以初始浓度为1CFU/m L、10 CFU/m L和100 CFU/m L接种到浓缩血小板中,经22℃保存7 d后,用实时定量荧光PCR方法进行细菌检测。结果细菌污染后的血小板在常规保存条件下,最长保存期<7 d,不同接种浓度的细菌生长情况的变化趋势基本一致,所有种类的细菌均在d 1、2表现出迅猛的增殖高峰,d 3以后增殖趋于平缓。结论该Real-time PCR检测体系可定量地检测出血小板的细菌污染的情况,可适用于血小板输注前的快速细菌污染检测。
