RESUMEN
Three-dimensional (3D)-printed orthopedic surgical guides have the potential to provide personalized precision treatment. Non-isocyanate polyurethane (NIPU) is commonly used in the 3D printing of biomedical materials but its application in the orthopedic surgical guide is limited by poor mechanical properties and biocompatibility. In this study, we fabricated non-isocyanate polyurethane acrylate (NIPUA) photosensitive resin with superior biocompatibility and mechanical properties required for 3D-printed orthopedic surgical guides. NIPU prepolymer was synthesized by a ring-opening reaction and a ring acrylation reaction. NIPUA was further synthesized using polyethylene glycol diacrylate (PEGDA) as a modified material based on sustainable synthesis with reduced synthesis time. NIPUA showed the best tensile and flexural strengths when the PEGDA content reached 12 wt.%. NIPUA exhibited higher thermal stability, hemocompatibility, superior biocompatibility to ME3T3-E1 bone cells and C1C12 muscle cells, and non-immunogenic effect toward macrophages compared with commercial photosensitive resins. Commercial resins triggered a severe inflammatory response during in vivo implantation, but this effect was not observed during NIPUA implantation. Transcriptome analysis showed downregulation of cell death and cell cycle disruption-related genes, such as CDK2, CDKN1a, and GADD45a, and upregulation of autophagy and anti-tumor activity-related genes, such as MYC, PLK1, and BUB1b, in NIPUA-treated MC3T3-E1 cells compared with commercial resin-treated MC3T3-E1 cells. In conclusion, NIPUA resin showed excellent mechanical and thermal properties as well as good biocompatibility toward bone cells, muscle cells, and macrophages, suggesting its possible application in the 3D printing of customized orthopedic surgical guides.
RESUMEN
BACKGROUND: Since the first diagnosed case of infection with the novel coronavirus (SARS-CoV-2), there has been a rapid spread of the disease with an increasing number of cases confirmed every day, as well as a rising death toll. An association has been reported between acute kidney injury (AKI) and mortality in patients infected with SARS-CoV-2. Therefore, our study was conducted to explore possible risk factors of AKI as well as whether AKI was a risk factor for worse outcome, especially mortality among patients with coronavirus disease (COVID-19). METHODS: We included all hospital admissions with confirmed or clinically diagnosed COVID-19 from January 29 to February 25, 2020. We collected demographic and epidemiological information, past medical history, symptoms, laboratory tests, treatments, and outcome data from electronic medical records. A total of 492 patients with diagnosed or clinically diagnosed COVID-19 were included in this study. RESULTS: The prevalence rate of AKI was 7.32%. Among the factors associated with AKI, males versus females (aOR 2.73), chronic kidney disease (aOR 42.2), hypertension (aOR 2.82), increased leucocytes (aOR 6.08), and diuretic use (aOR 7.89) were identified as independent risk factors for AKI among patients infected by SARS-CoV-2. There was a significant difference in hospital fees and death in patients with and without AKI (p < 0.05). The mortality rate in patients with AKI was 63.9%. CONCLUSIONS: AKI was widespread among patients with COVID-19. The risk factors of AKI in COVID-19 patients included sex, chronic kidney disease, hypertension, infection, and diuretic use. AKI may be associated with a worse outcome, especially mortality in COVID-19 patients.
