A comparative study of PSPVP and PSIBG in the treatment of stage II-III Kummell's disease.

BACKGROUND: Percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) are commonly employed for Kummell's disease in stages II-III; however, these techniques produce some complications. OBJECTIVE: To compare the clinical efficacy and imaging results of percutaneous vertebroplasty + bone cement-augmented short-segment pedicle screw fixation (PSPVP) versus transpedicular intracorporeal bone grafting + pedicle screw fixation (PSIBG) in the treatment of stage II-III Kummell's disease. METHODS: A total of 69 patients admitted between November 2017 and March 2021 were included in this study; 36 of these were treated with PSPVP, and 33 were treated with PSIBG. Patients in the two groups were compared in terms of perioperative, follow-up, and imaging data. RESULTS: No statistically significant differences were found between the two groups in terms of operation duration (P > 0.05). However, the PSPVP group was superior to the PSIBG group in terms of incision length, intraoperative blood loss, and length of stay (P < 0.05). All patients were followed up for more than 12 months. The VAS score, height of anterior vertebral margin, kyphosis Cobb angle, wedge angle of the affected vertebra at seven days after surgery and last follow-up, and the ODI index at the last follow-up of the two groups were significantly improved compared with figures before surgery (P < 0.05). Compared with values before surgery, no statistically significant differences were found in the height of the posterior vertebral margin in the PSPVP group at seven days after surgery and at the last follow-up (P > 0.05). There were also no statistically significant differences in the VAS score, ODI index, kyphosis Cobb angle, and wedge angle of the affected vertebra between the two groups at corresponding time points (P > 0.05). The heights of the anterior and posterior vertebral margins in the PSIBG group were better than those in the PSPVP group after surgery and at the last follow-up (P < 0.05). In the PSPVP group, a pedicle screw fracture occurred in one patient two months after surgery, while an upper adjacent vertebral fracture occurred in one patient eight months after surgery. CONCLUSION: Both PSPVP and PSIBG can achieve good early clinical efficacy in the treatment of stage II-III Kummell's disease, with PSPVP being relatively less invasive while producing a poorer orthopedic effect and more complications than PSIBG.

Systematic Review of Silk Scaffolds in Musculoskeletal Tissue Engineering Applications in the Recent Decade.

During the past decade, various novel tissue engineering (TE) strategies have been developed to maintain, repair, and restore the biomechanical functions of the musculoskeletal system. Silk fibroins are natural polymers with numerous advantageous properties such as good biocompatibility, high mechanical strength, and low degradation rate and are increasingly being recognized as a scaffolding material of choice in musculoskeletal TE applications. This current systematic review examines and summarizes the latest research on silk scaffolds in musculoskeletal TE applications within the past decade. Scientific databases searched include PubMed, Web of Science, Medline, Cochrane library, and Embase. The following keywords and search terms were used: musculoskeletal, tendon, ligament, intervertebral disc, muscle, cartilage, bone, silk, and tissue engineering. Our Review was limited to articles on musculoskeletal TE, which were published in English from 2010 to September 2019. The eligibility of the articles was assessed by two reviewers according to prespecified inclusion and exclusion criteria, after which an independent reviewer performed data extraction and a second independent reviewer validated the data obtained. A total of 1120 articles were reviewed from the databases. According to inclusion and exclusion criteria, 480 articles were considered as relevant for the purpose of this systematic review. Tissue engineering is an effective modality for repairing or replacing injured or damaged tissues and organs with artificial materials. This Review is intended to reveal the research status of silk-based scaffolds in the musculoskeletal system within the recent decade. In addition, a comprehensive translational research route for silk biomaterial from bench to bedside is described in this Review.

Single-cell RNA-seq reveals functionally distinct biomaterial degradation-related macrophage populations.

Macrophages play crucial roles in host tissue reaction to biomaterials upon implantation in vivo. However, the complexity of biomaterial degradation-related macrophage subpopulations that accumulate around the implanted biomaterials in situ is not fully understood. Here, using single cell RNA-seq, we analyze the transcriptome profiles of the various cell types around the scaffold to map the scaffold-induced reaction, in an unbiased approach. This enables mapping of all biomaterial degradation-associated cells at high resolution, revealing distinct subpopulations of tissue-resident macrophages as the major cellular sources of biomaterial degradation in situ. We also find that scaffold architecture can affect the mechanotransduction and catabolic activity of specific material degradation-related macrophage subpopulations in an Itgav-Mapk1-Stat3 dependent manner, eventually leading to differences in scaffold degradation rate in vivo. Our work dissects unanticipated aspects of the cellular and molecular basis of biomaterial degradation at the single-cell level, and provides a conceptual framework for developing functional tissue engineering scaffolds in future.

Effects of knurl tooth angle on mechanical and thermal behaviors of aluminum ultrasonic welding.

Ultrasonic welding (USW) has been receiving more and more attentions in material joining field due to its advantages of cleanness and high efficiency. The knurl tooth angle (KTA), as a key factor of horn knurl geometry (HKG), has significant influences on the contact and friction behavior of the joint formation. Although there have been some researches on the simulation of ultrasonic welding, the 3D finite element (FE) model considering the influence of KTA has not been reported. In this study, the FE models of different KTAs are established to reveal the effects of KTA on joint formation. The simulation result shows that the KTA greatly influences the process parameters of the USW after 0.025 s. The gaps of the faying interface and local stress concentration in the sonotrode-workpiece contact area, caused by KTAs less than 120°, are the main reasons for the strength reduction of the joint. The higher average equivalent plastic strain and temperature of the welding area, formed by KTAs greater than 130°, are turned out to be the main reasons for the formation of more bonds. The simulation has been verified by experiments, and the results provide guidance to improve the quality of the joint.

A collagen-coated sponge silk scaffold for functional meniscus regeneration.

Tissue engineering is a promising solution for meniscal regeneration after meniscectomy. However, in situ reconstruction still poses a formidable challenge due to multifunctional roles of the meniscus in the knee. In this study, we fabricate a silk sponge from 9% (w/v) silk fibroin solution through freeze drying and then coat its internal space and external surface with collagen sponge. Subsequently, various characteristics of the silk-collagen scaffold are evaluated, and cytocompatibility of the construct is assessed in vitro and subcutaneously. The efficacy of this composite scaffold for meniscal regeneration is evaluated through meniscus reconstruction in a rabbit meniscectomy model. It is found that the internally coated collagen sponge enhances the cytocompatibility of the silk sponge, and the external layer of collagen sponge significantly improves the initial frictional property. Additionally, the silk-collagen composite group shows more tissue ingrowth and less cartilage wear than the pure silk sponge group at 3 months postimplantation in situ. These findings thus demonstrate that the composite scaffold had less damage to the joint surface than the silk alone through promoting functional meniscal regeneration after meniscectomy, which indicates its clinical potential in meniscus reconstruction.

[Diagnosis and treatment of odontoid fracture combined with lower cervical spinal injury].

OBJECTIVE: To investigate the mechanism, clinical features and treatment of odontoid fracture combined with lower cervical spinal injury. METHODS: From January 1999 to December 2004, 57 cases of type II or shallow type III odontoid fractures were studied retrospectively. Six cases were found combined with lower cervical injury, the mean age was 54 years, and 4 of the 6 cases were complicated with cervical spondylarthrosis or ankylosing spondylitis. For the lower cervical injury, fracture-dislocation was found in 2 cases, the disruption of disc and ligament was found in 4 cases among which 2 cases were suffered from incomplete spinal cord injury; Both were caused by lower cervical spinal injury. All of the 6 cases were performed with surgery in odontoid fracture and lower cervical spinal injury simultaneously; Lower cervical spinal injuries were stabilized firstly in 2 cases, which responsible for neurological involvement; For the other 4 cases without neurological involvement, stabilization was performed in odontoid fracture firstly in 2 cases, due to inability to achieve reduction of odontoid fracture preoperatively, however, for the another 2 cases with anatomic reduction of the odontoid fracture preoperatively, lower cervical injuries were stabilized firstly. RESULTS: After an average follow-up of 10 months, all cases were obtained solid fusion both in odontoid fracture and lower cervical spinal injury, and without the complications associated with operation and prolonged bed rest. Two cases with neurological defect improved 1 scale in Frankel score. CONCLUSIONS: The incidence of odontoid fracture combined with lower cervical spinal injury is about 10.5% of the odontoid fracture, and it is vulnerable in the elderly patient with cervical spondylarthrosis. MRI should be used routinely for accurate diagnosis. Surgical stabilization is the choice of treatment due to facilitating early rehabilitation and reducing the complications. The surgical schedule is planned according to the fact of neurological involvement and the extent of stability between the odontoid fracture and lower cervical spinal injury.

Long-term effects of knitted silk-collagen sponge scaffold on anterior cruciate ligament reconstruction and osteoarthritis prevention.

Anterior cruciate ligament (ACL) is difficult to heal after injury due to the dynamic fluid environment of joint. Previously, we have achieved satisfactory regeneration of subcutaneous tendon/ligament with knitted silk-collagen sponge scaffold due to its specific "internal-space-preservation" property. This study aims to investigate the long-term effects of knitted silk-collagen sponge scaffold on ACL regeneration and osteoarthritis prevention. The knitted silk-collagen sponge scaffold was fabricated and implanted into a rabbit ACL injury model. The knitted silk-collagen sponge scaffold was found to enhance migration and adhesion of spindle-shaped cells into the scaffold at 2 months post-surgery. After 6 months, ACL treated with the knitted silk-collagen sponge scaffold exhibited increased expression of ligament genes and better microstructural morphology. After 18 months, the knitted silk-collagen sponge scaffold-treated group had more mature ligament structure and direct ligament-to-bone healing. Implanted knitted silk-collagen sponge scaffolds degraded much more slowly compared to subcutaneous implantation. Furthermore, the knitted silk-collagen sponge scaffold effectively protected joint surface cartilage and preserved joint space for up to 18 months post-surgery. These findings thus demonstrated that the knitted silk-collagen sponge scaffold can regenerate functional ACL and prevent osteoarthritis in the long-term, suggesting its clinical use as a functional bioscaffold for ACL reconstruction.

A cylindrical standing wave ultrasonic motor using bending vibration transducer.

A cylindrical standing wave ultrasonic motor using bending vibration transducer was proposed in this paper. The proposed stator contains a cylinder and a bending vibration transducer. The two combining sites between the cylinder and the transducer locate at the adjacent wave loops of bending vibration of the transducer and have a distance that equal to the half wave length of bending standing wave excited in the cylinder. Thus, the bending mode of the cylinder can be excited by the bending vibration of the transducer. Two circular cone type rotors are pressed in contact to the end rims of the teeth, and the preload between the rotors and stator is accomplished by a spring and nut system. The working principle of the proposed motor was analyzed. The motion trajectories of teeth were deduced. The stator was designed and analyzed with FEM. A prototype motor was fabricated and measured. Typical output of the prototype is no-load speed of 165rpm and maximum torque of 0.45Nm at an exciting voltage of 200V(rms).

Actuating mechanism and design of a cylindrical traveling wave ultrasonic motor using cantilever type composite transducer.

BACKGROUND: Ultrasonic motors (USM) are based on the concept of driving the rotor by a mechanical vibration excited on the stator via piezoelectric effect. USM exhibit merits such as simple structure, quick response, quiet operation, self-locking when power off, nonelectromagnetic radiation and higher position accuracy. PRINCIPAL FINDINGS: A cylindrical type traveling wave ultrasonic motor using cantilever type composite transducer was proposed in this paper. There are two cantilevers on the outside surface of cylinder, four longitudinal PZT ceramics are set between the cantilevers, and four bending PZT ceramics are set on each outside surface of cantilevers. Two degenerate flexural vibration modes spatially and temporally orthogonal to each other in the cylinder are excited by the composite transducer. In this new design, a single transducer can excite a flexural traveling wave in the cylinder. Thus, elliptical motions are achieved on the teeth. The actuating mechanism of proposed motor was analyzed. The stator was designed with FEM. The two vibration modes of stator were degenerated. Transient analysis was developed to gain the vibration characteristic of stator, and results indicate the motion trajectories of nodes on the teeth are nearly ellipses. CONCLUSIONS: The study results verify the feasibility of the proposed design. The wave excited in the cylinder isn't an ideal traveling wave, and the vibration amplitudes are inconsistent. The distortion of traveling wave is generated by the deformation of bending vibration mode of cylinder, which is caused by the coupling effect between the cylinder and transducer. Analysis results also prove that the objective motions of nodes on the teeth are three-dimensional vibrations. But, the vibration in axial direction is minute compared with the vibrations in circumferential and radial direction. The results of this paper can guide the development of this new type of motor.

The effect of incorporation of exogenous stromal cell-derived factor-1 alpha within a knitted silk-collagen sponge scaffold on tendon regeneration.

This study developed a bioactive knitted silk-collagen sponge scaffold by incorporation of exogenous SDF-1 alpha, to enable selective migration and homing of cells for in situ tendon regeneration. With in vitro studies, it was observed that CXCR4 gene expression and migration of bone mesenchymal stromal cells and hypo-dermal fibroblasts were more sensitive to exogenous SDF-1 alpha, while expression of tendon repair gene markers by hypo-dermal fibroblasts and Achilles tendon fibroblasts were more sensitive to exogenous SDF-1 alpha. With a rat Achilles tendon injury model, exogenous SDF-1 alpha was shown to reduce infiltration of inflammatory cells and enhance migration of fibroblast-like cells into the scaffold at 4 days and 1 week post-surgery. After 4 weeks, SDF-1 alpha treated tendon had increased expression of tendon repair gene markers and endogenous SDF-1 alpha, exhibited more physiological microstructures with larger diameter collagen fibrils, and had better biomechanical properties than the control group. Hence, our bioactive scaffold improved efficacy of tendon regeneration by increasing the recruitment of fibroblast-like cells, enhancing local endogenous SDF-1 alpha and tendon extracellular matrix production, and decreasing accumulation of inflammatory cells. Incorporation of SDF-1 alpha within a knitted silk-collagen sponge scaffold can therefore be a practical application for tendon tissue engineering.

Bcl-2 and caspase-8 related anoikis resistance in human osteosarcoma MG-63 cells.

Detachment of adherent cells from extracellular matrix results in apoptosis, a process termed "anoikis". Resistance to anoikis is implicated in the progression of many malignancies by facilitating the migration and eventual colonization of distant sites. Human kidney epithelial cells 293T, human osteoblast cells hFOB 1.19 and human osteosarcoma cells Saos-2 significantly underwent anoikis when adherence was prevented. But human osteosarcoma MG-63 cells were distinctly anoikis resistant when detached. They formed large aggregates and showed little apoptosis compared to the other cells. When MG-63 cells were in suspension, caspase-8, physically associated with death receptor was activated by cell-matrix detachment, whereas. Caspase-3 and caspase-9 were not activated. Translational level of Bcl-2 significantly increased in a time-dependent manner, but the level of beta-catenin and PI3K did not. Caspase-8 participates in an anoikis-inducing process in MG-63 cells at an early time, and overexpression of Bcl-2 blocks activation of caspase-8 making MG-63 cells anoikis resistant.