Injectable and high-strength PLGA/CPC loaded ALN/MgO bone cement for bone regeneration by facilitating osteogenesis and inhibiting osteoclastogenesis in osteoporotic bone defects.

Osteoporosis (OP) can result in slower bone regeneration than the normal condition due to the imbalance between osteogenesis and osteoclastogenesis, making osteoporotic bone defects healing a significant clinical challenge. Calcium phosphate cement (CPC) is a promising bone substitute material due to its good osteoinductive activity, however, the drawbacks such as fragility, slow degradation rate and incapability to control bone loss restrict its application in osteoporotic bone defects treatment. Currently, we developed the PLGA electrospun nanofiber sheets to carry alendronate (ALN) and magnesium oxide nanoparticle (nMgO) into CPC, therefore, to obtain a high-strength bone cement (C/AM-PL/C). The C/AM-PL/C bone cement had high mechanical strength, anti-washout ability, good injection performance and drug sustained release capacity. More importantly, the C/AM-PL/C cement promoted the osteogenic differentiation of bone marrow mesenchymal stem cells and neovascularization via the release of Mg2+ (from nMgO) and Ca2+ (during the degradation of CPC), and inhibited osteoclastogenesis via the release of ALN in vitro. Moreover, the injection of C/AM-PL/C cement significantly improved bone healing in an OP model with femur condyle defects in vivo. Altogether, the injectable C/AM-PL/C cement could facilitate osteoporotic bone regeneration, demonstrating its capacity as a promising candidate for treatment of osteoporotic bone defects.

Injectable nanofiber-reinforced bone cement with controlled biodegradability for minimally-invasive bone regeneration.

Injectable materials show their special merits in regeneration of damaged/degenerated bones in minimally-invasive approach. Injectable calcium phosphate bone cement (CPC) has attracted broad attention for its bioactivity, as compared to non-degradable polymethyl methacrylate cement. However, its brittleness, poor anti-washout property and uncontrollable biodegradability are the main challenges to limit its further clinical application mainly because of its stone-like dense structure and fragile inorganic-salt weakness. Herein, we developed a kind of injectable CPC bone cement with porous structure and improved robustness by incorporating poly(lactide-co-glycolic acid) (PLGA) nanofiber into CPC, with carboxymethyl cellulose (CMC) to offer good injectability as well as anti-wash-out capacity. Furthermore, the introduction of PLGA and CMC also enabled a formation of initial porous structure in the cements, where PLGA nanofiber endowed the cement with a dynamically controllable biodegradability which provided room for cell movement and bone ingrowth. Interestingly, the reinforced biodegradable cement afforded a sustainable provision of Ca2+ bioactive components, together with its porous structure, to improve synergistically new bone formation and osteo-integration in vivo by using a rat model of femur condyle defect. Further study on regenerative mechanisms indicated that the good minimally-invasive bone regeneration may come from the synergistic enhanced osteogenic effect of calcium ion enrichment and the improved revascularization capacity contributed from the porosity as well as the lactic acid released from PLGA nanofiber. These results indicate the injectable bone cement with high strength, anti-washout property and controllable biodegradability is a promising candidate for bone regeneration in a minimally-invasive approach.

Incorporating redox-sensitive nanogels into bioabsorbable nanofibrous membrane to acquire ROS-balance capacity for skin regeneration.

Facing the high incidence of skin diseases, it is urgent to develop functional materials with high bioactivity for wound healing, where reactive oxygen species (ROS) play an important role in the wound healing process mainly via adjustment of immune response and neovasculation. In this study, we developed a kind of bioabsorbable materials with ROS-mediation capacity for skin disease therapy. Firstly, redox-sensitive poly(N-isopropylacrylamide-acrylic acid) (PNA) nanogels were synthesized by radical emulsion polymerization method using a disulfide molecule as crosslinker. The resulting nanogels were then incorporated into the nanofibrous membrane of poly(l-lactic acid) (PLLA) via airbrushing approach to offer bioabsorbable membrane with redox-sensitive ROS-balance capacity. In vitro biological evaluation indicated that the PNA-contained bioabsorbable membrane improved cell adhesion and proliferation compared to the native PLLA membrane. In vivo study using mouse wound skin model demonstrated that PNA-doped nanofibrous membranes could promote the wound healing process, where the disulfide bonds in them were able to adjust the ROS level in the wound skin for mediation of redox potential to achieve higher wound healing efficacy.

Preparation of CNF/PDMS Superhydrophobic Coatings with Good Abrasion Resistance Using a One-Step Spray Method.

Complex preparation methods and weak mechanical properties of superhydrophobic coatings hinder their applicability. To address these problems, cellulose nanofibers (CNFs) were used as structural materials to augment the roughness properties, while polydimethylsiloxane (PDMS) was used as the adhesive. Based on the results of previous studies, superhydrophobic coatings with good mechanical properties can be prepared by spraying the mixture onto a substrate surface; herein, the mixture comprised modified CNFs and PDMS. The resulting coating possessed excellent superhydrophobicity, which allowed a maximum water contact angle (WCA) of 158°. Furthermore, it exhibited great knife-scratch-resistance properties and good abrasion performance, which was evaluated by abrading with 800-grit sandpaper for 19 cycles (abrasion length of 380 cm) under a 100 g load. Based on the simple operation and abrasion resistance, the coating shows great potential for practical application.

Bispectral Index Values Are Accurate Diagnostic Indices Correlated With Glasgow Coma Scale Scores.

OBJECTIVE: The Glasgow Coma Scale (GCS) is widely used in neurosurgery to evaluate the depth of coma in patients with brain injury. The bispectral index (BIS) was developed primarily to monitor the depth of unconsciousness. Recent evidence suggests that BIS may also help in the assessment of brain injury. This study explores the correlation between GCS scores and BIS values in patients with brain injury. METHODS: Fifty patients were divided into 2 groups-moderate (GCS 9-12) and severe (GCS 3-8)-in this prospective, double-blind, observational study. Bispectral index data were recorded when electromyography was less than 40 and signal quality index was greater than 75 for 5 minutes. Linear regression was used to examine the correlation between BIS and GCS, and receiver operating characteristic curves were plotted. Cutoff points were identified to show the feasibility and accuracy of BIS for assessing brain injury. RESULTS: The mean BIS value of the moderate group was 65.62 ± 12.84, and that of the severe group was 46.27 ± 17.35. Bispectral index values were significantly correlated with GCS (R = 0.729, P < .01). The regression line and 95% confidence interval were determined; the regression equation was BIS = 5.46*GCS + 12.72. The receiver operating characteristic curve showed high diagnostic accuracy when GCS is less than 9; the area under the curve was 0.8164, and the cutoff point (BIS value) corresponding to the maximum sensitivity (0.91) and specificity (0.63) was 60.2. CONCLUSION: BIS values and GCS scores were significantly correlated in patients with brain injury. As a continuous and objective measurement, BIS is a viable evaluation and monitoring tool for brain injury.

[Electroacupuncture intervention combined with general anesthesia for craniocerebral operations].

OBJECTIVE: To determine the safety and effectiveness of electroacupuncture (EA) intervention combined with general anesthesia (GA) for craniocerebral tumor-removal surgery involving cerebral eloquent areas. METHODS: A total of 20 patients with cerebral tumors (durosarcoma, neurogliocytoma, metastatic tumor) involving the cerebral eloquent areas were recruited in the present summary. They were equally divided into general anesthesia (GA) group and EA + GA group. Patients of the EA + GA group were treated with EA stimulation (2 Hz/100 Hz) of the bilateral Fengchi (GB 20), Shuaigu (GB 8) and acupuncture stimulation of Quanliao (SI 18), Zulinqi (GB 41) and Taichong (LR 3), and not given intubation during surgery. Patients of the GA group were treated with intravenous administration of Propofol, Fentanyl, Midazolam, Isopropanol, etc. In addition, all the patients were given with controlled hypotension by intravenous injection of Propofol and Fentanyl. Dosages of Propofol and Sulfentanyl used were recorded. Karnofsky performance status scale was used to assess the patient's general well-being and activities of daily life. RESULTS: The craniocerebral tumor-removal surgery was successful in all the 20 patients. Compared with the GA group, the dosages of Sulfentanyl and Propofol of the EA+ GA group were significantly lower (P < 0.05). No significant difference was found between the GA and EA+ GA groups in Karnofsky performance scores (P > 0.05). Patients of the EA+GA group experienced successful tumour-removal surgery without trachea cannula, were awake and could make a good cooperation with the operator during surgery. They had no aggravation of neurofunctional disturbance following the operation. CONCLUSION: EA combined with general anesthesia is safe and effective for patients with craniocerebral tumor-removal operations involving cerebral eloquent areas.

Paraganglioma with intracranial metastasis: a case report and review of the literature.

Paragangliomas are rare neuroendocrine tumors of neural crest origin. They are mostly benign, however; malignant tumors with aggressive behavior and distant metastasis can also occur. Intracranial involvement is extremely rare and has been sporadically reported in the literature. Here we report a case who presented with progressive neurologic deficits due to multiple intracranial lesions found to be metastasis from an occult retroperitoneal malignant paraganglioma.

[Effects of electroacupuncture (EA) at early stage on functions of the limbs in the postoperative patient of hypertensive hemorrhage].

OBJECTIVE: To investigate the rehabilitation effect of electroacupuncture (EA) at early stage on hemiplegia in the postoperative patient of hypertensive hemorrhage. METHODS: Seventy-two cases of postoperative patient of hypertensive hemorrhage were divided into an EA group (n = 42) treated with EA at Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Zusanli (ST 36), etc., from 1-3 days after operation, twice each day; and a control group (n = 30) with functional exercises. Their rehabilitation effects were compared after treatment of one month. RESULTS: The rehabilitation effect in the EA group was significant better than that in the control group (P < 0.01). CONCLUSION: EA at early stage has good recovery effect for the patient of hemiplegia after operation of hypertensive hemorrhage.