Asymmetry of tensile versus compressive elasticity and permeability contributes to the regulation of exchanges in collagen gels.

The Starling principle describes exchanges between blood and tissues based on the balance of hydrostatic and osmotic flows. However, the permeation properties of the main constituent of tissues, namely, collagen, in response to the stress exerted by blood pressure remain poorly characterized. Here, we develop an instrument to determine the elasticity and permeability of collagen gels under tensile and compressive stress based on measuring the temporal change in pressure in an air cavity sealed at the outlet of a collagen slab. Data analysis with an analytical model reveals a drop in the permeability and enhanced strain stiffening of native collagen gels under compression versus tension, both effects being essentially lost after chemical cross-linking. Furthermore, we report the control of the permeability of native collagen gels using sinusoidal fluid injection, an effect explained by the asymmetric response in tension and compression. We lastly suggest that blood-associated pulsations could contribute to exchanges within tissues.

Tensile and Compressive Mechanical Behaviour of Human Blood Clot Analogues.

Endovascular thrombectomy procedures are significantly influenced by the mechanical response of thrombi to the multi-axial loading imposed during retrieval. Compression tests are commonly used to determine compressive ex vivo thrombus and clot analogue stiffness. However, there is a shortage of data in tension. This study compares the tensile and compressive response of clot analogues made from the blood of healthy human donors in a range of compositions. Citrated whole blood was collected from six healthy human donors. Contracted and non-contracted fibrin clots, whole blood clots and clots reconstructed with a range of red blood cell (RBC) volumetric concentrations (5-80%) were prepared under static conditions. Both uniaxial tension and unconfined compression tests were performed using custom-built setups. Approximately linear nominal stress-strain profiles were found under tension, while strong strain-stiffening profiles were observed under compression. Low- and high-strain stiffness values were acquired by applying a linear fit to the initial and final 10% of the nominal stress-strain curves. Tensile stiffness values were approximately 15 times higher than low-strain compressive stiffness and 40 times lower than high-strain compressive stiffness values. Tensile stiffness decreased with an increasing RBC volume in the blood mixture. In contrast, high-strain compressive stiffness values increased from 0 to 10%, followed by a decrease from 20 to 80% RBC volumes. Furthermore, inter-donor differences were observed with up to 50% variation in the stiffness of whole blood clot analogues prepared in the same manner between healthy human donors.

Influence mechanism of structure on shear mechanical deformation characteristics of loess-steel interface.

The mechanical properties of loess-steel interface are of great significance for understanding the residual strength and deformation of loess. However, the undisturbed loess has significant structural properties, while the remolded loess has weak structural properties. There are few reports on the mechanical properties of loess-steel interface from the structural point of view. This paper focused on the ring shear test between undisturbed loess as well as its remolded loess and steel interface under the same physical mechanics and test conditions (water content, shear rate and vertical pressure), and explored the influence mechanism of structure on the mechanical deformation characteristics of steel-loess interface. The results show that the shear rate has little effect on the residual strength of the undisturbed and remolded loess-steel interface. However, the water content has a significant influence on the residual strength of the loess-steel interface, moreover, the residual internal friction angle is the dominant factor supporting the residual strength of the loess-steel interface. In general, the residual strength of the undisturbed loess-steel interface is greater than that of the remolded loess specimen (for example, the maximum percentage of residual strength difference between undisturbed and remolded loess specimens under the same moisture content is 6.8%), which is because that compared with the mosaic arrangement structure of the remolded loess, the overhead arrangement structure of the undisturbed loess skeleton particles makes the loess particles on the loess-steel interface re-adjust the arrangement direction earlier and reach a stable speed relatively faster. The loess particles with angular angles in the undisturbed loess make the residual internal friction between the particles greater than the smoother particles of the remolded loess (for example, the maximum percentage of residual cohesion difference between undisturbed and remolded loess specimens under the same vertical pressure is 4.29%), and the intact cement between undisturbed loess particles brings stronger cohesion than the remolded loess particles with destroyed cement (for example, the maximum difference percentage of residual cohesion between undisturbed and remolded soil specimens under the same vertical pressure is 33.80%). The test results provide experimental basis for further revealing the influence mechanism of structure, and parameter basis for similar engineering construction.

Hydraulic permeability and compressive properties of porcine and human synovium.

The synovium is a multilayer connective tissue separating the intra-articular spaces of the diarthrodial joint from the extra-synovial vascular and lymphatic supply. Synovium regulates drug transport into and out of the joint, yet its material properties remain poorly characterized. Here, we measured the compressive properties (aggregate modulus, Young's modulus, and Poisson's ratio) and hydraulic permeability of synovium with a combined experimental-computational approach. A compressive aggregate modulus and Young's modulus for the solid phase of synovium were quantified from linear regression of the equilibrium confined and unconfined compressive stress upon strain, respectively (HA = 4.3 ± 2.0 kPa, Es = 2.1 ± 0.75, porcine; HA = 3.1 ± 2.0 kPa, Es = 2.8 ± 1.7, human). Poisson's ratio was estimated to be 0.39 and 0.40 for porcine and human tissue, respectively, from moduli values in a Monte Carlo simulation. To calculate hydraulic permeability, a biphasic finite element model's predictions were numerically matched to experimental data for the time-varying ramp and hold phase of a single increment of applied strain (k = 7.4 ± 4.1 × 10-15 m4/N.s, porcine; k = 7.4 ± 4.3 × 10-15 m4/N.s, human). We can use these newly measured properties to predict fluid flow gradients across the tissue in response to previously reported intra-articular pressures. These values for material constants are to our knowledge the first available measurements in synovium that are necessary to better understand drug transport in both healthy and pathological joints.

Linear and Nonlinear Biphasic Mechanical Properties of Goat IVDs Under Different Swelling Conditions in Confined Compression.

To define technical specifications for artificial substitutes, it is necessary to model their mechanical behaviour. Here we studied the linear and nonlinear biphasic models for Nucleus Pulposus (NP) and Annulus Fibrosus (AF). The associated material parameters were obtained using confined compression stress relaxation tests on goat intervertebral disc (IVD) samples. The first parameter, aggregate modulus HA0, which essentially describes load-bearing capacity of the solid phase, was larger for AF (HA0 = 0.53 ± 0.06 MPa) than for NP (HA0 = 0.26 ± 0.04 MPa). For hydraulic permeability, which quantifies the ability to transmit interstitial fluid, it was the opposite (k0 = (0.20 ± 0.07) × 10-15 m4/Ns for AF and k0 = (0.67 ± 0.08)×10-15 m4/Ns for NP). The values of nonlinearity coefficients, nonlinear stiffening coefficient ß and non-dimensional nonlinear permeability coefficient M, reflected that these tissues had nonlinear elastic behaviour and permeability. Also, investigating the effect of swelling conditions in sample preparation showed that for both AF and NP, confined-swollen samples had higher aggregate modulus and lower permeability values compared to the free-swollen ones. The quantitative description of the nonlinear properties of AF and NP provided a better understanding of IVD behaviour as well as technical specifications for their artificial substitutes.

In Vitro Compression Model for Orthodontic Tooth Movement Modulates Human Periodontal Ligament Fibroblast Proliferation, Apoptosis and Cell Cycle.

Human Periodontal Ligament Fibroblasts (hPDLF), as part of the periodontal apparatus, modulate inflammation, regeneration and bone remodeling. Interferences are clinically manifested as attachment loss, tooth loosening and root resorption. During orthodontic tooth movement (OTM), remodeling and adaptation of the periodontium is required in order to enable tooth movement. hPDLF involvement in the early phase-OTM compression side was investigated for a 72-h period through a well-studied in vitro model. Changes in the morphology, cell proliferation and cell death were analyzed. Specific markers of the cell cycle were investigated by RT-qPCR and Western blot. The study showed that the morphology of hPDLF changes towards more unstructured, unsorted filaments under mechanical compression. The total cell numbers were significantly reduced with a higher cell death rate over the whole observation period. hPDLF started to recover to pretreatment conditions after 48 h. Furthermore, key molecules involved in the cell cycle were significantly reduced under compressive force at the gene expression and protein levels. These findings revealed important information for a better understanding of the preservation and remodeling processes within the periodontium through Periodontal Ligament Fibroblasts during orthodontic tooth movement. OTM initially decelerates the hPDLF cell cycle and proliferation. After adapting to environmental changes, human Periodontal Ligament Fibroblasts can regain homeostasis of the periodontium, affecting its reorganization.

Mechanical activities of self-beating cardiomyocyte aggregates under mechanical compression.

Since the discovery of synchronous pulsations in cardiomyocytes (CMs), electrical communication between CMs has been emphasized; however, recent studies suggest the possibility of mechanical communication. Here, we demonstrate that spherical self-beating CM aggregates, termed cardiac spheroids (CSs), produce enhanced mechanical energy under mechanical compression and work cooperatively via mechanical communication. For single CSs between parallel plates, compression increased both beating frequency and beating energy. Contact mechanics revealed a scaling law on the beating energy, indicating that the most intensively stressed cells in the compressed CSs predominantly contributed to the performance of mechanical work against mechanical compression. For pairs of CSs between parallel plates, compression immediately caused synchronous beating with mechanical coupling. Compression tended to strengthen and stabilize the synchronous beating, although some irregularity and temporary arrest were observed. These results suggest that mechanical compression is an indispensable control parameter when evaluating the activities of CMs and their aggregates.

Depth and strain rate-dependent mechanical response of chondrocytes in reserve zone cartilage subjected to compressive loading.

The role of the growth plate reserve zone is not well understood. It has been proposed to serve as a source of stem cells and to produce morphogens that control the alignment of clones in preparation for the transition into the proliferative zone. We hypothesized that if such a role exists, there are likely to be mechanoregulatory stimuli in cellular response through the depth of the reserve zone. A poroelastic multiscale finite element model of bone/growth-plate/bone was developed for examining the reserve zone cell transient response when compressed to 5% of the cartilage thickness at strain rates of 0.18%/s, 5%/s, 50%/s, and 200%/s. Chondrocyte maximum principal strains, height-, width-, and membrane-strains were found to be highly dependent on reserve zone tissue depth and strain rate. Cell-level strains and fluid transmembrane outflow from the cell were influenced by the permeability of the calcified cartilage between subchondral bone plate and reserve zone and by the applied strain rate. Cell strain levels in the lower reserve zone were less sensitive to epiphyseal permeability than in the upper reserve zone. In contrast, the intracellular fluid pressures were relatively uniform with reserve zone tissue depth and less sensitive to epiphyseal permeability. Fluid shear stress, induced by fluid flow over the cell surface, provided mechanoregulatory signals potentially sufficient to stimulate reserve zone chondrocytes near the subchondral bone plate interface. These results suggest that the strain rate and tissue depth dependence of cell-level strains and cell surface fluid shear stress may provide mechanoregulatory cues in the reserve zone.

Large Lytic Defects Produce Kinematic Instability and Loss of Compressive Strength in Human Spines: An in Vitro Study.

BACKGROUND: In patients with spinal metastases, kinematic instability is postulated to be a predictor of pathologic vertebral fractures. However, the relationship between this kinematic instability and the loss of spinal strength remains unknown. METHODS: Twenty-four 3-level thoracic and lumbar segments from 8 cadaver spines from female donors aged 47 to 69 years were kinematically assessed in axial compression (180 N) and axial compression with a flexion or extension moment (7.5 Nm). Two patterns of lytic defects were mechanically simulated: (1) a vertebral body defect, corresponding to Taneichi model C (n = 13); and (2) the model-C defect plus destruction of the ipsilateral pedicle and facet joint, corresponding to Taneichi model E (n = 11). The kinematic response was retested, and compression strength was measured. Two-way repeated-measures analysis of variance was used to test the effect of each model on the kinematic response of the segment. Multivariable linear regression was used to test the association between the kinematic parameters and compressive strength of the segment. RESULTS: Under a flexion moment, and for both models C and E, the lesioned spines exhibited greater flexion range of motion (ROM) and axial translation than the control spines. Both models C and E caused lower extension ROM and greater axial, sagittal, and transverse translation under an extension moment compared with the control spines. Two-way repeated-measures analysis revealed that model E, compared with model C, caused significantly greater changes in extension and torsional ROM under an extension moment, and greater sagittal translation under a flexion moment. For both models C and E, greater differences in flexion ROM and sagittal translation under a flexion moment, and greater differences in extension ROM and in axial and transverse translation under an extension moment, were associated with lower compressive strength of the lesioned spines. CONCLUSIONS: Critical spinal lytic defects result in kinematic abnormalities and lower the compressive strength of the spine. CLINICAL RELEVANCE: This experimental study demonstrates that lytic foci degrade the kinematic stability and compressive strength of the spine. Understanding the mechanisms for this degradation will help to guide treatment decisions that address inferred instability and fracture risk in patients with metastatic spinal disease.

Time-lapsed imaging of nanocomposite scaffolds reveals increased bone formation in dynamic compression bioreactors.

Progress in bone scaffold development relies on cost-intensive and hardly scalable animal studies. In contrast to in vivo, in vitro studies are often conducted in the absence of dynamic compression. Here, we present an in vitro dynamic compression bioreactor approach to monitor bone formation in scaffolds under cyclic loading. A biopolymer was processed into mechanically competent bone scaffolds that incorporate a high-volume content of ultrasonically treated hydroxyapatite or a mixture with barium titanate nanoparticles. After seeding with human bone marrow stromal cells, time-lapsed imaging of scaffolds in bioreactors revealed increased bone formation in hydroxyapatite scaffolds under cyclic loading. This stimulatory effect was even more pronounced in scaffolds containing a mixture of barium titanate and hydroxyapatite and corroborated by immunohistological staining. Therefore, by combining mechanical loading and time-lapsed imaging, this in vitro bioreactor strategy may potentially accelerate development of engineered bone scaffolds and reduce the use of animals for experimentation.

Effect of Strain Rates on Failure of Mechanical Properties of Lumbar Intervertebral Disc Under Flexion.

OBJECTIVE: To evaluate the strain-rate-dependent viscoelastic properties of the intervertebral disc by in vitro experiments. METHOD: The biomechanical experiments were conducted from September 2019 to December 2019. The lumbar spines of sheep were purchased within 4-6 hours from the local slaughterhouse, and the intervertebral disc samples were divided into three groups. In rupture group, the samples were used to test the mechanical behavior of the intervertebral disc rupture at different strain rates. In fatigue injury group, the samples were used to test the mechanical behavior of fatigue injury on the intervertebral disc under different strain rates. In internal displacement group, the samples were used to test the internal displacement distribution of the intervertebral disc at different strain rates by applying an optimized digital image correlation (DIC) technique. RESULTS: Both the yielding and cracking phenomenon occurs at fast and medium loading rates, while only the yielding phenomenon occurs at a slow loading rate. The yield stress, compressive strength, and elastic modulus all increase with the increase of the strain rate, while the yield strain decreases with the increase of the strain rate. The logarithm of the elastic modulus in the intervertebral disc is approximately linear with the logarithm of the strain rate under different strain rates. Both before and after fatigue loading, the stiffness in the loading and unloading curves of the intervertebral disc is inconsistent, forming a hysteresis loop, which is caused by the viscoelastic effect. The strain rate has no significant effect on the internal displacement distribution of the intervertebral disc. Based on the experimental data, the constitutive relationship of the intervertebral disc at different strain rates is obtained. The fitting curves are well coupled with the experimental data, while the fitting parameters are approximately linear with the logarithm of the strain rate. CONCLUSIONS: These experiments indicate that the strain rate has a significant effect on the mechanical behavior of the intervertebral disc rupture and fatigue injury, while the constitutive equation can predict the rate-dependent mechanical behavior of lumbar intervertebral disc under flexion very well. These results have important theoretical guiding significance for preventing lumbar disc herniation in daily life.

How Osmoviscoelastic Coupling Affects Recovery of Cyclically Compressed Intervertebral Disc.

STUDY DESIGN: Osmoviscoelastic behavior of cyclically loaded cervical intervertebral disc. OBJECTIVE: The aim of this study was to evaluate in vitro the effects of physiologic compressive cyclic loading on the viscoelastic properties of cervical intervertebral disc and, examine how the osmoviscoelastic coupling affects time-dependent recovery of these properties following a long period of unloading. SUMMARY OF BACKGROUND DATA: The human neck supports repetitive loadings during daily activities and recovery of disc mechanics is essential for normal mechanical function. However, the response of cervical intervertebral disc to cyclic loading is still not very well defined. Moreover, how loading history conditions could affect the time-dependent recovery is still unclear. METHODS: Ten thousand cycles of compressive loading, with different magnitudes and saline concentrations of the surrounding fluid bath, are applied to 8 motion segments (composed by 2 adjacent vertebrae and the intervening disc) extracted from the cervical spines of mature sheep. Subsequently, specimens are hydrated during 18 hours of unloading. The viscoelastic disc responses, after cyclic loading and recovery phase, are characterized by relaxation tests. RESULTS: Viscoelastic behaviors are significantly altered following large number of cyclic loads. Moreover, after 18-hour recovery period in saline solution at reference concentration (0.15 mol/L), relaxation behaviors were fully restored. Nonetheless, full recovery is not obtained whether the concentration of the surrounding fluid, that is, hypo-, iso-, or hyper-osmotic conditions. CONCLUSION: Cyclic loading effects and full recovery of viscoelastic behavior after hydration at iso-osmotic condition (0.15 mol/L) are governed by osmotic attraction of fluid content in the disc due to imbalance between the external load and the swelling pressure of the disc. After removal of the load, the disc recovers its viscoelastic properties following period of rest. Nevertheless, the viscoelastic recovery is a chemically activated process and its dependency on saline concentration is governed by fluid flow due to imbalance of ions between the disc tissues and the surrounding fluid. LEVEL OF EVIDENCE: 3.

Study on the Similarity of Biomechanical Behavior between Gelatin and Porcine Liver.

As a natural polymer, gelatin is increasingly being used as a substitute for animals or humans for the simulation and testing of surgical procedures. In the current study, the similarity verification was neglected and a 10 wt.% or 20 wt.% gelatin sample was used directly. To compare the mechanical similarities between gelatin and biological tissues, different concentrations of gelatin samples were subjected to tensile, compression, and indentation tests and compared with porcine liver tissue. The loading rate in the three tests fully considered the surgical application conditions; notably, a loading speed up to 12 mm/s was applied in the indentation testing, the tensile test was performed at a speed of 1 mm/s until fracture, and the compression tests were compressed at a rate of 0.16 mm/s and 1 mm/s. A comparison of the results shows that the mechanical behaviors of low-concentration gelatin samples involved in the study are similar to the mechanical behavior of porcine liver tissue. The results of the gelatin material were mathematically expressed by the Mooney-Rivlin model and the Prony series. The results show that the material properties of gelatin can mimic the range of mechanical characteristics of porcine liver, and gelatin can be used as a matrix to further improve the similarity between substitute materials and biological tissues.

Preparation and characterization of a novel polylactic acid/hydroxyapatite composite scaffold with biomimetic micro-nanofibrous porous structure.

Combining synthetic polymer scaffolds with inorganic bioactive factors is widely used to promote the bioactivity and bone conductivity of bone tissue. However, except for the chemical composition of scaffold, the biomimetic structure also plays an important role in its application. In this study, we report the fabrication of polylactic acid/hydroxyapatite (PLA/HA) composite nanofibrous scaffolds via phase separation method to mimic the native extracellular matrix (ECM). The SEM analysis showed that the addition of HA dramatically impacted the morphology of the PLA matrix, which changed from 3D nanofibrous network structure to a disorderly micro-nanofibrous porous structure. At the same time, HA particles could be evenly dispersed at the end of the fiber. The FTIR and XRD demonstrated that there was not any chemical interaction between PLA and HA. Thermal analyses showed that HA could decrease the crystallization of PLA, but improve the thermal decomposition temperature of the composite scaffold. Moreover, water contact angle analysis of the PLA/HA composite scaffold demonstrated that the hydrophilicity increased with the addition of HA. Furthermore, apatite-formation ability tests confirmed that HA could not only more and faster induced the deposition of weak hydroxyapatite but also induced specific morphology of HA.

Compression stiffening of fibrous networks with stiff inclusions.

Tissues commonly consist of cells embedded within a fibrous biopolymer network. Whereas cell-free reconstituted biopolymer networks typically soften under applied uniaxial compression, various tissues, including liver, brain, and fat, have been observed to instead stiffen when compressed. The mechanism for this compression-stiffening effect is not yet clear. Here, we demonstrate that when a material composed of stiff inclusions embedded in a fibrous network is compressed, heterogeneous rearrangement of the inclusions can induce tension within the interstitial network, leading to a macroscopic crossover from an initial bending-dominated softening regime to a stretching-dominated stiffening regime, which occurs before and independently of jamming of the inclusions. Using a coarse-grained particle-network model, we first establish a phase diagram for compression-driven, stretching-dominated stress propagation and jamming in uniaxially compressed two- and three-dimensional systems. Then, we demonstrate that a more detailed computational model of stiff inclusions in a subisostatic semiflexible fiber network exhibits quantitative agreement with the predictions of our coarse-grained model as well as qualitative agreement with experiments.

Differing trabecular bone architecture in dinosaurs and mammals contribute to stiffness and limits on bone strain.

The largest dinosaurs were enormous animals whose body mass placed massive gravitational loads on their skeleton. Previous studies investigated dinosaurian bone strength and biomechanics, but the relationships between dinosaurian trabecular bone architecture and mechanical behavior has not been studied. In this study, trabecular bone samples from the distal femur and proximal tibia of dinosaurs ranging in body mass from 23-8,000 kg were investigated. The trabecular architecture was quantified from micro-computed tomography scans and allometric scaling relationships were used to determine how the trabecular bone architectural indices changed with body mass. Trabecular bone mechanical behavior was investigated by finite element modeling. It was found that dinosaurian trabecular bone volume fraction is positively correlated with body mass similar to what is observed for extant mammalian species, while trabecular spacing, number, and connectivity density in dinosaurs is negatively correlated with body mass, exhibiting opposite behavior from extant mammals. Furthermore, it was found that trabecular bone apparent modulus is positively correlated with body mass in dinosaurian species, while no correlation was observed for mammalian species. Additionally, trabecular bone tensile and compressive principal strains were not correlated with body mass in mammalian or dinosaurian species. Trabecular bone apparent modulus was positively correlated with trabecular spacing in mammals and positively correlated with connectivity density in dinosaurs, but these differential architectural effects on trabecular bone apparent modulus limit average trabecular bone tissue strains to below 3,000 microstrain for estimated high levels of physiological loading in both mammals and dinosaurs.

Leprdb/+ Dams Protect Wild-type Male Offspring Bone Strength from the Detrimental Effects of a High-Fat Diet.

The prevalence of maternal obesity is increasing at an alarming rate and increases the life-long risk of developing cardiometabolic disease in adult offspring. Leptin, an adipokine, is systemically elevated in the obese milieu. We recently showed that maternal hyperleptinemia without obesity improves offspring insulin sensitivity and glucose tolerance while protecting against weight gain on a high-fat, high-sugar (HFD). Here, we investigate the effect of maternal hyperleptinemia on offspring bone by using 2 independent maternal models. First, we compared wild-type (WT) offspring from severely hyperleptinemic Leprdb/+ (DB/+) dams with those from WT dams. In the second model, WT females were implanted with miniosmotic pumps that released either saline (group SAL) or leptin (group LEP; 650ng/hour) and the WT offspring were compared. At 23 weeks of age, a subset of offspring were challenged with a HFD for 8 weeks. When the offspring were 31 weeks of age, bone geometry, strength, and material properties were investigated. The HFD increased trabecular bone volume but decreased both total breaking strength and material strength of femora from the offspring of WT dams. However, male offspring of DB/+ dams were protected from the detrimental effects of a HFD, while offspring of LEP dams were not. Further material analysis revealed a modest decrease in advanced glycation end product accumulation coupled with increased collagen crosslinking in male offspring from DB/+ dams on a HFD. These data suggest that while maternal leptin may protect bone quality from the effects of a HFD, additional factors of the maternal environment controlled by leptin receptor signaling are likely also involved.

The effectiveness of a self-made modular elastic compression device for patients with a fracture of the tibia and fibula.

BACKGROUND: To evaluate the effectiveness of a self-made modular elastic compression device for patients with a fracture of the tibia and fibula. METHODS: Fifty-nine healthy adult patients with a unilateral fracture of the tibia and fibula were randomly divided into an experimental group and a control group. The experimental group was given the self-made combined elastic compression device for the compression treatment of the affected limbs after the operation. The main endpoints included the convenience, safety, and effectiveness of the self-made modular elastic compression device for patients with a fracture of the tibia and fibula. RESULTS: There were 29 cases in the experimental group and 30 cases in the control group. There were no significant differences between the two groups in the general data: age, gender, fracture site, and cause of injury. The preoperative swelling elimination time was 3.3 ± 1.2 days, and the postoperative swelling elimination time was 3.1 ± 1.4 days in the experimental group; the preoperative swelling elimination time was 6.3 ± 1.2 days, and the postoperative swelling elimination time was 7.3 ± 1.2 days in the control group. The preoperative and postoperative swelling degree in the experimental group was shorter than those in the control group. The difference in the postoperative detumescence time between the experimental group (3.1 ± 1.4 days) and the control group (7.3 ± 1.2 days) was significant, and the total hospital stay was 8.1 ± 1.5 days in the experimental group and 13 ± 2.5 days in the control group with a statistical significance of P < 0.05. The change of discharge hemoglobin volume (11.2 ± 6.5 g/L) of the experimental group was lower than that of the control group (3.5 ± 1.2 days), the total drainage volume was 260 ± 50 ml, and the change of admission and discharge hemoglobin volume was 30.3 ± 10.4 g/L. Specifically, although the difference in the average hospital stay between the two groups was statistically significant, the difference was only 1 day, and the clinical difference was not significant. However, in the change of the cumulative drainage volume and hemoglobin volume, the experimental group that was given compression therapy was significantly lower than the control group with a statistical significance (P < 0.05). The pressure injury (4 cases) in the experimental group was significantly lower than that in the control group (8 cases) (P < 0.05). CONCLUSION: A modular combined elastic compression device in patients with a tibial and fibular fracture can significantly accelerate a patient's rehabilitation, shorten the hospital stay, reduce blood loss, relieve the patient's pain, and relieve the patient's social-economic burden during recovery.

Evaluation of using spray-dried glutinous rice starch as a direct compression hydrophilic matrix tablet.

BACKGROUND: Our previous study found that spray-dried glutinous rice starch (sGRS) is larger in size, rounder in shape and better in flowability than native GRS. It has the potential to be used for direct compression hydrophilic matrix (HM) tablets. OBJECTIVE: This study aimed to investigate the factors that affect the propranolol release from directly compressed sGRS HM tablets. METHODS: The effects of the amount of sGRS, the compaction pressure and the amount of magnesium stearate on the drug release rate from sGRS directly compressed HM were investigated. In vitro drug releases were performed. The dilution potential of sGRS was investigated. RESULTS: The higher the sGRS content, the slower the release rate of propranolol. The compaction pressure and the amount of magnesium stearate did not significantly affect the release rate of the drug. The sGRS showed plastic deformation under compaction with a dilution potential of 46%. CONCLUSIONS: sGRS can be used as a direct compression HM. The amount of sGRS significantly affected the release rate of the drug from the matrix.

Mechanical behavior of a titanium alloy scaffold mimicking trabecular structure.

BACKGROUND: Additively manufactured porous metallic structures have recently received great attention for bone implant applications. The morphological characteristics and mechanical behavior of 3D printed titanium alloy trabecular structure will affect the effects of artificial prosthesis replacement. However, the mechanical behavior of titanium alloy trabecular structure at present clinical usage still is lack of in-depth study from design to manufacture as well as from structure to mechanical function. METHODS: A unit cell of titanium alloy was designed to mimick trabecular structure. The controlled microarchitecture refers to a repeating array of unit-cells, composed of titanium alloy, which make up the scaffold structure. Five kinds of unit cell mimicking trabecular structure with different pore sizes and porosity were obtained by modifying the strut sizes of the cell and scaling the cell as a whole. The titanium alloy trabecular structure was fabricated by 3D printing based on Electron Beam Melting (EBM). The paper characterized the difference between the designs and fabrication of trabecular structures, as well as mechanical properties and the progressive collapse behavior and failure mechanism of the scaffold. RESULTS: The actual porosities of the EBM-produced bone trabeculae are lower than the designed, and the load capacity of a bearing is related to the porosity of the structure. The larger the porosity of the structure, the smaller the stiffness and the worse the load capacity is. The fracture interface of the trabecular structure under compression is at an angle of 45o with respect to the compressive axis direction, which conforms to Tresca yield criterion. The trabeculae-mimicked unit cell is anisotropy. Under quasi-static loading, loading speed has no effect on mechanical performance of bone trabecular specimens. There is no difference of the mechanical performance at various orientations and sites in metallic workspace. The elastic modulus of the scaffold decreases by 96%-93% and strength reduction 96%-91%, compared with titanium alloy dense metals structure. The apparent elastic modulus of the unit-cell-repeated scaffold is 0.39-0.618 GPa, which is close to that of natural bone and stress shielding can be reduced. CONCLUSION: We have systematically studied the structural design, fabrication and mechanical behavior of a 3D printed titanium alloy scaffold mimicking trabecula bone. This study will be benefit of the application of prostheses with proper structures and functions.