Surface modification of electrospun fibers with mechano-growth factor for mitigating the foreign-body reaction

The implantation of synthetic polymeric scaffolds induced foreign-body reaction(FBR)seriously influence the wound healing and impair functionality recovery.A novel short peptide,mechano-growth factor(MGF),was introduced in this study to modify an electrospun polycaprolactone(PCL)fibrous scaffold to direct the macrophage phenotype transition and mitigate the FBR.In vitro studies discovered the cell signal transduction mechanism of MGF regulates the macrophage polarization via the expression of related genes and proteins.We found that macrophages response the MGF stimuli via endocytosis,then MGF promotes the histone acetylation and upregulates the STAT6 expression to direct an anti-inflammatory phenotype transition.Subsequently,an immunoregulatory electrospun PCL fibrous scaffold was modified by silk fibroin(SF)single-component layer-by-layer assembly,and the SF was decorated with MGF via click chemistry.Macrophages seeded on scaffold to identify the function of MGF modified scaffold in directing macrophage polarization in vitro.Parallelly,rat subcutaneous implantation model and rat tendon adhesion model were performed to detect the immunomodulatory ability of the MGF-modified scaffold in vivo.The results demonstrate that MGF-modified scaffold is beneficial to the transformation of macrophages to M2 phenotype in vitro.More importantly,MGF-functionalized scaffold can inhibit the FBR at the subcutaneous tissue and prevent tissue adhesion.

颌下腺迁徙性鱼刺异物1例

咽部鱼刺异物在耳鼻咽喉头颈外科较为常见,迁徙至颈部也偶有报道,至于迁徙至颌下腺的鱼刺异物,董鹏飞等[1]曾报道1例,本院也发现颌下腺迁徙性异物1例,现报道如下。1临床资料患者,男,44岁。因发现右颌下痛性肿块2个月入院。患者于2个月前发现右颌下有一枚肿块,约小核桃大小,伴有隐痛,偶有进食后肿胀,无畏寒、发热,

Foreign body retained in liver long after gauze packing

This case report describes a foreign body retained in the liver long after perihepatic gauze packing. A 64-year-old female patient had suffered a rib fracture and liver rupture during a traffic accident in 1973. She discovered a mass in her right hypochondrium. Her hepatic ultrasonography showed a round mass (20.3 cm × 17.3 cm × 16.0 cm in size) with fluid echogenicity in the right lobe of her liver, and a hepatic cystic-solid mass (19.7 cm × 18.5 cm × 15.6 cm in size) was identified in an abdominal computerized tomography scan. Several pieces of gauze were extracted, and brown pus from the hepatic mass was suctioned during her exploratory laparotomy. Histology documented gauze remnants with necrotic material inclusions and fibrotic capsules. To our knowledge, this patient's case represents the longest time for which a foreign body has been retained in the liver. In addition, we conducted a comprehensive literature review of foreign bodies retained in the liver. Foreign bodies may be introduced into the liver via penetrating trauma, surgical procedures or the ingestion of foreign bodies (which then migrate from the gut). Thus, they can be classified into the following three categories: penetrating, medical and migrated foreign bodies. The details of the case are thoroughly described.

Magnesium implant degradation provides immunomodulatory and proangiogenic effects and attenuates peri-implant fibrosis in soft tissues

Implants made of magnesium(Mg)are increasingly employed in patients to achieve osteosynthesis while degrading in situ.Since Mg implants and Mg^(2+)have been suggested to possess anti-inflammatory properties,the clinically observed soft tissue inflammation around Mg implants is enigmatic.Here,using a rat soft tissue model and a 1-28 d observation period,we determined the temporo-spatial cell distribution and behavior in relation to sequential changes of pure Mg implant surface properties and Mg^(2+)release.Compared to nondegradable titanium(Ti)implants,Mg degradation exacerbated initial inflammation.Release of Mg degradation products at the tissue-implant interface,culminating at 3 d,actively initiated chemotaxis and upregulated mRNA and protein immunomodulatory markers,particularly inducible nitric oxide synthase and toll-like receptor-4 up to 6 d,yet without a cytotoxic effect.Increased vascularization was demonstrated morphologically,preceded by high expression of vascular endothelial growth factor.The transition to appropriate tissue repair coincided with implant surface enrichment of Ca and P and reduced peri-implant Mg^(2+)concentration.Mg implants revealed a thinner fibrous encapsulation compared with Ti.The detailed understanding of the relationship between Mg material properties and the spatial and time-resolved cellular processes provides a basis for the interpretation of clinical observations and future tailoring of Mg implants.

An immunomodulatory polypeptide hydrogel for osteochondral defect repair

Osteochondral injury is a common and frequent orthopedic disease that can lead to more serious degenerative joint disease.Tissue engineering is a promising modality for osteochondral repair,but the implanted scaffolds are often immunogenic and can induce unwanted foreign body reaction(FBR).Here,we prepare a polypept(o)ide-based PAA-RGD hydrogel using a novel thiol/thioester dual-functionalized hyperbranched polypeptide P(EG3Glu-co-Cys)and maleimide-functionalized polysarcosine under biologically benign conditions.The PAA-RGD hydrogel shows suitable biodegradability,excellent biocompatibility,and low immunogenicity,which together lead to optimal performance for osteochondral repair in New Zealand white rabbits even at the early stage of implantation.Further in vitro and in vivo mechanistic studies corroborate the immunomodulatory role of the PAA-RGD hydrogel,which induces minimum FBR responses and a high level of polarization of macrophages into the immunosuppressive M2 subtypes.These findings demonstrate the promising potential of the PAA-RGD hydrogel for osteochondral regeneration and highlight the importance of immunomodulation.The results may inspire the development of PAA-based materials for not only osteochondral defect repair but also various other tissue engineering and bio-implantation applications.

儿童呼吸道异物并发症的急症处理

呼吸道异物指喉、气管和支气管异物,是耳鼻咽喉科常见急重症之一,多发生于儿童,尤以1～5岁为常见,3岁以下者更为多见。其严重程度取决于异物的性质和造成气道阻塞的程度,轻者可造成肺部损害,重者为猝死的原因之一。因此,防止和妥善处理其并发症,一直为耳鼻咽喉科医务人员所重视。儿童气管。

使用球囊扩张器取出结肠镜检查过程中掉落的AmpliEYE

AmplifEYE can increase the detection rate of adenomatous polyps and stabilize the mucosa for easy biopsy and polypectomy.But it can also become a foreign body when it is dislodged during the procedure.We report a case of dislodged AmplifEYE during colonoscopy that was successfully retrieved using a balloon dilator.