Periosteum is a thin fibrous layer that covers most bones. It resides in a dynamic mechanically loaded environment and provides a niche for pluripotent cells and a source for molecular factors that modulate cell behav...Periosteum is a thin fibrous layer that covers most bones. It resides in a dynamic mechanically loaded environment and provides a niche for pluripotent cells and a source for molecular factors that modulate cell behaviour. Elucidating periosteum regenerative poten-tial has become a hot topic in orthopaedics. This review discusses the state of the art of osteochondral tissue engineering rested on periosteum derived progenitor cells(PDPCs) and suggests upcoming research direc-tions. Periosteal cells isolation, characterization and migration in the site of injury, as well as their differen-tiation, are analysed. Moreover, the role of cell mecha-nosensing and its contribution to matrix organization, bone microarchitecture and bone stenght is examined. In this regard the role of periostin and its upregulation under mechanical stress in order to preserve PDPC sur-vival and bone tissue integrity is contemplated. The re-view also summarized the role of the periosteum in the field of dentistry and maxillofacial reconstruction. The involvement of microRNAs in osteoblast differentiation and in endogenous tissue repair is explored as well. Fi-nally the novel concept of a guided bone regenerationbased on the use of periosteum itself as a smart mate-rial and the realization of constructs able to mimic the extracellular matrix features is talked out. Additionally, since periosteum can differentiate into insulin produc-ing cells it could be a suitable source in allogenic trans-plantations. That innovative applications would takeadvantage from investigations aimed to assess PDPCimmune privilege.展开更多
Periosteum,a membrane covering the surface of the bone,plays an essential role in maintaining the function of bone tissue—and especially in providing nourishment and vascularization during the bone regeneration proce...Periosteum,a membrane covering the surface of the bone,plays an essential role in maintaining the function of bone tissue—and especially in providing nourishment and vascularization during the bone regeneration process.Currently,most artificial periostea have relatively weak mechanical strength and a rapid degradation rate,and they lack integrated angiogenesis and osteogenesis functions.In this study,a bi-layer,biomimetic,artificial periosteum composed of a methacrylated gelatin–nano-hydroxyapatite(GelMA-nHA)cambium layer and a poly(N-acryloyl 2-lycine)(PACG)-GelMA-Mg^(2+)fibrous layer was fabricated via 3D printing.The GelMA-nHA layer is shown to undertake the function of improving osteogenic differentiation of rat bone marrow mesenchymal stem cells with the sustainable release of Ca^(2+) from nHA nanoparticles.The hydrogen-bonding-strengthened P(ACG-GelMA-L)-Mg^(2+)hydrogel layer serves to protect the inner defect site and prolong degradation time(60 days)to match new bone regeneration.Furthermore,the released magnesium ion exhibits a prominent effect in regulating the polarization phenotype of macrophage cells into theM2 phenotype and thus promotes the angiogenesis of the human umbilical vein endothelial cells in vitro.This bi-layer artificial periosteum was implanted into a critical-sized cranial bone defect in rats,and the 12-week post-operative outcomes demonstrate optimal new bone regeneration.展开更多
Objective: To study the efficacy of combined use of a new grafting material, new reconstituted bone xenograft (NRBX) and free periosteal graft in repair of segmental bony defects. Methods: NRBX was made by combining r...Objective: To study the efficacy of combined use of a new grafting material, new reconstituted bone xenograft (NRBX) and free periosteal graft in repair of segmental bony defects. Methods: NRBX was made by combining recombi- nant human BMP2(rhBMP2) and an antigen-free bovine cancellous bone (BCB) as a carrier. NRBX was used alone, in combination with free periosteal graft to repair a 1. 5 cm defect in the radius of rabbit. The defect-repairing capability for each of the treatment modalities was assessed with radiographical, biomechanical, densitometrical and histological methods. Results: NRBX used alone was capable of healing the defect in large by 16 weeks, with a similar repair process and mecha- nism seen with econstituted bone xenograft (RBX). Combined use of NRBX and free periosteal graft was superior in terms of increased and quality of the new bone formed at the early stage of the repair pass (within 12 weeks) to NRBX used alone, with the defect basically healed by 12 weeks. Conclusion: Both methods are effective in repairing segmental bone defects, but NRBX used in combination with free periosteal graft is preferred, because of the satisfactory osteogenesis, osteoconduction and osteoinduction.展开更多
BACKGROUND Nodular fasciitis(NF)is a self-limiting tumor that mostly occurs in the subcutaneous superficial fascia.NF originating from the appendicular periosteum is extremely rare.A large NF lesion of periosteal orig...BACKGROUND Nodular fasciitis(NF)is a self-limiting tumor that mostly occurs in the subcutaneous superficial fascia.NF originating from the appendicular periosteum is extremely rare.A large NF lesion of periosteal origin can be misdiagnosed as a malignant bone tumor and may cause overtreatment.CASE SUMMARY A right axillary mass was found in a 46-year-old man and was initially diagnosed intraoperatively as low-grade sarcoma,but later diagnosed as NF after postresection histopathological evaluation.Furthermore,fluorescence in situ hybridization analysis revealed a USP6 gene rearrangement that confirmed the diagnosis.To the best of our knowledge,this is the first case of NF in the humeral periosteum.CONCLUSION NF poses a diagnostic challenge as it is often mistaken for sarcoma.Postoperative histopathological examination of whole sections can be combined with immunohistochemical staining and,if necessary,the diagnosis can be confirmed by molecular detection,and thus help avoid overtreatment.展开更多
Backgrounds: Reconstruction after hemipelvectomy is very important for rehabilitation into society. The pelvis plays an important role for support of the intra-abdominal organs. Methods: We operated 3 cases using fill...Backgrounds: Reconstruction after hemipelvectomy is very important for rehabilitation into society. The pelvis plays an important role for support of the intra-abdominal organs. Methods: We operated 3 cases using fillet flaps with the femoral periosteum for reconstruction of hemipelvectomy defect. Results: It is useful to elevate the flap all around with the femoral periosteum, because the periosteum can be sutured to supporting pelvic structures with the aim to support intra-abdominal organs. Conclusion: Without alternative supports for the bony pelvis, pelvic reconstructions are at risk for hernia and it may be difficult for outpatients to fit their habiliments after radical cure. The rigid support for the intra-abdominal organs occurs in association with the suture pelvic and femoral periosteum.展开更多
To reconstruct tracheal defect after tumor excision,we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.Methods The contralateral musculo-periosteum flap of the s...To reconstruct tracheal defect after tumor excision,we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.Methods The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy.The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully.Results All flaps survived with epithelization and osteogenesis.The endotracheal tubes were pulled out safely without trachea stenosis in all the patients.Conclusion The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged.This method extends the application of the musculo-periosteum flap.3 refs,4 figs.展开更多
The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative ...The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative stress at the fracture site.However,the introduction of artificial periosteum has demonstrated its ability to promote bone regeneration through the provision of appropriate mechanical support and controlled release of proosteogenic factors.In this study,a poly(L-lactic acid)(PLLA)/hyaluronic acid(HA)-based nanofibrous membrane was fabricated using the coaxial electrospinning technique.The incorporation of irisin into the core-shell structure of PLLA/HA nanofibers(PLLA/HA@Irisin)achieved its sustained release.In vitro experiments demonstrated that the PLLA/HA@Irisin membranes exhibited favorable biocompatibility.The osteogenic differentiation of bone marrow mesenchymal stem cells(BMMSCs)was improved by PLLA/HA@Irisin,as evidenced by a significant increase in alkaline phosphatase activity and matrix mineralization.Mechanistically,PLLA/HA@Irisin significantly enhanced the mitochondrial function of BMMSCs via the activation of the sirtuin 3 antioxidant pathway.To assess the therapeutic effectiveness,PLLA/HA@Irisin membranes were implanted in situ into critical-sized calvarial defects in rats.The results at 4 and 8 weeks post-surgery indicated that the implantation of PLLA/HA@Irisin exhibited superior efficacy in promoting vascularized bone formation,as demonstrated by the enhancement of bone matrix synthesis and the development of new blood vessels.The results of our study indicate that the electrospun PLLA/HA@Irisin nanofibers possess characteristics of a biomimetic periosteum,showing potential for effectively treating critical-sized bone defects by improving the mitochondrial function and maintaining redox homeostasis of BMMSCs.展开更多
Background:Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction.However,surgeons worldwide have not agreed on the details of graft harvesting,including rib selection,si...Background:Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction.However,surgeons worldwide have not agreed on the details of graft harvesting,including rib selection,side preference,operation mode,cutting methods,and handling of the periosteum and perichondrium.This study aimed to provide an overview of the novel techniques used for auto-rib harvesting in rhinoplasty within the past 5 years and identify potential avenues for future research.Methods:We searched for related articles in PubMed,Embase,and Web of Science from 2019 to 2023,summa-rized crucial but controversial steps in recent practice,and analyzed their theoretical basis and clinical feasibility.Results:Auto-rib and cartilage open harvest is still mainstream in rhinoplasty and reconstruction,with the 5th to 8th ribs and cartilage being the most used.The laparoscopic harvest is gaining attention,being second only to the open harvest,with the 9th/10th ribs and cartilages being particularly convenient.The clinical applications of full-cut and split-cut methods differ in their advantages.Except for some special reasons,almost all studies tended to preserve the periosteum and perichondrium in situ,and few surgeons chose to harvest the grafts on the left side.Conclusion:Multiple techniques have emerged,requiring surgeons to balance the benefits and risks of various strategies at each step.New theories and techniques should be fully tested promptly and in clinical practice before wide application.Overall,a professional consensus is needed for better directivity,precision,and stability in clinical practice.展开更多
Background Repair of large bone defects remains a challenge for clinicians. The present study investigated the ability of mesenchymal stem cells （MSCs） and/or periosteum-loaded poly（lactic-co-glycolic acid） （PLGA...Background Repair of large bone defects remains a challenge for clinicians. The present study investigated the ability of mesenchymal stem cells （MSCs） and/or periosteum-loaded poly（lactic-co-glycolic acid） （PLGA） to promote new bone formation within rabbit ulnar segmental bone defects. Methods Rabbit bone marrow-derived MSCs （passage 3） were seeded onto porous PLGA scaffolds. Forty segmental bone defects, each 15 mm in length, were created in the rabbit ulna, from which periosteum was obtained. Bone defects were treated with either PLGA alone （group A）, PLGA ＋ MSCs （group B）, periosteum-wrapped PLGA （group C） or periosteum-wrapped PLGA/MSCs （group D）. At 6 and 12 weeks post-surgery, samples were detected by gross observation, radiological examination （X-ray and micro-CT） and histological analyses. Results Group D, comprising both periosteum and MSCs, showed better bone quality, higher X-ray scores and a greater amount of bone volume compared with the other three groups at each time point （P 〈0.05）. No significant differences in radiological scores and amount of bone volume were found between groups B and C （P 〉0.05）, both of which were significantly higher than group A （P 〈0.05）. Conclusions Implanted MSCs combined with periosteum have a synergistic effect on segmental bone regeneration and that periosteum plays a critical role in the process. Fabrication of angiogenic and osteogenic cellular constructs or tissue-engineered periosteum will have broad applications in bone tissue engineering.展开更多
Objective ： To inquire into the therapeutic effectiveness of free iliac crest grafts with periosteum on old acetabular defects. Methods： From February 1996 to June 2005, 9 patients were treated with free iliac cres...Objective ： To inquire into the therapeutic effectiveness of free iliac crest grafts with periosteum on old acetabular defects. Methods： From February 1996 to June 2005, 9 patients were treated with free iliac crest grafts with periosteum to reconstruct old acetabular defects. There were 7 males and 2 females and the average age was 41.3 years. The acetabular defects were caused by traffic accidents in 6 cases and fall injury in 3 cases. The time from injury to treatment was 4-13 months and averaged 8 months. Intraoperatively we firstly removed the acetabular fracture fragments of the posterior wall. The femoral head was then reducted. Bone graft was harvested from the iliac crest with periosteum, which was sculpted with a rongeur to conform to the defect. The concave （ iliac fossa） side of the graft was placed toward the femoral head. The graft was securedly fixed by two to three leg screws. Results ： Postoperative syndrome was not found in any of the cases. Harris＇ score system showed that the score raised from 32. 3 points preoperatively to 81 points postoperatively. The hip function was evaluated as excellent in 3 cases, good in 4 cases and fair in 2 cases. Conclusions, Although this procedure could not exactly reproduce the anatomy of the hip joint, it enables to restore the posterior stability, provide bone-stock for the hip joints and prevent dislocation of the femoral head.展开更多
Periosteum is a thin membrane that encases the surfaces of most bones.It is composed of an outer fibrous layer contains longitudinally oriented cells and collagen fibers and an inner cambial layer that consists of mul...Periosteum is a thin membrane that encases the surfaces of most bones.It is composed of an outer fibrous layer contains longitudinally oriented cells and collagen fibers and an inner cambial layer that consists of multipotent mesenchymal stem cells（MSCs）and osteogenic progenitor cells.Periosteum has a function of regulating cell and collagen arrangement,which is important to the integrity,modelling and remodelling of bone,particularly during bone defect repair.Apart from autograft and allograft,artificial periosteum,or tissue-engineered periosteum mimicking native periosteum in structure or function,made up of small intestinal submucosa,acellular dermis,induced membrane,cell sheets,and polymeric scaffolds,and so on,has been developed to be used in bone defect repair.In this review,we classify the artificial periosteum into three approaches based on the material source,that is,native tissues,scaffoldfree cell sheets and scaffold-cell composites.Mechanisms,methods and efficacy of each approach are provided.Existing obstacles and enabling technologies for future directions are also discussed.展开更多
目的分析并对比自体带骨膜髂骨移植与同种异体骨骨粉联合富血小板凝胶(platelet rich gel,PRP)治疗HeppleⅤ型距骨骨软骨损伤(osteochondral injury,OLT)。方法选取浙江中医药大学附属金华中医院2018年10月至2022年10月收入的HeppleⅤ型...目的分析并对比自体带骨膜髂骨移植与同种异体骨骨粉联合富血小板凝胶(platelet rich gel,PRP)治疗HeppleⅤ型距骨骨软骨损伤(osteochondral injury,OLT)。方法选取浙江中医药大学附属金华中医院2018年10月至2022年10月收入的HeppleⅤ型OLT患者62例为研究对象,根据其治疗方式将其分为移植组(接受自体带骨膜髂骨移植治疗,31例)、联合组(接受同种异体骨骨粉联合PRP治疗,31例)。对患者进行术后12个月门诊随访研究,评估并比较两组患者术后12个月治疗效果、踝关节活动度(range of motion,ROM)、美国骨科足踝外科学会(American Society of Orthopedic Foot andAnkle Surgeons,AOFAS)踝-后足评分、疼痛评分、满意度、并发症发生率差异。结果移植组治疗总有效率(96.77%)与联合组(93.55%)相比,差异无统计学意义(P>0.05)。术后12个月两组ROM、AOFAS评分均改善(P<0.05),组间差异无统计学意义(P>0.05)。两组患者术后1个月、3个月、6个月、12个月,两组疼痛评分均较术前有所降低(P<0.05)。移植组患者主观总满意度(77.42%),低于联合组(96.77%,P<0.05)。移植组并发症总发生率(19.35%)与联合组(3.23%)相比,明显更高(P<0.05)。结论同种异体骨骨粉联合PRP可避免额外手术切口,患者主观满意度更高,术后并发症发生率低。展开更多
Background Estrogen deficiency contributes to postmenopausal osteoporosis. Periosteum might be a potential target of estrogen, but the underlying mechanism at gene level is far from being elucidated. The objective of ...Background Estrogen deficiency contributes to postmenopausal osteoporosis. Periosteum might be a potential target of estrogen, but the underlying mechanism at gene level is far from being elucidated. The objective of this study was to investigate the correlation between estrogen and fatty acid synthase （FAS） expression in periosteum. Methods Human periosteum cells were cultured in vitro. Expressed genes in the substrated cDNA library were verified using semi-quantitative PCR and real-time PCR. The expression of FAS in periosteum of ovarectomized （OVX） SD rats was investigated. Results FAS gene was most significantly expressed in the subtracted cDNA library of periosteal cells screened by semi-quantitative PCR. Low FAS expression was verified by real-time PCR in the estrogen exposed human periosteum rather than in the control. The estradiol levels were （20.81±12.62） pg/ml, （19.64±4.35） pg/ml and （13.47±1.84） pg/ml in the sham group, the control, and the OVX group, respectively. The estradiol levels in the OVX group was significantly lower （P=-0.0386）. The FAS gene expression in periosteum in the OVX group, sham group, and control group was 3.09±1.97, 1.33±0.47 and 1.51±1.32, respectively. The gene expression in the OVX group was significantly higher （P=0.0372）. Conclusion Estrogen modulates FAS gene expression in in vitro human perisoteum as well as in in vivo rat periosteum.展开更多
基金Supported by Italian FIRB and PRIN project grants,No.2010J8RYS7 and No.RBAP10MLK7
文摘Periosteum is a thin fibrous layer that covers most bones. It resides in a dynamic mechanically loaded environment and provides a niche for pluripotent cells and a source for molecular factors that modulate cell behaviour. Elucidating periosteum regenerative poten-tial has become a hot topic in orthopaedics. This review discusses the state of the art of osteochondral tissue engineering rested on periosteum derived progenitor cells(PDPCs) and suggests upcoming research direc-tions. Periosteal cells isolation, characterization and migration in the site of injury, as well as their differen-tiation, are analysed. Moreover, the role of cell mecha-nosensing and its contribution to matrix organization, bone microarchitecture and bone stenght is examined. In this regard the role of periostin and its upregulation under mechanical stress in order to preserve PDPC sur-vival and bone tissue integrity is contemplated. The re-view also summarized the role of the periosteum in the field of dentistry and maxillofacial reconstruction. The involvement of microRNAs in osteoblast differentiation and in endogenous tissue repair is explored as well. Fi-nally the novel concept of a guided bone regenerationbased on the use of periosteum itself as a smart mate-rial and the realization of constructs able to mimic the extracellular matrix features is talked out. Additionally, since periosteum can differentiate into insulin produc-ing cells it could be a suitable source in allogenic trans-plantations. That innovative applications would takeadvantage from investigations aimed to assess PDPCimmune privilege.
基金the National Key Research and Development Program(No.2018YFA0703100)the National Natural Science Foundation of China(No.51733006).
文摘Periosteum,a membrane covering the surface of the bone,plays an essential role in maintaining the function of bone tissue—and especially in providing nourishment and vascularization during the bone regeneration process.Currently,most artificial periostea have relatively weak mechanical strength and a rapid degradation rate,and they lack integrated angiogenesis and osteogenesis functions.In this study,a bi-layer,biomimetic,artificial periosteum composed of a methacrylated gelatin–nano-hydroxyapatite(GelMA-nHA)cambium layer and a poly(N-acryloyl 2-lycine)(PACG)-GelMA-Mg^(2+)fibrous layer was fabricated via 3D printing.The GelMA-nHA layer is shown to undertake the function of improving osteogenic differentiation of rat bone marrow mesenchymal stem cells with the sustainable release of Ca^(2+) from nHA nanoparticles.The hydrogen-bonding-strengthened P(ACG-GelMA-L)-Mg^(2+)hydrogel layer serves to protect the inner defect site and prolong degradation time(60 days)to match new bone regeneration.Furthermore,the released magnesium ion exhibits a prominent effect in regulating the polarization phenotype of macrophage cells into theM2 phenotype and thus promotes the angiogenesis of the human umbilical vein endothelial cells in vitro.This bi-layer artificial periosteum was implanted into a critical-sized cranial bone defect in rats,and the 12-week post-operative outcomes demonstrate optimal new bone regeneration.
文摘Objective: To study the efficacy of combined use of a new grafting material, new reconstituted bone xenograft (NRBX) and free periosteal graft in repair of segmental bony defects. Methods: NRBX was made by combining recombi- nant human BMP2(rhBMP2) and an antigen-free bovine cancellous bone (BCB) as a carrier. NRBX was used alone, in combination with free periosteal graft to repair a 1. 5 cm defect in the radius of rabbit. The defect-repairing capability for each of the treatment modalities was assessed with radiographical, biomechanical, densitometrical and histological methods. Results: NRBX used alone was capable of healing the defect in large by 16 weeks, with a similar repair process and mecha- nism seen with econstituted bone xenograft (RBX). Combined use of NRBX and free periosteal graft was superior in terms of increased and quality of the new bone formed at the early stage of the repair pass (within 12 weeks) to NRBX used alone, with the defect basically healed by 12 weeks. Conclusion: Both methods are effective in repairing segmental bone defects, but NRBX used in combination with free periosteal graft is preferred, because of the satisfactory osteogenesis, osteoconduction and osteoinduction.
基金Supported by Jilin Province Department of Finance Project,No.2019SCZT005,No.2019SRCJ007 and No.2020SCZT007National Natural Science Foundation of China,No.81902342and Health Commission of Jilin Province,No.2019Q002.
文摘BACKGROUND Nodular fasciitis(NF)is a self-limiting tumor that mostly occurs in the subcutaneous superficial fascia.NF originating from the appendicular periosteum is extremely rare.A large NF lesion of periosteal origin can be misdiagnosed as a malignant bone tumor and may cause overtreatment.CASE SUMMARY A right axillary mass was found in a 46-year-old man and was initially diagnosed intraoperatively as low-grade sarcoma,but later diagnosed as NF after postresection histopathological evaluation.Furthermore,fluorescence in situ hybridization analysis revealed a USP6 gene rearrangement that confirmed the diagnosis.To the best of our knowledge,this is the first case of NF in the humeral periosteum.CONCLUSION NF poses a diagnostic challenge as it is often mistaken for sarcoma.Postoperative histopathological examination of whole sections can be combined with immunohistochemical staining and,if necessary,the diagnosis can be confirmed by molecular detection,and thus help avoid overtreatment.
文摘Backgrounds: Reconstruction after hemipelvectomy is very important for rehabilitation into society. The pelvis plays an important role for support of the intra-abdominal organs. Methods: We operated 3 cases using fillet flaps with the femoral periosteum for reconstruction of hemipelvectomy defect. Results: It is useful to elevate the flap all around with the femoral periosteum, because the periosteum can be sutured to supporting pelvic structures with the aim to support intra-abdominal organs. Conclusion: Without alternative supports for the bony pelvis, pelvic reconstructions are at risk for hernia and it may be difficult for outpatients to fit their habiliments after radical cure. The rigid support for the intra-abdominal organs occurs in association with the suture pelvic and femoral periosteum.
文摘To reconstruct tracheal defect after tumor excision,we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.Methods The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy.The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully.Results All flaps survived with epithelization and osteogenesis.The endotracheal tubes were pulled out safely without trachea stenosis in all the patients.Conclusion The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged.This method extends the application of the musculo-periosteum flap.3 refs,4 figs.
基金supported by the Natural Science Foundation of Jiangsu Province(BK20220046)Key Laboratory of Orthopaedics of Suzhou(SZS2022017)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD).
文摘The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone defects.The challenge of enhancing regenerative potential in bone healing is further compounded by oxidative stress at the fracture site.However,the introduction of artificial periosteum has demonstrated its ability to promote bone regeneration through the provision of appropriate mechanical support and controlled release of proosteogenic factors.In this study,a poly(L-lactic acid)(PLLA)/hyaluronic acid(HA)-based nanofibrous membrane was fabricated using the coaxial electrospinning technique.The incorporation of irisin into the core-shell structure of PLLA/HA nanofibers(PLLA/HA@Irisin)achieved its sustained release.In vitro experiments demonstrated that the PLLA/HA@Irisin membranes exhibited favorable biocompatibility.The osteogenic differentiation of bone marrow mesenchymal stem cells(BMMSCs)was improved by PLLA/HA@Irisin,as evidenced by a significant increase in alkaline phosphatase activity and matrix mineralization.Mechanistically,PLLA/HA@Irisin significantly enhanced the mitochondrial function of BMMSCs via the activation of the sirtuin 3 antioxidant pathway.To assess the therapeutic effectiveness,PLLA/HA@Irisin membranes were implanted in situ into critical-sized calvarial defects in rats.The results at 4 and 8 weeks post-surgery indicated that the implantation of PLLA/HA@Irisin exhibited superior efficacy in promoting vascularized bone formation,as demonstrated by the enhancement of bone matrix synthesis and the development of new blood vessels.The results of our study indicate that the electrospun PLLA/HA@Irisin nanofibers possess characteristics of a biomimetic periosteum,showing potential for effectively treating critical-sized bone defects by improving the mitochondrial function and maintaining redox homeostasis of BMMSCs.
文摘Background:Autologous costal grafts are used universally in clinical practice for rhinoplasty and reconstruction.However,surgeons worldwide have not agreed on the details of graft harvesting,including rib selection,side preference,operation mode,cutting methods,and handling of the periosteum and perichondrium.This study aimed to provide an overview of the novel techniques used for auto-rib harvesting in rhinoplasty within the past 5 years and identify potential avenues for future research.Methods:We searched for related articles in PubMed,Embase,and Web of Science from 2019 to 2023,summa-rized crucial but controversial steps in recent practice,and analyzed their theoretical basis and clinical feasibility.Results:Auto-rib and cartilage open harvest is still mainstream in rhinoplasty and reconstruction,with the 5th to 8th ribs and cartilage being the most used.The laparoscopic harvest is gaining attention,being second only to the open harvest,with the 9th/10th ribs and cartilages being particularly convenient.The clinical applications of full-cut and split-cut methods differ in their advantages.Except for some special reasons,almost all studies tended to preserve the periosteum and perichondrium in situ,and few surgeons chose to harvest the grafts on the left side.Conclusion:Multiple techniques have emerged,requiring surgeons to balance the benefits and risks of various strategies at each step.New theories and techniques should be fully tested promptly and in clinical practice before wide application.Overall,a professional consensus is needed for better directivity,precision,and stability in clinical practice.
文摘Background Repair of large bone defects remains a challenge for clinicians. The present study investigated the ability of mesenchymal stem cells （MSCs） and/or periosteum-loaded poly（lactic-co-glycolic acid） （PLGA） to promote new bone formation within rabbit ulnar segmental bone defects. Methods Rabbit bone marrow-derived MSCs （passage 3） were seeded onto porous PLGA scaffolds. Forty segmental bone defects, each 15 mm in length, were created in the rabbit ulna, from which periosteum was obtained. Bone defects were treated with either PLGA alone （group A）, PLGA ＋ MSCs （group B）, periosteum-wrapped PLGA （group C） or periosteum-wrapped PLGA/MSCs （group D）. At 6 and 12 weeks post-surgery, samples were detected by gross observation, radiological examination （X-ray and micro-CT） and histological analyses. Results Group D, comprising both periosteum and MSCs, showed better bone quality, higher X-ray scores and a greater amount of bone volume compared with the other three groups at each time point （P 〈0.05）. No significant differences in radiological scores and amount of bone volume were found between groups B and C （P 〉0.05）, both of which were significantly higher than group A （P 〈0.05）. Conclusions Implanted MSCs combined with periosteum have a synergistic effect on segmental bone regeneration and that periosteum plays a critical role in the process. Fabrication of angiogenic and osteogenic cellular constructs or tissue-engineered periosteum will have broad applications in bone tissue engineering.
文摘Objective ： To inquire into the therapeutic effectiveness of free iliac crest grafts with periosteum on old acetabular defects. Methods： From February 1996 to June 2005, 9 patients were treated with free iliac crest grafts with periosteum to reconstruct old acetabular defects. There were 7 males and 2 females and the average age was 41.3 years. The acetabular defects were caused by traffic accidents in 6 cases and fall injury in 3 cases. The time from injury to treatment was 4-13 months and averaged 8 months. Intraoperatively we firstly removed the acetabular fracture fragments of the posterior wall. The femoral head was then reducted. Bone graft was harvested from the iliac crest with periosteum, which was sculpted with a rongeur to conform to the defect. The concave （ iliac fossa） side of the graft was placed toward the femoral head. The graft was securedly fixed by two to three leg screws. Results ： Postoperative syndrome was not found in any of the cases. Harris＇ score system showed that the score raised from 32. 3 points preoperatively to 81 points postoperatively. The hip function was evaluated as excellent in 3 cases, good in 4 cases and fair in 2 cases. Conclusions, Although this procedure could not exactly reproduce the anatomy of the hip joint, it enables to restore the posterior stability, provide bone-stock for the hip joints and prevent dislocation of the femoral head.
基金financially supported by National Natural Science Foundation of China(Nos.31525009 and 31271021)National 863 Project(No.2015AA020316)+2 种基金Sichuan Innovative Research Team Program for Young Scientists(No.2016TD0004)Zhejiang Provincial Science and Technology Grant(No.2017C33100)Zhejiang Provincial Natural Science Foundation of China(No.LY17H060010)
文摘Periosteum is a thin membrane that encases the surfaces of most bones.It is composed of an outer fibrous layer contains longitudinally oriented cells and collagen fibers and an inner cambial layer that consists of multipotent mesenchymal stem cells（MSCs）and osteogenic progenitor cells.Periosteum has a function of regulating cell and collagen arrangement,which is important to the integrity,modelling and remodelling of bone,particularly during bone defect repair.Apart from autograft and allograft,artificial periosteum,or tissue-engineered periosteum mimicking native periosteum in structure or function,made up of small intestinal submucosa,acellular dermis,induced membrane,cell sheets,and polymeric scaffolds,and so on,has been developed to be used in bone defect repair.In this review,we classify the artificial periosteum into three approaches based on the material source,that is,native tissues,scaffoldfree cell sheets and scaffold-cell composites.Mechanisms,methods and efficacy of each approach are provided.Existing obstacles and enabling technologies for future directions are also discussed.
文摘目的分析并对比自体带骨膜髂骨移植与同种异体骨骨粉联合富血小板凝胶(platelet rich gel,PRP)治疗HeppleⅤ型距骨骨软骨损伤(osteochondral injury,OLT)。方法选取浙江中医药大学附属金华中医院2018年10月至2022年10月收入的HeppleⅤ型OLT患者62例为研究对象,根据其治疗方式将其分为移植组(接受自体带骨膜髂骨移植治疗,31例)、联合组(接受同种异体骨骨粉联合PRP治疗,31例)。对患者进行术后12个月门诊随访研究,评估并比较两组患者术后12个月治疗效果、踝关节活动度(range of motion,ROM)、美国骨科足踝外科学会(American Society of Orthopedic Foot andAnkle Surgeons,AOFAS)踝-后足评分、疼痛评分、满意度、并发症发生率差异。结果移植组治疗总有效率(96.77%)与联合组(93.55%)相比,差异无统计学意义(P>0.05)。术后12个月两组ROM、AOFAS评分均改善(P<0.05),组间差异无统计学意义(P>0.05)。两组患者术后1个月、3个月、6个月、12个月,两组疼痛评分均较术前有所降低(P<0.05)。移植组患者主观总满意度(77.42%),低于联合组(96.77%,P<0.05)。移植组并发症总发生率(19.35%)与联合组(3.23%)相比,明显更高(P<0.05)。结论同种异体骨骨粉联合PRP可避免额外手术切口,患者主观满意度更高,术后并发症发生率低。
文摘Background Estrogen deficiency contributes to postmenopausal osteoporosis. Periosteum might be a potential target of estrogen, but the underlying mechanism at gene level is far from being elucidated. The objective of this study was to investigate the correlation between estrogen and fatty acid synthase （FAS） expression in periosteum. Methods Human periosteum cells were cultured in vitro. Expressed genes in the substrated cDNA library were verified using semi-quantitative PCR and real-time PCR. The expression of FAS in periosteum of ovarectomized （OVX） SD rats was investigated. Results FAS gene was most significantly expressed in the subtracted cDNA library of periosteal cells screened by semi-quantitative PCR. Low FAS expression was verified by real-time PCR in the estrogen exposed human periosteum rather than in the control. The estradiol levels were （20.81±12.62） pg/ml, （19.64±4.35） pg/ml and （13.47±1.84） pg/ml in the sham group, the control, and the OVX group, respectively. The estradiol levels in the OVX group was significantly lower （P=-0.0386）. The FAS gene expression in periosteum in the OVX group, sham group, and control group was 3.09±1.97, 1.33±0.47 and 1.51±1.32, respectively. The gene expression in the OVX group was significantly higher （P=0.0372）. Conclusion Estrogen modulates FAS gene expression in in vitro human perisoteum as well as in in vivo rat periosteum.
