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1.
Tomography ; 7(4): 855-865, 2021 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-34941644

RESUMO

This research compared the incidence of adjacent segment pathology (ASP) between anterior interbody lumbar fusion (ALIF) treatment and transforaminal lumbar interbody fusion (TLIF) treatment. Seventy patients were included in this retrospective study: 30 patients received ALIF treatment, and 40 patients received TLIF treatment at a single medical center between 2011 and 2020 with a follow-up of at least 12 months. The outcomes were radiographic adjacent segment pathology (RASP) and clinical adjacent segment pathology (CASP). The mean follow-up period was 42.10 ± 22.61 months in the ALIF group and 56.20 ± 29.91 months in the TLIF group. Following single-level lumbosacral fusion, ALIF is superior to TLIF in maintaining lumbar lordosis, whereas the risk of adjacent instability in the ALIF group is significantly higher. Regarding ASP, the incidence of overall RASP and CASP did not differ significantly between ALIF and TLIF groups.

2.
J Clin Med ; 10(21)2021 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-34768658

RESUMO

BACKGROUND: Short-segment lumbar spinal surgery is the most performed procedure for treatment of degenerative disc disease. However, population-based data regarding reoperation and joint replacement surgeries after short-segment lumbar spinal surgery is limited. METHODS: The study was a retrospective cohort design using the Taiwan National Health Insurance Research Database for data collection. Patients selected were diagnosed with lumbar degenerative disc disease and undergone lumbar discectomy surgery between 2002 and 2013. The Kaplan-Meier method was used to estimate the incidence of 1-year spine reoperation and joint replacement surgeries, and the Cox proportional hazard regression was used to examine risk factors associated with the outcomes of interest. RESULTS: A total of 90,105 patients were included. Incidences of 1-year spine reoperation and joint replacement surgeries for the hip and knee were 0.27, 0.04, and 0.04 per 100 people/month. Compared to fusion with the fixation group, fusion without fixation and the non-fusion group had higher risks of spine reoperation. Risk factors associated with spine reoperation included fusion without fixation, non-fusion surgery, age ≥ 45 years old, male gender, diabetes, a Charlson Comorbidity Index = 0, lowest social economic status, and steroid use history. Spine surgeries were not risk factors for joint replacement surgeries. CONCLUSIONS: Non-fusion surgery and spinal fusion without fixation had higher risks for spine reoperation. Spine surgeries did not increase the risk for joint replacement surgeries.

3.
Artigo em Inglês | MEDLINE | ID: mdl-34639259

RESUMO

Intravenous tranexamic acid (TXA) has been administered to reduce intraoperative blood loss in scoliosis surgery. However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group (p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion (p < 0.001), crystalloid volume (p = 0.041), and total transfusion volume (p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume (p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications.


Assuntos
Antifibrinolíticos , Atrofia Muscular Espinal , Escoliose , Ácido Tranexâmico , Antifibrinolíticos/uso terapêutico , Transfusão de Sangue , Humanos , Estudos Retrospectivos , Escoliose/cirurgia , Ácido Tranexâmico/uso terapêutico
4.
J Clin Med ; 10(12)2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34201202

RESUMO

Bisphosphonates are used as first-line treatment for the prevention of fragility fracture (FF); they act by inhibiting osteoclast-mediated bone resorption. The timing of their administration after FF surgery is controversial; thus, we compared the incidence of second FF, surgery for second FF, and adverse events associated with early initiation of bisphosphonates (EIBP, within 3 months of FF surgery) and late initiation of bisphosphonates (LIBP, 3 months after FF surgery) in bisphosphonate-naïve patients. This retrospective population-based cohort study used data from Taiwan's Health and Welfare Data Science Center (2004-2012). A total of 298,377 patients received surgeries for FF between 2006 and 2010; of them, 1209 (937 EIBP and 272 LIBP) received first-time bisphosphonates (oral alendronate, 70 mg, once a week). The incidence of second FF (subdistribution hazard ratio (SHR) = 0.509; 95% confidence interval (CI): 0.352-0.735), second FF surgery (SHR = 0.452; 95% CI: 0.268-0.763), and adverse events (SHR = 0.728; 95% CI: 0.594-0.893) was significantly lower in the EIBP group than in the LIBP group. Our findings indicate that bisphosphonates should be initiated within 3 months after surgery for FF.

5.
Patient Educ Couns ; 104(10): 2498-2504, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33741234

RESUMO

OBJECTIVE: To evaluate the efficacy of shared decision-making (SDM) intervention among patients with lumbar degenerative diseases (LDDs) in terms of decision self-efficacy, control preferences, SDM process, decision satisfaction, and conflict. METHODS: A total of 130 outpatients with LDDs recruited from orthopedic or rehabilitation clinics were randomly assigned to the SDM intervention (n = 67) or comparison (n = 63) groups. Patients in the intervention group received decision aids (DAs) with decision coaching and those in controlled group received standard educational materials from a health educator. The primary outcome was decision self-efficacy, and secondary outcomes were control preference, SDM process, conflict, and satisfaction. RESULTS: The SDM intervention significantly improved decision self-efficacy (mean difference [MD] = 7.1, 95% confidence interval [CI]: 1.7-12.5, partial η2 = 0.05) and reduced conflict (MD = -7.0, 95% CI: -12.2 to -1.9, partial η2 = 0.06), especially in patients without family involvement, compared with the health education group. However, no significant between-group differences were observed in other outcomes. CONCLUSION: SDM intervention improved SDM self-efficacy and reduced conflict in patients with LDDs. PRACTICE IMPLICATIONS: Clinicians can integrate DAs and decision coaching in SDM conversations. SDM intervention seems to engage patients in decision-making, especially those without family involvement.


Assuntos
Tomada de Decisão Compartilhada , Tutoria , Instituições de Assistência Ambulatorial , Comunicação , Tomada de Decisões , Humanos , Participação do Paciente
6.
BMC Musculoskelet Disord ; 22(1): 171, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573634

RESUMO

BACKGROUND: We developed a porous Ti alloy/PEEK composite interbody cage by utilizing the advantages of polyetheretherketone (PEEK) and titanium alloy (Ti alloy) in combination with additive manufacturing technology. METHODS: Porous Ti alloy/PEEK composite cages were manufactured using various controlled porosities. Anterior intervertebral lumbar fusion and posterior augmentation were performed at three vertebral levels on 20 female pigs. Each level was randomly implanted with one of the five cages that were tested: a commercialized pure PEEK cage, a Ti alloy/PEEK composite cage with nonporous Ti alloy endplates, and three composite cages with porosities of 40, 60, and 80%, respectively. Micro-computed tomography (CT), backscattered-electron SEM (BSE-SEM), and histological analyses were performed. RESULTS: Micro-CT and histological analyses revealed improved bone growth in high-porosity groups. Micro-CT and BSE-SEM demonstrated that structures with high porosities, especially 60 and 80%, facilitated more bone formation inside the implant but not outside the implant. Histological analysis also showed that bone formation was higher in Ti alloy groups than in the PEEK group. CONCLUSION: The composite cage presents the biological advantages of Ti alloy porous endplates and the mechanical and radiographic advantages of the PEEK central core, which makes it suitable for use as a single implant for intervertebral fusion.


Assuntos
Fusão Vertebral , Titânio , Animais , Benzofenonas , Desenvolvimento Ósseo , Feminino , Cetonas , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Polietilenoglicóis , Polímeros , Porosidade , Suínos , Microtomografia por Raio-X
8.
BMC Musculoskelet Disord ; 22(1): 58, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33422040

RESUMO

BACKGROUND: Full-endoscopic lumbar discectomy (FELD) is an alternative to posterior open surgery to treat a high-grade migrated herniated disc. However, because of the complexity of the surgery, success is dependent on the surgeon's skill. Therefore, patients are frequently treated using open discectomy. Anatomical constraints and technical difficulties can lead to the incomplete removal of high-grade migrated discs. METHODS: We retrospectively reviewed patients who had undergone FELD performed by a single surgeon between January 2010 and January 2014 from a prospective spine registry in an institute. Perioperative records and data of the Oswestry Disability Index, visual analog scale scores (preoperatively and 2 weeks, 6 weeks, 3 months, 6 months, 1 year, 2 years, and 5 years after the operation), and MacNab criteria were collected. RESULTS: Of 58 patients with a follow-up duration of > 5 years, (41 and 17 patients had undergone transforaminal endoscopic lumbar discectomy [TELD] and interlaminar endoscopic lumbar discectomy [IELD], respectively), the satisfaction rate was 87.8% (five unsatisfactory cases) for TELD and 100% for IELD. The overall percentage of patients with good to excellent results according to modified MacNab criteria was 91.3% (53/58 patients). Two patients had residual discs. Two patients needed an open discectomy due to recurrent disc herniation. One IELD patient received spinal fusion surgery due to segmental instability after 5 years. CONCLUSION: FELD has a high success rate for the management of high-grade migrated herniated discs. In patients with high-grade disc migration from L1 to L5, TELD is effective and safe. However, for L4-L5 and L5-S1 high-grade upward and downward disc migration, IELD is the favorable option and provides high patient satisfaction.


Assuntos
Discotomia Percutânea , Deslocamento do Disco Intervertebral , Estudos de Coortes , Endoscopia , Seguimentos , Humanos , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Sistema de Registros , Estudos Retrospectivos , Resultado do Tratamento
9.
Carbohydr Polym ; 254: 117270, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33357851

RESUMO

One-pot fabrication of sacchachitin (SC) for mass-production was developed and optimized by selecting KOH as alkaline agent in depigmentation step and utilizing NaClO2 as bleaching agent in subsequent step in the same pot. Overall yield of one-pot-fabricated SC was up to 35 %w/w of initial weight with a fibrous texture soft enough for mechanical disintegration into SC nanofibers (SCNFs) and better dispersion for producing TEMPO-oxidized SCNFs (T033SC). Both SCNFs and T033SC could form a 3D gelatinous scaffold into which MC3T3-E1 cells were attracted. Higher calcium-trapping ability of T033SC resulting from a greater extent of carboxylate groups provided an excellent bone regeneration environment that resulted in better outcomes of bone regeneration in a femur defect rat model compared to those with SCNFs possessed fewer carboxylate groups. In conclusion, biomaterial scaffolds based on TEMPO-oxidized SCNFs produced from one-pot fabricated SC showed great potential for bone regeneration due to unique physical and chemical properties.


Assuntos
Regeneração Óssea/fisiologia , Quitina/química , Glucanos/química , Nanofibras/química , Tecidos Suporte/química , Células 3T3 , Animais , Materiais Biocompatíveis/química , Substitutos Ósseos/química , Óxidos N-Cíclicos/química , Técnicas In Vitro , Teste de Materiais , Camundongos , Microscopia Eletrônica , Nanofibras/ultraestrutura , Osteoblastos/citologia , Oxirredução , Ratos , Ratos Sprague-Dawley
10.
Spine J ; 21(1): 122-133, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32871276

RESUMO

BACKGROUND CONTEXT: Lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) has been reported as an alternative treatment for degenerative lumbar central canal stenosis (DLCS). PURPOSE: To investigate the outcomes of LE-ULBD for different types of DLCS, including simple DLCS, DLCS with degenerative spondylolisthesis (DSL), and DLCS with degenerative scoliosis (DSC). STUDY DESIGN/SETTING: Prospective cohort study. PATIENT SAMPLE: One-hundred sixteen patients with DLCS who underwent LE-ULBD at a spine center from April 2015 to June 2017 were enrolled in this study. OUTCOME MEASURES: Operative time, postoperative duration of hospitalization, and clinical outcomes (Oswestry disability index [ODI], visual analog scale [VAS], and modified Macnab outcome scale), and adverse events. METHODS: A comparative analysis was performed evaluating medical records, radiological studies, and patient reported outcomes including ODI score, VAS scores and modified Macnab outcome scales in patients who underwent LE-ULBD. Data were prospectively collected at preoperative, postoperative 3-, 6-, 12-, 24-month to assess clinical and radiological outcomes and complications. RESULTS: The study analyzed 106 patients (45 men and 61 women, with a mean age of 69.5 years); 40 (37.8%) had simple DLCS, 41 (38.7%) had DLCS with DSL, and 25 (23.5%) had DLCS with DSC. The mean follow-up period was 33.3 months. The mean preoperative and postoperative follow-up ODI score and VAS scores for leg and back pain showed significant improvement in all time points. No significant difference was found among different pathologies in terms of VAS scores for back and leg pain, ODI scores and modified Macnab outcome scales at all follow-up periods. CONCLUSIONS: LE-ULBD is a feasible treatment method for DLCS. It did not result in worse outcomes in cases with DLCS with DSL or DLCS with DSC as compared with cases with simple DLCS.


Assuntos
Laminectomia , Estenose Espinal , Idoso , Constrição Patológica , Descompressão Cirúrgica , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/cirurgia , Resultado do Tratamento
11.
J Knee Surg ; 34(9): 941-951, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31952092

RESUMO

Simultaneous bilateral total knee arthroplasty (SBTKA) increases the rates of procedure-related complications and mortality compared with unilateral TKA. There are no well-defined guidelines for selecting patients to avoid mortality and proposing an upgrade treatment to decrease complication rates. This study aimed to evaluate whether optimal perioperative management could improve the safety of SBTKA. From 2005 to 2017, 1,166 cases of SBTKA were identified from 14,209 TKA procedures. We retrospectively examined the SBTKA patients' demographics, comorbidity profiles, procedure-related complications, and perioperative management during two time periods. Optimal perioperative workup for managing SBTKA significantly decreased the incidences of major complication from 6.2 to 2.4% (p = 0.001) and minor complications from 28.9 to 21.5% (p = 0.004) during period I and period II, respectively. The efficiency of less tourniquet use along with intraarticular tranexamic acid injection was demonstrated by the decreases of hemoglobin (Hb) change in the first 2 days after surgery (p = 0.005) and blood transfusion requirement (p = 0.035) during the SBTKA. Furthermore, the less tourniquet use group had less thigh pain (visual analog scale decreased from 6.0 to 4.2, p = 0.003), shorter duration of hospital stay (decreased from 7.8 to 7.1, p < 0.001), and lower coagulation time (decrease from 3.5 to 2.9, p < 0.001) than the routine tourniquet use group. Patient's screening must be performed carefully for cardiopulmonary compromise in patients aged >80 years and with an American Society of Anesthesiologists score of 3. Additionally, hospitalists should consider developing methods for the eligibility, testing, and perioperative monitoring of patients who undergo SBTKA with the aim of avoiding complications and improving outcomes.


Assuntos
Artroplastia do Joelho , Artroplastia do Joelho/efeitos adversos , Perda Sanguínea Cirúrgica , Humanos , Estudos Longitudinais , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Ácido Tranexâmico
12.
J Clin Med ; 11(1)2021 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-35011960

RESUMO

Robotic-arm-assisted unicompartmental knee arthroplasty (RUKA) was developed to increase the accuracy of bone alignment and implant positioning. This retrospective study explored whether RUKA has more favorable overall outcomes than conventional unicompartmental knee arthroplasty (CUKA). A total of 158 patients with medial compartment osteoarthritis were recruited, of which 85 had undergone RUKA with the Mako system and 73 had undergone CUKA. The accuracy of component positioning and bone anatomical alignment was compared using preoperative and postoperative radiograph. Clinical outcomes were evaluated using questionnaires, which the patients completed preoperatively and then postoperatively at six months, one year, and two years. In total, 52 patients from the RUKA group and 61 from the CUKA group were eligible for analysis. The preoperative health scores and Kellgren-Lawrence scores were higher in the RUKA group. RUKA exhibited higher implant positioning accuracy, thus providing a superior femoral implant angle, properly aligned implant placement, and a low rate of overhang. RUKA also achieved higher accuracy in bone anatomical alignment (tibial axis angle and anatomical axis angle) than CUKA, but surgical time was longer, and blood loss was greater. No significant differences were observed in the clinical outcomes of the two procedures.

13.
Int J Spine Surg ; 15(suppl 3): S54-S64, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34974421

RESUMO

BACKGROUND: From the 1990s, there has been growth in the literature demonstrating the feasibility of minimally invasive approaches for treating variety lumbar spinal disorders. There is still much work to be done in overcoming the technical challenges and explicate relative advantages of endoscopic techniques in lumbar spine surgery. In this comprehensive literature review, we discuss the history, indications, contraindications, surgical techniques, learning curves, technical tips, adverse events, and examine peer-reviewed studies addressing uniportal endoscopic interlaminar decompression in lumbar spinal surgery. METHODS: This literature review was conducted with keywords "endoscopic," "minimally invasive," "uniportal endoscopic decompression," "interlaminar decompression," and "lumbar spinal surgery" using PubMed, Embase, ClinicalKey, and Google Scholar. RESULTS: Review of 423 patients who underwent uniportal endoscopic interlaminar lumbar decompression showed satisfying results with 82% of patients no longer having leg pain, and 13% of patients having only occasional pain, with no significant operation-related deterioration in leg or back pain. To compare the outcomes between endoscopic and microscopic technique, a comparative review of 192 lumbar lateral recess stenosis patients demonstrated the uniportal endoscopic group had 29% shorter operation duration, 1.2% fewer perioperative complications, and significantly reduced postoperative pain (visual analog scale) over 5 days, and reduced use of pain medications. Multiple retrospective studies echoed the outcomes of endoscopic decompression surgery, showed shorter hospitalization time, lower mean dural expansion, lower increment of horizontal displacement measured, and less elevated levels of postoperative serum CPK (creatine phosphokinase) and CRP (c-reactive protein). Lastly, a systematic review and meta-analysis that enrolled 994 patients found that patients who received the full-endoscopic decompression technique showed statistically lower levels of back pain and leg pain and a 40% lower chance of having complications compared with those receiving microscopic decompression in lumbar stenosis. CONCLUSIONS: Based on our literature review, there are multiple positive outcomes with endoscopic interlaminar lumbar decompression, which reduces operation duration, perioperative complications, and better postoperative outcomes. However, the technical challenge highlights the importance of further training and innovation in this rapidly evolving field.

14.
Int J Mol Sci ; 21(20)2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33050160

RESUMO

In this study, we optimized the geometry and composition of additive-manufactured pedicle screws. Metal powders of titanium-aluminum-vanadium (Ti-6Al-4V) were mixed with reactive glass-ceramic biomaterials of bioactive glass (BG) powders. To optimize the geometry of pedicle screws, we applied a novel numerical approach to proposing the optimal shape of the healing chamber to promote biological healing. We examined the geometry and composition effects of pedicle screw implants on the interfacial autologous bone attachment and bone graft incorporation through in vivo studies. The addition of an optimal amount of BG to Ti-6Al-4V leads to a lower elastic modulus of the ceramic-metal composite material, effectively reducing the stress-shielding effects. Pedicle screw implants with optimal shape design and made of the composite material of Ti-6Al-4V doped with BG fabricated through additive manufacturing exhibit greater osseointegration and a more rapid bone volume fraction during the fracture healing process 120 days after implantation, per in vivo studies.


Assuntos
Alumínio , Desenvolvimento Ósseo , Vidro , Parafusos Pediculares , Pós , Próteses e Implantes , Titânio , Vanádio , Animais , Fenômenos Biomecânicos , Remodelação Óssea , Processamento de Imagem Assistida por Computador , Osseointegração , Estresse Mecânico , Suínos , Tomografia Computadorizada por Raios X
15.
Int J Mol Sci ; 21(8)2020 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-32344580

RESUMO

Spinal sarcopenia is a complex and multifactorial disorder associated with a loss of strength, increased frailty, and increased risks of fractures and falls. In addition, spinal sarcopenia has been associated with lumbar spine disorders and osteoporosis, which renders making decisions on treatment modalities difficult. Patients with spinal sarcopenia typically exhibit lower cumulative survival, a higher risk of in-hospital complications, prolonged hospital stays, higher postoperative costs, and higher rates of blood transfusion after thoracolumbar spine surgery. Several studies have focused on the relationships between spinal sarcopenia, appendicular muscle mass, and bone-related problems-such as osteoporotic fractures and low bone mineral density-and malnutrition and vitamin D deficiency. Although several techniques are available for measuring sarcopenia, each of them has its advantages and shortcomings. For treating spinal sarcopenia, nutrition, physical therapy, and medication have been proven to be effective; regenerative therapeutic options seem to be promising owing to their repair and regeneration potential. Therefore, in this narrative review, we summarize the characteristics, detection methodologies, and treatment options for spinal sarcopenia, as well as its role in spinal disorders.


Assuntos
Suscetibilidade a Doenças , Sarcopenia/etiologia , Sarcopenia/terapia , Coluna Vertebral/patologia , Terapia Combinada , Diagnóstico por Imagem , Gerenciamento Clínico , Progressão da Doença , Humanos , Tamanho do Órgão , Sarcopenia/diagnóstico , Doenças da Coluna Vertebral/diagnóstico , Doenças da Coluna Vertebral/etiologia , Doenças da Coluna Vertebral/terapia , Avaliação de Sintomas , Resultado do Tratamento
16.
Int J Nanomedicine ; 15: 1721-1730, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32210562

RESUMO

Introduction: In this study, the combination of TEMPO-oxidized sacchachitin nanofibers (TOSCNFs) with chitosan-activated platelet-rich plasma (cPRP) was evaluated for remedying dry eye syndrome (DES). Methods: TOSCNFs, designated T050SC, were generated. T050SC combined with chitosan-activated (cPRP) was formulated as eye drops for application for severe DES. To evaluate the effects of cPRP and TOSCNFs on the repair of corneal injury, in vitro studies were conducted using Statens Seruminstitut rabbit corneal (SIRC) epithelial cells for cell proliferation and cell migration assays, and a severe DES animal model using rabbits was established with benzalkonium chloride (BAC) treatment for the evaluation. Results: Results showed that the optimal eye formulation contained PRP activated by 350 µg/mL of the low-molecular-weight chitosan group (L3) combined with 300 µg/mL TO50SC (L3+T050SC). In the WST-1 cell-proliferation assay, L3 and L3+TO50SC significantly increased Statens SIRC cell proliferation after 24 hrs of incubation. In the SIRC cell migration assay, the L3+TO50SC group showed a wound-healing efficiency of 89% after 24-hr treatment. After 5 days of treatment, Schirmer's test results did not simulate the dry eye animal model. Typical cornea appearance and eye fluorescein staining results showed that the L3 group had the best effect on improving cornea haze and epithelial damage. Conclusion: This study has determined that TOSCNFs effectively promoted the healing effect on severe cases of corneal damage, and also might enhance the clinical application and medical potential of PRP in ophthalmology.


Assuntos
Quitina/química , Óxidos N-Cíclicos/química , Síndromes do Olho Seco/terapia , Glucanos/química , Nanofibras/química , Plasma Rico em Plaquetas/metabolismo , Animais , Sobrevivência Celular/efeitos dos fármacos , Quitina/farmacologia , Córnea/efeitos dos fármacos , Córnea/patologia , Córnea/cirurgia , Modelos Animais de Doenças , Síndromes do Olho Seco/patologia , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/patologia , Fibroblastos/efeitos dos fármacos , Glucanos/farmacologia , Nanofibras/ultraestrutura , Oxirredução , Coelhos , Regeneração/efeitos dos fármacos
17.
Carbohydr Polym ; 229: 115507, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31826505

RESUMO

TEMPO-oxidization and mechanical disintegration were utilized to develop sacchachitin nanofibers (SCNF) with a 3D gel structure for being an ideal scaffold. Mechanically disintegrated SCNF (MDSCNF) with NanoLyzer® at 20,000 psi for 5 cycles and TEMPO-oxidized SCNF (TOSCNF) produced with 5.0 and 10.0 mmole NaClO/g SC was designated as SCN5, T050SC, and T100SC, respectively. All 2% MDSCNF suspensions were demonstrated to be in gel form, while all except T100SC of 2% TOSCNF suspensions showed to be wet fiber-like hydrogel. In diabetic wound healing study, both SCN5 and T050SC incorporated in AMPS (2-acrylamide-2-methyl-propane sulfonate)-based wound dressing were showed to accelerate diabetic wound healing forming nearly the same as normal tissues. T050SC/H further provided the healed wound with growth of sweat glands and hair follicles indicating the wound had healed as functional tissue. Conclusively, TEMPO-oxidized SCNF-based hydrogel scaffolds showed greater potentials in tissue regeneration due to its unique physical and chemical properties.


Assuntos
Materiais Biocompatíveis/farmacologia , Quitina/química , Óxidos N-Cíclicos/química , Diabetes Mellitus/fisiopatologia , Fenômenos Mecânicos , Nanofibras/química , Cicatrização/efeitos dos fármacos , Materiais Biocompatíveis/química , Oxirredução
18.
Chin Med ; 15(1): 100, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-33514380

RESUMO

BACKGROUND: Ganoderma sp., such as Ganoderma tsugae (GT), play an important role in traditional Chinese medicine. Ganoderma sp. contains several constituents, including Sacacchin, which has recently drawn attention because it can not only enhance the repair of muscle damage but also strengthen the muscle enforcement. Although Ganoderma sp. have a therapeutic effect for neuromuscular disorders, the underlying mechanism remains unclear. This study investigated the effect and underlying molecular mechanism of micronized sacchachitin (mSC) on satellite cells (SCs), which are known as the muscle stem cells. METHODS: The myogenic cells, included SCs (Pax7+) were isolated from tibialis anterior muscles of a healthy rat and were cultured in growth media with different mSC concentrations. For the evaluation of SC proliferation, these cultivated cells were immunostained with Pax7 and bromodeoxyuridine assessed simultaneously. The molecular signal pathway was further investigated by using Western blotting and signal pathway inhibitors. RESULTS: Our data revealed that 200 µg/mL mSC had an optimal capability to significantly enhance the SC proliferation. Furthermore, this enhancement of SC proliferation was verified to be involved with activation of TAK1-JNK-AP-1 signaling pathway through TLR2, whose expression on SC surface was confirmed for the first time here. CONCLUSION: Micronized sacchachitin extracted from GT was capable of promoting the proliferation of SC under a correct concentration.

19.
Int J Hyperthermia ; 36(1): 932-937, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31535591

RESUMO

Background: Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is an alternative local therapy for patients with painful bone metastasis. However, little is known about the prognostic and predictive factors of MRgFUS in treating bone metastasis. Materials and methods: This retrospective study analyzed the performance status, treated site, pretreatment pain score, pretreatment tumor volume and lesion coverage volume factor (CVF) of 31 patients who underwent MRgFUS. A numerical rating scale for pain was used at the same time to assess the clinical response. Radiographic responses were evaluated using a modified version of The University of Texas MD Anderson Cancer Center criteria and reference to the MR imaging or computed tomography scans obtained 3 months after treatment. Univariate and multivariate logistic regression analyses were conducted to examine the effect of variables on clinical and radiographic responses. Results: The overall clinical response rate was 83.9% and radiographic response rate was 67.7%. Multivariate logistic regression analysis revealed that the better pretreatment Karnofsky performance status (KPS) (odds ratio: 1.220, 95% confidence interval (CI): 1.033-1.440; p = 0.019) was significantly associated with a more positive clinical response, and that the lesion CVF (odds ratio: 1.183, 95% CI: 1.029-1.183; p = 0.0055) was an independent prognostic factor for radiographic responses. The radiographic response of patients with lesion CVF ≥70% and CVF <70% were 91.7% and 52.6%, respectively (p = 0.0235). Conclusion: The pretreatment KPS was an independent prognostic factor for clinical responses, and lesion CVF was an independent prognostic factor for radiographic responses.


Assuntos
Neoplasias Ósseas/secundário , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
20.
Biomed Res Int ; 2019: 4714279, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31531354

RESUMO

Little is known about the function of acid-sensing ion channels (ASICs) in bone cells or osteoporotic vertebral fractures (OVF). This study delineated ASICs expression in adult human bone marrow-mesenchymal stem cells- (BM-MSC-) derived osteoblasts and in OVF bone cells. Adult BM-MSC-derived osteoblasts were isolated and cultured in different pH values. Osteogenic markers as alkaline phosphatase (ALP), osteopontin (OPN), and osteocalcin (OC) mRNA were assessed. Western blots method was applied to analyze ASICs protein expression in different pH values. Amiloride was added into the osteogenic media to analyze the Na+/K+ ATPase change. We harvested the vertebral cancellous bone through a bone biopsy needle in 26 OVF patients when performing percutaneous vertebroplasty. Six vertebral bone specimens obtained from 4 patients with high-energy vertebral fractures were used as the control. The reverse transcription polymerase chain reaction was performed to analyze the quantitative mRNA expression of ASICs. Osteogenic markers as ALP, OPN, and OC mRNA were higher expressed in increasing pH values throughout osteoblastogenesis. ASIC proteins were higher expressed in lower pH media, especially ASIC3, and ASIC4. The highest protein expression at days 7, 14, and 21 was ASIC2, ASIC4, and ASIC3, respectively. Expression of Na+/K+ ATPase was significantly decreased in cultured osteoblasts by addition of amiloride into the pH 6.9 osteogenic media. ASIC2 mRNA was most highly expressed with a 65.93-fold increase in the biopsied vertebral bone cells in OVF compared with the control. In conclusion, we found osteoblastogenesis was reduced in an acidic environment, and ASIC2, ASIC3, and ASIC4 were most highly expressed in turn during osteoblastogenesis within acidic media. ASIC2 was the most abundantly expressed gene in human bone cells in OVF compared with the control. ASIC2 could be crucial in the pathogenesis of osteoporosis and could serve as a therapeutic target for antiosteoporotic therapies.


Assuntos
Canais Iônicos Sensíveis a Ácido/metabolismo , Osso e Ossos/metabolismo , Fraturas por Osteoporose/metabolismo , Fraturas da Coluna Vertebral/metabolismo , Coluna Vertebral/metabolismo , Animais , Medula Óssea/metabolismo , Células Cultivadas , Humanos , Células-Tronco Mesenquimais/metabolismo , Osteoblastos/metabolismo , Osteócitos/metabolismo , Osteopontina/metabolismo , RNA Mensageiro/metabolismo
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