Development of novel hybrid 3D-printed degradable artificial joints incorporating electrospun pharmaceutical- and growth factor-loaded nanofibers for small joint reconstruction.

Small joint reconstruction remains challenging and can lead to prosthesis-related complications, mainly due to the suboptimal performance of the silicone materials used and adverse host reactions. In this study, we developed hybrid artificial joints using three-dimensional printing (3D printing) for polycaprolactone (PCL) and incorporated electrospun nanofibers loaded with drugs and biomolecules for small joint reconstruction. We evaluated the mechanical properties of the degradable joints and the drug discharge patterns of the nanofibers. Empirical data revealed that the 3D-printed PCL joints exhibited good mechanical and fatigue properties. The drug-eluting nanofibers sustainedly released teicoplanin, ceftazidime, and ketorolac in vitro for over 30, 19, and 30 days, respectively. Furthermore, the nanofibers released high levels of bone morphogenetic protein-2 and connective tissue growth factors for over 30 days. An in vivo animal test demonstrated that nanofiber-loaded joints released high concentrations of antibiotics and analgesics in a rabbit model for 28 days. The animals in the drug-loaded degradable joint group showed greater activity counts than those in the surgery-only group. The experimental data suggest that degradable joints with sustained release of drugs and biomolecules may be utilized in small joint arthroplasty.

Combination of inductive effect of lipopolysaccharide and in situ mechanical conditioning for forming an autologous vascular graft in vivo.

Autologous vascular grafts have the advantages of better biocompatibility and prognosis. However, previous studies that implanted bare polymer tubes in animals to grow autologous tubular tissues were limited by their poor yield rates and stability. To enhance the yield rate of the tubular tissue, we employed a design with the addition of overlaid autologous whole blood scaffold containing lipopolysaccharides (LPS). Furthermore, we applied in vivo dynamic mechanical stimuli through cyclically inflatable silicone tube to improve the mechanical properties of the harvested tissues. The effectiveness of the modification was examined by implanting the tubes in the peritoneal cavity of rats. A group without mechanical stimuli served as the controls. After 24 days of culture including 16 days of cyclic mechanical stimuli, we harvested the tubular tissue forming on the silicone tube for analysis or further autologous interposition vascular grafting. In comparison with those without cyclic dynamic stimuli, tubular tissues with this treatment during in vivo culture had stronger mechanical properties, better smooth muscle differentiation, and more collagen and elastin expression by the end of incubation period in the peritoneal cavity. The grafts remained patent after 4 months of implantation and showed the presence of endothelial and smooth muscle cells. This model shows a new prospect for vascular tissue engineering.

[Therapeutic effects of titanium elastic nails for the treatment of clavicular fractures in elder children].

OBJECTIVE: To research the application and clinical effect of titanium elastic nails (TEN) for the treatment of closed clavicular fracture in elder children. METHODS: From October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation, including 9 boys and 7 girls with an average age of 14.2 yeats old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures, excluding the long-oblique patients. Neer function score after 3 months follow-up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with TEN technique. RESULTS: All patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection, TEN broken, delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences (t=2.12, P>0.05) between the healthy side (98.75±2.70) and injured side(96.69±6.22)of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides (P<0.05). The intramedullary nail was removed after X-rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well. CONCLUSION: Internal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion, beauty, safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.

Varicose veins in hairdressers and associated risk factors: a cross-sectional study.

BACKGROUND: Varicose veins (VV) cause not only cosmetic problems but also clinical symptoms such as pain of the affected limbs. Whereas an occupation associated with orthostasis has been recognized as a risk factor of VV, epidemiological studies on working populations are limited. We conducted a study to identify the risk factors of lower limb VV among hairdressers in Taiwan and evaluate their effects, with a focus on long-term standing at work. METHODS: We recruited participants from members of a hairdressers union in southern Taiwan and conducted a questionnaire survey. Data on demographic characteristics, body weight and height, work history, medical history, and other potential related factors were collected from each participant. RESULTS: A total of 182 hairdressers participated in the survey, and 44 (24.2%) had lower limb VV. Uni-variate analyses showed that hairdressers with lower limb VV tended to be older (49.3 vs. 44.7 years, p = 0.032), have a family history of VV (25.6% vs. 9.9%, p = 0.011), doing housework in standing position (86.4% vs. 71.0% , p = 0.042), have a longer work history (30.5 vs. 24.0 years, p = 0.005), and stand longer at work (213.9 vs. 176.0 hour/month, p = 0.008). In multivariate analysis, in hairdressers ≤ 45 years old, the only significant risk factor was a family history of VV (odds ratio [OR] = 11.9, 95% confidence interval [95% CI] = 1.1-133.5). In hairdressers > 45 years old, the risk factors included standing working for > 260 hours per month (OR = 31.8, 95% CI = 1.8-566.5) and working as a hairdresser for > 30 years (for 31-42 years, OR = 10.9, 95% CI = 1.6-73.8; for ≥ 43 years, OR = 12.0, 95% CI = 1.6-88.5). CONCLUSIONS: In hairdressers ≤ 45 years old, family history of VV is a major risk factor for developing lower limb VV, while in those who are > 45 years old, the effects of occupational risk factors are more prominent.