The significance of the best puncture side bone cement/vertebral volume ratio to prevent paravertebral vein leakage of bone cement during vertebroplasty: a retrospective study.

OBJECTIVES: To verify the clinical significance of the best puncture-side bone cement/vertebral volume ratio (PSBCV/VV%) and bone cement leakage in paravertebral veins during vertebroplasty. METHODS: This was a retrospective analysis of a total of 210 patients from September 2021 to December 2022, who were divided into an observation group (110 patients) and a control group (100 patients). In the observation group, patients' preoperative computed tomography (CT) data were imported into Mimics software, and the VV was calculated using the three-dimensional (3D) reconstruction function. Then, based on the best PSBCV/VV% of 13.68% determined in a previous study, the optimal PSBCV to be injected during vertebroplasty was calculated. In the control group, vertebroplasty was performed directly using the conventional method. The incidence of cement leakage into paravertebral veins was observed postoperatively in both groups. RESULTS: There were no statistically significant differences (P > 0.05) in the evaluated indicators between the two groups pre- or postoperatively, including the anterior vertebral margin height, mid-vertebral height, injured vertebral Cobb angle, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). Intragroup comparisons showed improvements in the anterior vertebral height, mid-vertebral height, injured vertebral Cobb angle, VAS score, and ODI after surgery compared with before surgery (P < 0.05). In the observation group, there were 3 cases of cement leakage into the paravertebral veins, for a leakage rate of 2.7%. In the control group, there were 11 cases of cement leakage into the paravertebral veins, for a leakage rate of 11%. The difference in the leakage rate between the two groups was statistically significant (P = 0.016). CONCLUSION: In vertebroplasty, preoperative VV calculations using Mimics software, combined with calculation of the PSBCV according to the best PSBCV/VV% (13.68%), can effectively prevent leakage of bone cement into paravertebral veins and further prevent serious life-threatening complications such as pulmonary embolism.

Correlation analysis of the puncture-side bone cement/vertebral body volume ratio and bone cement leakage in the paravertebral vein in vertebroplasty.

OBJECTIVES: To explore the influencing factors of bone cement leakage in the paravertebral vein after vertebroplasty for the treatment of osteoporotic vertebral compression fractures (OVCFs) and to determine the correlation between the puncture-side bone cement/vertebral body volume ratio and bone cement leakage in the paravertebral vein. METHODS: This was a retrospective analysis of 495 patients (585 vertebral bodies) with OVCFs treated from August 2018 to May 2021 in our hospital. The patients' postoperative CT data were imported into Mimics software, and the three-dimensional(3D) reconstruction function was used to calculate the bone cement volume (BCV), puncture-side bone cement volume (PSBCV), and vertebral body volume (VBV); the bone cement/vertebral body volume ratio (BCV/VCV%) and puncture-side bone cement/vertebral body volume ratio (PSBCV/VCV%) were additionally calculated. Sex, Age, Body mass index(BMI), Bone density, BCV, PSBCV, VBV, BCV/VCV%, and PSBCV/VCV were compared between the leakage group and the non-leakage group. Logistic regression analysis was used to assess the correlations between the factors that statistically significantly differed between the two groups and the presence of leakage in the paravertebral veins. A receiver operating characteristic (ROC) curve was used to determine the diagnostic value of the PSBCV/VCV% and to obtain the optional cut-off value. RESULTS: A total of 102 males and 393 females with an average age of 72.89 (52 ~ 93) years were included in our study. There were 57 cases of cement leakage (59 vertebral bodies) in the paravertebral vein. There were 438 patients (526 vertebral bodies) without paravertebral cement leakage. Univariate analysis showed that the differences in sex, bone density, PSBCV, and PSBCV/VCV% between the two groups were statistically significant (P < 0.05). Logistic regression analysis showed that there were correlations between sex, bone density, and PSBCV/VCV% and the presence of paravertebral cement leakage (P < 0.05). The ROC curve showed that the area under the curve of the PSBCV/VCV% for the diagnosis of cement leakage in the paravertebral vein was greater than 0.65, and P < 0.05, indicating a diagnostic value. The best cut-off point for the diagnosis of paravertebral cement leakage with the PSBCV/VCV% was 13.68%, with a sensitivity of 84.7% and specificity of 37.8%. CONCLUSION: Sex, bone density, and PSBCV/VCV% are risk factors for cement leakage in the paravertebral veins after vertebroplasty for the treatment of OVCFs; the PSBCV/VCV% is strongly associated with paravertebral venous leakage, and the optimal PSBCV/VCV% is 13.68%. When the PSBCV/VCV% exceeds the optimal value, the risk of cement leakage in the paravertebral vein becomes significantly increased.

Rhodopsin-Like Ionic Gate Fabricated with Graphene Oxide and Isomeric DNA Switch for Efficient Photocontrol of Ion Transport.

Rhodopsin, composed of opsin and isomeric retinal, acts as the primary photoreceptor by converting light into electric signals. Inspired by rhodopsin, we have fabricated a light-regulated ionic gate on the basis of the design of a graphene oxide (GO)-biomimetic DNA-nanochannel architecture. In this design, photoswitchable azobenzene (Azo)-DNA is introduced to the surface of porous anodic alumina (PAA) membrane. With modulation of the interaction between the GO blocker and Azo-DNA via flexibly regulating trans and cis states of Azo under the irradiation of visible and ultraviolet light, alternatively, the ionic gate is switched between ON and OFF states. This newly constructed ionic gate can possess high efficiency for the control of ion transport because of the high blocking property of GO and the rather tiny path within the barrier layer which are both first employed to fabricate ionic gate. We anticipate that this rhodopsin-like ionic gate may provide a new model and method for the investigation of ion channel, ion function, and ion quantity. In addition, because of the advantages of simple fabrication, good biocompatibility, and universality, this bioinspired system may have potential applications as optical sensors, in photoelectric transformation, and in controllable drug delivery.

Development of a non-blurring, dual-imaging tissue marker for gastrointestinal tumor localization.

BACKGROUND: Knowing the exact location of gastrointestinal tumors both preoperatively and intraoperatively is essential for planning and performing laparoscopic surgery. Different techniques have been introduced to ascertain tumor locations during surgery, but none of these are fully satisfactory at establishing the minimum margins for organ resection while retaining curability. A new, non-blurring tissue marker, detectable by both X-ray computed tomography (CT) and near-infrared (NIR) fluorescence laparoscopy, has been developed, and we here examine its utility using an animal model. METHODS: Liposomes, comprised phospholipids and an NIR fluorescent dye (an indocyanine green derivative), and emulsions, consisting of phospholipids and oily radiographic contrast medium, were combined with polyglycerol-polyricinoleate to form giant cluster-like vesicles. This vesicular dispersion (300 µl) was administered into the porcine gastric submucosa using a gastroendoscope, and the detectability of the marker was examined using X-ray CT and NIR fluorescence laparoscopy. RESULTS: One hour after the administration of the vesicular dispersion, X-ray CT identified four individual injection sites, each at a 1-cm radius of a metal hemostasis clip. NIR fluorescence laparoscopy detected individual fluorescent spots 18 hours after the administration of the vesicular dispersion. CONCLUSION: We anticipate that this newly developed tissue marker will contribute to the preoperative simulation of laparoscopic gastrointestinal cancer surgery and its intraoperative navigation.

[Three dimensional CT for measuring mandibles morphology in 54 normal Chinese adults].

OBJECTIVE: To establish a method of morphologic measurement of the mandibles and obtain the average values of three dimensional morphologic measurements of the mandibles. METHODS: A method of morphologic measurement of the mandibles was established firstly. The three dimensional CT data of 54 normal adult skulls were measured by this method. The data were analyzed by SPSS 13.0 statistical software. RESULTS: In the study, 84 groups of mean values and standard deviations of the length, width, height, depth, thickness and angle of the mandibular contour in males and females were obtained. There were significant differences between the male and the female in the 66 of the 84 groups data, while the 16 of the 84 groups data had no significant differences and distributed symmetry on both sides of the mandibles. No correlation was found in the mandibular contour data in length, width, height and depth. CONCLUSION: The characteristics of adult mandibular contours are different between males and females, indicating that each individual has its own morphologic features.

Evaluation and Calibration of CBCT Reconstruction Models.

PURPOSE: This study proposes a method for improving the accuracy of three-dimensional (3D) models generated through cone-beam computed tomography (CBCT). METHODS: A 3D cuboid model fitted with a »-scale dentition on its top surface was constructed to simulate an alveolar bone with teeth. A physical specimen of the model was printed and the distance between its opposite sides was measured using a vernier caliper. The physical model was light-scanned, and the surface data of the generated 3D model were corrected by calibrating the distance between opposite sides against the vernier caliper measurements. The physical model was also scanned using CBCT to reconstruct a second 3D model. The overall deviation between the two models and the distance deviation in each direction of the cuboid and dentition were quantified and statistically analyzed. RESULTS: The overall deviation between the reconstructed CBCT model and the calibrated structured light-scanned model was 0.098 ± 0.001 mm. Following calibration, the overall deviation was 0.010 ± 0.006 mm. A one-way variance analysis suggested that the overall deviations' differences were not statistically significant (P < 0.05). CONCLUSION: This study lays a solid foundation for accurate dental implantation.

Direct acupuncture of nitric oxide by an electrochemical microsensor with high time-space resolution.

Measurement of signal molecule is critically important for understanding living systems. Nitric oxide (NO) is a key redox signal molecule that shows diverse roles in virtually all life forms. However, probing into NO's activities is challenging as NO has restricted lifetime (<10 s) and limited diffusion distance (usually <200 µm). So, for the direct acupuncture of NO within the time-space resolution, an electrochemical microsensor has been designed and fabricated in this work. Fabrication of the microsensor is achieved by (1) selective assembly of an electrocatalytic transducer, (2) attaching the transducer on carbon fiber electrode, and (3) covered it with a screen layer to reduce signal interference. The fabricated microsensor exhibits high sensitivity (LOD, 13.5 pM), wide detection range (100 pM-5 µM), and good selectivity. Moreover, studies have revealed that the availability of the sensor for efficient detection of NO is due to the formation of a specific DNA/porphyrin hybrid structure that has synergetic effects on NO electrocatalysis. Therefore, NO release by cells and tissues can be directly and precisely traced, in which we have obtained the release pattern of NO by different cancer cell lines, and have known its dynamics in tumor microenvironment. The fabricated electrocatalytic microsensor may provide a unique and useful tool for the direct assay of NO with high time-space resolution, which promisingly gives a technical solution for the bioassay of NO in living systems.

[Application of Curved Diffusion Needle in unilateral percutaneous vertebroplasty].

OBJECTIVE: To evaluate the effectiveness of Curved Diffusion Needle in unilateral percutaneous vertebroplasty (PVP) by compared with bilateral PVP. METHODS: A clinical data of 93 patients with osteoporotic vertebral compression fracture (OVCF) treated with PVP between January 2020 and January 2021 was retrospectively analyzed, including 47 patients underwent unilateral PVP assisted with Curved Diffusion Needle (unilateral group) and 46 patients underwent bilateral PVP (bilateral group). There was no significant difference in gender, age, cause of injury, time from injury to operation, T value of bone mineral density, AO classification, distribution of injured vertebrae, and preoperative visual analogue scale (VAS) score, Oswestry disability index (ODI), relative height of injured vertebrae, and Cobb angle between the two groups ( P>0.05). The operation time, the amount of bone cement injection, the incidence of bone cement leakage, the bone cement diffusion distribution, VAS score, ODI, the relative height of injured vertebrae, and Cobb angle were recorded and compared between the two groups. RESULTS: All operations successfully completed. The operation time was significantly shorter in unilateral group than in bilateral group ( t=-13.936, P=0.000), and the amount of bone cement injection was significantly less in unilateral group than in bilateral group ( t=-13.237, P=0.000). The incidence of bone cement leakage in unilateral group was 19.14%, which was significantly lower than that in bilateral group (39.13%) ( χ 2=4.505, P=0.034). The score of bone cement distribution in unilateral group was 7.0±1.3, of which 41 cases were excellent and 6 cases were well. The score of bilateral group was 7.4±0.8, of which 43 cases were excellent and 3 cases were well. There was no significant difference in score and grading of bone cement distribution between the two groups ( t=-1.630, P=0.107; Z=-1.013, P=0.311). All patients were followed up and the follow-up time was 3-10 months (mean, 6.5 months) in unilateral group and 3-10 months (mean, 6.1 months) in bilateral group. The VAS score, ODI, the relative height of injured vertebrae, and Cobb angle at 24 hours after operation and last follow-up were significantly better than those before operation in the two groups ( P<0.05). There were significant differences in all indicators between 24 hours after operation and last follow-up ( P<0.05). There was no significant difference in all indexes between the two groups ( P>0.05) at the same time point after operation. During follow-up, there was no complication such as contralateral vertebral collapse, refracture, adjacent vertebral fracture, or local kyphosis in the two groups. CONCLUSION: Unilateral PVP assisted with Curved Diffusion Needle for OVCF is beneficial to the distribution of bone cement, which can not only achieve similar effectiveness to bilateral PVP, but also achieve shorter operation time, less bone cement injection, and lower risk of bone cement leakage.

A novel polymer micelle as a targeted drug delivery system for 10-hydroxycamptothecin with high drug-loading properties and anti-tumor efficacy.

A novel polyethylene glycol-polycaprolactone-poly-l-tyrosine (MPEG-PCL-PTyr) amphiphilic triblock copolymer micelle was synthesized for the first time. 10-hydroxycamptothecin (HCPT) was embedded in MPEG-PCL-PTyr nanomicelles using the emulsion solvent evaporation method. A series of was conducted to confirm the structure of the compound and to evaluate the physical properties of the MPEG-PCL-PTyr nanomicelles. Cellular uptake, cytotoxicity, and apoptosis were assessed using flow cytometry and MTT assays. Confocal microscopy and flow cytometry results demonstrated that the nanocapsules carrying HCPT had significantly increased anti-tumor activity against HepG2 cells and could target HepG2 cell lysosomes with obvious liver targeting. In addition, the drug-loaded nanomicelles could significantly block the S phase of cancer cells and induce apoptosis; thus, they could be potential carriers for future 10-HCPT delivery and cancer treatment.

Electrochemical Trans-Channel Assay for Efficient Evaluation of Tumor Cell Invasiveness.

Efficiently assessing the invasive capability of tumor cells is critical both for the research and treatment of cancer. Here, we report a novel method called the electrochemical trans-channel assay for efficient evaluation of tumor cell invasiveness. A bioinspired extracellular matrix degradation model (EDM) has been first fabricated on a porous anodic alumina (PAA) membrane to construct the electrochemical apparatus. Upon contacting the invasive tumor cells, invasive capability can be sensitively evaluated by the degree of EDM impairment, which is recorded by the electrochemical trans-channel ionic currents in a label-free manner. Compared to the most commonly used trans-well migration method, this assay can be accomplished in an efficient way that is significantly faster (20 min) and more convenient. Besides, quantitation can also be realized for monitoring the invasion process, which cannot be achieved by other currently used methods. Our proposed electrochemical trans-channel assay method has shown a synergistic effect for the evaluation of tumor cell invasiveness, providing a promising method for clinical assessment or prognostic applications of tumor metastasis.

Tunable and Controlled Release of Cobalt Ions from Metal-Organic Framework Hydrogel Nanocomposites Enhances Bone Regeneration.

Cobalt (Co) ions, which can mimic hypoxia to promote angiogenesis, exhibit great potential for bone repair. However, a key point for the use of Co ions is that their release profile should be controllable and, more importantly, suitable for the bone regeneration process. Here, 2-ethylimidazole (eIm) was introduced into zeolitic imidazolate framework-67 (ZIF-67) to slow down Co-ion release and fabricate eIm-doped ZIF-67 (eIm/ZIF-67), which was combined into gelatin methacrylate (GelMA) to obtain an in situ photo-cross-linking nanocomposite hydrogel as a tunable Co-ion controlled release system. A tunable and controlled release of Co ions from the nanocomposite hydrogel was achieved by variation of linker composition, and GelMA with 75% eIm/ZIF-67 (with 75% eIm in the precursor solutions) could maintain a 21-day sustained release of Co ions, which is matched with early-stage angiogenesis during the bone formation process. Our in vitro study also showed that the GelMA@eIm/ZIF-67 hydrogel could reduce cytotoxicity and effectively promote the angiogenic activity of human umbilical vein endothelial cells (HUVECs) and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). Moreover, an in vivo rat calvarial defect model demonstrated that the GelMA@eIm/ZIF-67 hydrogel exhibited remarkably enhanced bone formation and neovascularization abilities and had good biocompatibility as shown in organ histopathological examinations. Therefore, this novel nanocomposite hydrogel has strong therapeutic potential as a desirable Co-ion controlled release system and a powerful proangiogenic/osteogenic agent for the treatment of bone defects.

Design and fabrication of flexible DNA polymer cocoons to encapsulate live cells.

The capability to encapsulate designated live cells into a biologically and mechanically tunable polymer layer is in high demand. Here, an approach to weave functional DNA polymer cocoons has been proposed as an encapsulation method. By developing in situ DNA-oriented polymerization (isDOP), we demonstrate a localized, programmable, and biocompatible encapsulation approach to graft DNA polymers onto live cells. Further guided by two mutually aided enzymatic reactions, the grafted DNA polymers are assembled into DNA polymer cocoons at the cell surface. Therefore, the coating of bacteria, yeast, and mammalian cells has been achieved. The capabilities of this approach may offer significant opportunities to engineer cell surfaces and enable the precise manipulation of the encapsulated cells, such as encoding, handling, and sorting, for many biomedical applications.

[Effect of porous polyethylene channel implants on volume reconstruction of large orbital wall fractures evaluated by computed tomography measurement].

OBJECTIVE: To assess the clinical effectiveness of porous polyethylene medpor channel implants (MCI) to restore orbital volume in repairing orbital wall fractures, evaluated by computed tomography (CT) and volume measurement program. METHODS: Sixteen patients with unilateral large orbital fractures were included in this study. Computed tomography (CT) scans were used to obtain computer-based orbital volume measurement to assess the change in orbital volume pre- and post-operatively. Pre- and post-operative enophthalmos were measured using a Hertel exophthalmometer. The average time interval between injury and surgery was (17.4+/-10.0) days, and the mean follow-up period was 9 months. RESULTS: Postoperative CT scan showed that most of the MCI to be well positioned. The orbital volume of the injured orbit was significantly increased [mean: (28.16+/-4.32) cm3] as compared with unaffected orbit preoperatively (t=3.044, P<0.01). There was no statistical difference in orbital volume between the injured and normal orbits after orbital reconstruction (t=0.069, P>0.05). The orbital volume change after reconstructive surgery was significantly positively correlated with the decrease of enophthalmos (r=0.715, P<0.01). In order to resolve 2 mm enophthalmos, more than 2.86 cm3 orbital volume augmentation is recommended. CONCLUSIONS: Orbital volume measurement by CT scan is useful in the post-traumatic evaluation of severity of orbital fractures, and it can help predict the degree of late enophthalmos. Orbital reconstruction with the MCI, when indicated, is recommended.

Exposure rate of unwrapped hydroxyapatite orbital implants in enucleation surgery.

OBJECTIVE: To document the long-term exposure rate of unwrapped coralline hydroxyapatite (HA) orbital implants and explore possible risk factors. DESIGN: This retrospective case series (May 2008-April 2013) reviewed the 234 patients with anophthalmia who underwent insertion of an unwrapped HA orbital implant by one of two different surgical closing techniques. RESULTS: Of the 234 cases, 151 underwent a rectus end-to-end suturing closure technique and 83 underwent a rectus orthotopic suturing closure technique. The time of follow-up ranged from 25 months to 69 months (mean 41.9 months). Implant exposure developed in 11 cases. Three in the rectus end-to-end suturing closure group (2.0%) and eight in the rectus orthotopic suturing closure group (9.6%). In the rectus end-to-end suturing technique, a crosswise fixation of vascularised rectus muscle tissue is formed across the front of the implant; in this group the incidence of implant exposure was reduced (OR=8.11, p=0.013). Prior ocular surgery was found to be a factor increasing the incidence of HA exposure (OR=2.73, p=0.032). CONCLUSIONS: The placement of an unwrapped HA orbital implant with rectus end-to-end suturing in enucleation surgery was associated with a low rate of exposure in most cases. The end-to-end suturing creates a joint-like structure over the HA sphere, protecting the Tenon's capsule and conjunctiva from its rough surface and reducing the risk of implant exposure. Prior ocular surgery may be another risk factor for HA exposure.

[Preliminary study on the reconstruction and analysis of digital maxillary cast of infants with cleft lip and palate].

OBJECTIVE: To reconstruct a digital maxillary cast of infants with cleft lip and palate (CLP) by laser scanning and to provide an analysis method for the edentulous cast of CLP. METHODS: Under general anesthesia, an edentulous cast of one infant with right CLP was made and scanned by laser scanner. Using reverse engineering software, this cast surface was reconstructed. RESULTS: By this method, the digital cast could be observed from each degree and direction, and on this digital cast, the reference landmarks formeasarenment were determined, and the cast was then segmented, measured, and calculated. CONCLUSIONS: The 3-D analysis developed is an ideal tool for the examination of 3-D morphological changes in the edentulous maxilla of patients with CLP. This newly developed analysis enables a quantification of the extent and direction of morphological changes in the maxilla of infants with CLP.

[Preliminary study on the comparison and analysis of the digital maxillary alveolar casts].

OBJECTIVE: To develop a three-dimensional (3-D) comparison and measuring techniques to analyze changes in palatal forms of the serial maxillary alveolar cast and to evaluate the significance of the different reference change indexes. METHODS: Following digitizing the casts with a 3-D laser scanner and using reverse engineering software Geomagic Studio 7.0 for a pair of 3-D digital maxillary alveolar cast of an infant of UCLP before and after cheiloplasty, a pair of cast surfaces were reconstructed. The reference points and the character lines were extracted. RESULTS: The model coordinate system and the datum planes were established on the basis of reference points extracted. The newly developed analysis technique completed 3-D comparison of palatal forms of UCLP infants before and after cheiloplasty. Distances and volumes changes between the surfaces were determined and expressed graphically. CONCLUSIONS: With establishing the model coordinate system and the datum plane, it is possible to visualize the comparison outcome of the reference change indexes longitudinally. The various reference change indexes may reflect the trend of the infant maxillary growth.