背景:随着干细胞研究的不断深入和对肾脏缺血再灌注损伤机制的逐渐明晰,干细胞治疗肾脏缺血再灌注损伤已在动物实验中广泛开展并取得了较大进展。因此,有必要开展系统评价以探究干细胞治疗肾脏缺血再灌注损伤的具体疗效。目的:基于动物...背景:随着干细胞研究的不断深入和对肾脏缺血再灌注损伤机制的逐渐明晰,干细胞治疗肾脏缺血再灌注损伤已在动物实验中广泛开展并取得了较大进展。因此,有必要开展系统评价以探究干细胞治疗肾脏缺血再灌注损伤的具体疗效。目的:基于动物实验系统评估干细胞对缺血再灌注损伤肾功能、结构和机体免疫功能的影响及其向临床转化的可行性。方法:计算机检索PubMed、Web of science、Embase、CNKI、维普和万方数据库,检索时间截止2019年5月。由2名研究者独立筛选文献、提取资料,采用SYRCLE动物实验偏倚风险评估工具评价纳入研究的方法学质量,并根据CERQual工具对证据质量进行评估。结果与结论:最终纳入17篇动物实验,但各研究间存在较大的临床异质性,故进行定性描述。相比于安慰剂组,干细胞治疗组动物的肾功能(血清肌酐和血尿素氮水平)均有改善,机体的免疫状况及肾脏的组织损伤也有所好转,但6个结局指标的证据质量均为“低”,同时纳入研究存在一定的偏倚风险。由于纳入研究存在实验设计、证据质量等方面的问题,尚不能确定干细胞的确切疗效以及是否能够或有必要开展进一步临床研究。因此,在开展临床试验之前,有必要进行高质量的临床前研究进一步评估干细胞治疗肾脏缺血再灌注损伤的疗效及向临床转化的可行性,以降低其向临床转化时的风险。展开更多
Enhanced antiinfection activities, improved hemocompatibility and osteo-compatibility, and reinforced osseointegration are among the most important considerations in designing multifunctional orthopedic biomaterials.H...Enhanced antiinfection activities, improved hemocompatibility and osteo-compatibility, and reinforced osseointegration are among the most important considerations in designing multifunctional orthopedic biomaterials.Hereby, anti-infective and osteogenic multifunctional 3 D printed porous Ti6 Al4 V implant with excellent hemocompatibility was successfully designed and fabricated. In brief, osteogenic micro-arc oxidation（MAO） coatings with micro/nanoscale porous topography were generated in situ on3 D printed Ti6 Al4 V scaffolds, on which heparin and vancomycin were easily immobilized. The surface microstructure,morphology, and chemical compositions were characterized employing scanning electron microscopy（SEM）, X-ray photoelectron spectroscopy（XPS） and Fourier transform infrared spectroscopy（FTIR）. High loading capacity and sustained vancomycin release profiles were revealed using high performance liquid chromatography（HPLC）. Favorable antibacterial and antibiofilm performances against pathogenic Staphylococcus aureus（S. aureus） were validated in vitro through microbial viability assays, Live/Dead bacterial staining, and crystal violet staining. Human mesenchymal stem cells（h MSCs） were seeded on the scaffolds and their proliferation and viability were assessed using Cell Counting Kit and Live/Dead cell viability kit. Further, osteoblastic differentiation abilities were evaluated using alkaline phosphatase（ALP） activity as a hall marker. Additionally, the improved hemocompatibility of the heparinized scaffolds was confirmed by activated partial thromboplastin time（APTT）, prothrombin time（PT） and thrombin time（TT）. Overall, our results show that the surface-modified 3 D printed porous Ti6 Al4 V possesses balanced antibacterial and osteogenic functions while exhibiting extra anticlotting effects, boding well for future application in customized functional reconstruction of intricate bone defects.展开更多
文摘背景:随着干细胞研究的不断深入和对肾脏缺血再灌注损伤机制的逐渐明晰,干细胞治疗肾脏缺血再灌注损伤已在动物实验中广泛开展并取得了较大进展。因此,有必要开展系统评价以探究干细胞治疗肾脏缺血再灌注损伤的具体疗效。目的:基于动物实验系统评估干细胞对缺血再灌注损伤肾功能、结构和机体免疫功能的影响及其向临床转化的可行性。方法:计算机检索PubMed、Web of science、Embase、CNKI、维普和万方数据库,检索时间截止2019年5月。由2名研究者独立筛选文献、提取资料,采用SYRCLE动物实验偏倚风险评估工具评价纳入研究的方法学质量,并根据CERQual工具对证据质量进行评估。结果与结论:最终纳入17篇动物实验,但各研究间存在较大的临床异质性,故进行定性描述。相比于安慰剂组,干细胞治疗组动物的肾功能(血清肌酐和血尿素氮水平)均有改善,机体的免疫状况及肾脏的组织损伤也有所好转,但6个结局指标的证据质量均为“低”,同时纳入研究存在一定的偏倚风险。由于纳入研究存在实验设计、证据质量等方面的问题,尚不能确定干细胞的确切疗效以及是否能够或有必要开展进一步临床研究。因此,在开展临床试验之前,有必要进行高质量的临床前研究进一步评估干细胞治疗肾脏缺血再灌注损伤的疗效及向临床转化的可行性,以降低其向临床转化时的风险。
基金the Grant from Ministry of Science and Technology of China(2016YFB1101501)and researchfinancial support from the Beijing AKEC Medical Co.,Ltd.Medical Research Center of Peking University Third Hospital
文摘Enhanced antiinfection activities, improved hemocompatibility and osteo-compatibility, and reinforced osseointegration are among the most important considerations in designing multifunctional orthopedic biomaterials.Hereby, anti-infective and osteogenic multifunctional 3 D printed porous Ti6 Al4 V implant with excellent hemocompatibility was successfully designed and fabricated. In brief, osteogenic micro-arc oxidation（MAO） coatings with micro/nanoscale porous topography were generated in situ on3 D printed Ti6 Al4 V scaffolds, on which heparin and vancomycin were easily immobilized. The surface microstructure,morphology, and chemical compositions were characterized employing scanning electron microscopy（SEM）, X-ray photoelectron spectroscopy（XPS） and Fourier transform infrared spectroscopy（FTIR）. High loading capacity and sustained vancomycin release profiles were revealed using high performance liquid chromatography（HPLC）. Favorable antibacterial and antibiofilm performances against pathogenic Staphylococcus aureus（S. aureus） were validated in vitro through microbial viability assays, Live/Dead bacterial staining, and crystal violet staining. Human mesenchymal stem cells（h MSCs） were seeded on the scaffolds and their proliferation and viability were assessed using Cell Counting Kit and Live/Dead cell viability kit. Further, osteoblastic differentiation abilities were evaluated using alkaline phosphatase（ALP） activity as a hall marker. Additionally, the improved hemocompatibility of the heparinized scaffolds was confirmed by activated partial thromboplastin time（APTT）, prothrombin time（PT） and thrombin time（TT）. Overall, our results show that the surface-modified 3 D printed porous Ti6 Al4 V possesses balanced antibacterial and osteogenic functions while exhibiting extra anticlotting effects, boding well for future application in customized functional reconstruction of intricate bone defects.
