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1.
Macromol Biosci ; : e2000336, 2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33346401

RESUMO

Bone defects remains a challenge for surgeons. Bone graft scaffold can fill the defect and enhance the bone regeneration. Demineralized bone matrix (DBM) is an allogeneic bone graft substitute, which can only be used as a filling material rather than a structural bone graft. Coating of the scaffolds with nanoscale DBM may enhance the osteoinductivity or osteoconductivity. Herein the lyophilization method is presented to coat the nano-DBM on surface of the porous polycaprolactone (PCL)/ß-tricalcium phosphate (ß-TCP) scaffolds fabricated by 3D printing technology. The morphology, elastic modulus, in vitro cell biocompatibility, and in vivo performance are investigated. Scanning electron microscope (SEM) shows DBM particle clusters with size of 200-500 nm are observed on scaffolds fibers after coating. MC3T3-E1 cells on nano-DBM coated PCL/ß-TCP scaffold show better activity than on PCL/ß-TCP scaffold. In vivo tests show better infiltration of new bone tissue in nano-DBM coated PCL/ß-TCP scaffold than PCL/ß-TCP scaffold via the interface. These results show the presence of nano-DBM coating on PCL/ß-TCP scaffold could enhance the attachment, proliferation, and viability of cells and benefit for the new bone formation surrounding and deep inside the scaffolds. Nano-DBM could potentially be used as a new kind of biomaterial for bone defect treatment.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32776174

RESUMO

PURPOSE: To systematically review the clinical manifestations and treatment outcomes of patients with subaxial cervical spinal tuberculosis (SCS-TB) and evaluate the current evidence for surgical or nonsurgical treatment. METHOD: A systematic review was performed using the PubMed, ScienceDirect, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Studies published in English from January 2000 to December 2018 were included in the search. A reference lists search of relevant articles was also conducted for other potential references. The risk of bias was assessed with the 13-item criteria recommended by the Cochrane Back and Neck Group and the Methodological Index for Non-Randomized Studies. RESULTS: Fifteen articles were included with a total of 456 patients, of which only 1 study was randomized and fourteen were nonrandomized. The most common symptom reported was neck pain and stiffness, and the most common segment involved was C5. Of the 456 patients, 329 (72.1%) were treated surgically. Most experienced neurologic recovery after surgery. Instrumentation resulted in maintenance of the correction of alignment throughout the follow-up period. The use of radical debridement is still in debate. CONCLUSIONS: Anti-TB therapy is necessary for all SCS-TB patients, including those underwent surgical management. For patients with neurological dysfunction, the surgical method with decompression and instrumentation could provide better cervical spinal alignment and stability. For adult, the radical debridement remains in debate, while for children, radical debridement may cause the development of progressive kyphosis during growth. Larger randomized comparative studies with longer follow-up times are needed.

3.
Spine (Phila Pa 1976) ; 45(19): 1320-1328, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32355140

RESUMO

STUDY DESIGN: A cross-sectional study. OBJECTIVE: The aim of this study was to investigate the prevalence of ossification of posterior longitudinal ligament (OPLL) in patients with degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA: OPLL of the cervical spine is one of the main entities of DCM in Asian populations. However, few studies have reported the prevalence of cervical OPLL in DCM patients. METHODS: A total of 7210 DCM patients (4546 males and 2664 females; mean age: 54 years) who underwent cervical spine three-dimensional computed tomography (3D-CT) at the Shanghai Changzheng Hospital between January 2012 and December 2016 were included in this study. Demographic data including age, sex, height, body weight, body mass index (BMI), concomitant diabetes mellitus (DM), and hypertension were recorded. The imaging diagnosis criterion for OPLL was thickness >2 mm on axial imaging. RESULTS: The overall prevalence of OPLL in the 7210 DCM patients was 18.22%, including 19.73% in males and 15.65% in females, with a significant difference between the two groups (P < 0.001). The prevalence of OPLL in DM and hypertensive patients was significantly higher than that in non-DM and normotensive patients (24.16% vs. 18.76% and 22.26% vs. 17.91%, both P < 0.001). Comparison by age and BMI showed that the prevalence of OPLL was the highest in the 70- to 79-year age group (21.91%) and obesity group (26.51%), respectively. CONCLUSION: This CT-based study revealed that the overall prevalence of OPLL in DCM patients was 18.22%. Furthermore, old age, male sex, comorbid hypertension or DM, and high BMI were risk factors for cervical OPLL. Given its high prevalence, CT examination is suggested to identify possible OPLL in DCM patients. LEVEL OF EVIDENCE: 2.

4.
Spine (Phila Pa 1976) ; 45(11): 741-746, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31923132

RESUMO

STUDY DESIGN: Retrospective study. OBJECTIVE: To determine the optimal open side in unilateral open-door laminoplasty (UODL) for lateral cervical ossification of posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: No literature has reported which side of the vertebral arch should be chosen as the open side in UODL for lateral cervical OPLL. METHODS: Patients with lateral cervical OPLL who were treated with UODL between 2013 and 2018 were retrospectively analyzed in two groups: Group A, where the open side was contralateral to the ectopic bone, and Group B, where the open side was ipsilateral to the ectopic bone. The Japanese Orthopaedic Association (JOA) Score, JOA recovery rate, spinal canal enlargement rate, cervical range of motion (ROM), and spinal cord area (SCA) were measured to evaluate and compare the clinical outcomes between the two groups. Statistical analysis was performed by t test and Hotelling T2 test. RESULTS: There was no significant difference in patient demographics and major complications between the two groups. The postoperative JOA Score and JOA recovery rate in Group A were significantly higher than those in Group B. There was no significant difference in cervical ROM within or between the two groups during the 2-year follow-up period, nor was there significant difference in spinal canal enlargement between the two groups. However, both postoperative SCA and increased SCA in Group A were significantly higher than those in Group B. CONCLUSION: The contralateral open side approach is preferable to the ipsilateral open side approach in UODL for lateral cervical OPLL. LEVEL OF EVIDENCE: 3.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Laminoplastia/métodos , Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Resultado do Tratamento
5.
Am J Transl Res ; 10(5): 1457-1468, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29887959

RESUMO

Osteoporosis is a common disease associated with age and menopausal status. Postmenopausal osteoporosis is the most common type of primary osteoporosis and is accompanied by increased risk of osteoporotic fracture. Natural and herbal compounds have long been used to prevent and treat many human diseases. Here, we demonstrated that tanshinone IIA prevented ovariectomy-induced bone loss in an in vivo mouse model that closely mimics osteoporosis. In addition, we found that tanshinone IIA inhibited the receptor activator of nuclear factor NF-κB ligand (RANKL)-induced osteoclast differentiation and osteoclastogenesis in vitro. Tanshinone IIA treatment also abrogated RANKL-induced activation of the NF-κB pathway, PI3-kinase/Akt signaling, and the mitogen-activated protein kinase (MAPK) pathways, including nuclear translocation of NF-κB p65 and phosphorylation of IκB, extracellular signal-regulated kinase (ERK), p38, and Akt. Inactivation of these pathways resulted in deceased expression of osteoclastogenesis-related markers. These results suggest that tanshinone IIA, a natural drug, has the potential to treat and prevent bone loss diseases, including postmenopausal osteoporosis.

6.
World Neurosurg ; 116: e929-e933, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29852300

RESUMO

OBJECTIVE: To investigate the incidence, distribution characteristics, and radiographic features of the ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the nuchal ligament (ONL) and to analyze the correlation between the location of ONL and degree of ossification in patients with cervical OPLL. METHODS: From January 2010 to December 2016, the clinical data of 217 patients with cervical OPLL were reviewed retrospectively. Type and location of OPLL and ONL were determined on computed tomography images and lateral radiograph films. For patients with the local type of ONL, the segment with the largest spinal canal occupation ratio (COR) of OPLL was determined on cross-sectional computed tomography slices. The correlation between the location of ONL and segment with the largest COR of OPLL was evaluated. RESULTS: Of the 217 patients with cervical OPLL, 118 patients (54.4%) had OPLL combined with ONL (92 male and 26 female patients). The incidence of ONL was almost 1.4 times greater in males than in female patients (P = 0.03). C5-C6 (49.5%) was the segment at which ONL occurred most. Of 60 patients with the local type of ONL, 34 patients' ONL was located at the segment with largest COR of OPLL. The matching ratio was the largest (77.8%) when the type of OPLL was locally circumscribed (P = 0.003). CONCLUSIONS: The incidence of ONL was 54.4% in patients with cervical OPLL, and male patients were affected more than female patients. ONL occurred most in segment C5-C6. The location of local-type ONL commonly corresponded to the segment with the largest COR of OPLL when type of OPLL was circumscribed.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Imagem por Ressonância Magnética/métodos , Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Ligamentos Longitudinais/diagnóstico por imagem , Ligamentos Longitudinais/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
World Neurosurg ; 115: e172-e177, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29649650

RESUMO

BACKGROUND: Ossification of the posterior longitudinal ligament (OPLL) is a 3-dimensional (3D) disease that causes cervical myelopathy. The conventional 2-dimensional (2D) measurement of OPLL has limitations in estimating cord compression and myelopathy. In this study, we attempted to use 3D computed tomography (CT) and magnetic resonance imaging (MRI) to measure the 3D occupying ratio of OPLL and investigate its significance in the assessment of spinal cord myelopathy. METHODS: Three-dimensional CT and MRI were performed in 50 patients with cervical OPLL at a neutral position before surgery. MRI was done to determine the extent of spinal cord compression. The CT data were saved in DICOM format and analyzed using Mimics 17.0. Then a 3D model of OPLL was semiautomatically segmented at a specific threshold. The following data were measured: diameter of the spinal canal, thickness of the OPLL, and 3D volume of the OPLL and spinal canal. The Japanese Orthopedic Association (JOA) score was used to assess the cervical spinal cord function. RESULTS: Pearson correlation analysis showed that both the occupying ratio and the 3D occupying ratio were significantly and negatively correlated with the JOA score. Multiple linear regression analysis indicated that only the 3D occupying ratio showed a significantly negative correlation with the JOA score, whereas age, sex, and the occupying ratio were insignificantly associated with the JOA score. CONCLUSIONS: The 3D occupying ratio of OPLL is a reliable indicator for assessing the severity of spinal cord myelopathy. MRI provides more details about cord compression, making the measurement more accurate and objective.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imagem por Ressonância Magnética/métodos , Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem , Doenças da Medula Espinal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Vértebras Cervicais/cirurgia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Doenças da Medula Espinal/cirurgia
8.
World Neurosurg ; 110: e1025-e1030, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29229351

RESUMO

OBJECTIVE: The degree of hypertrophy of thoracic ossification of ligamentum flavum (TOLF) is related to the severity of the myelopathy. There is no uniform measuring method to calculate the spinal canal occupation ratio (COR) of TOLF simply and effectively. The study was to determine an appropriate measuring method to calculate the COR of TOLF. METHODS: A total of 37 computed tomography cross-sectional imaging scans (bone window) from 22 patients were analyzed retrospectively in this study. The ventral side of the lamina or superior facet was selected as bottom in Method 1, and a line perpendicular to the anteroposterior diameter and on the dorsal side of the spinal canal was selected as bottom in Method 2. The maximum thickness of the bilateral ossified mass to the bottom is d1 and d2. The maximum distance from the anterior wall of the spinal canal to the bottom is d. COR of Method 1 or 2 was (d1 + d2)/2d × 100%. Standard COR values calculated by software served as controls. RESULTS: The standard COR values were <50% in 10 images, 51%-60% in 9 images, 61%-70% in 10 images, and >71% in 8 images. There was no significant difference between COR1 and COR in every range. There were significant differences between COR2 and COR in the ≤50%, 51%-60%, and 61%-70% groups but they were not statistically significant in the >70% group. CONCLUSIONS: Method 1 is a convenient and practical method to measure the COR of ossification in patients with TOLF.


Assuntos
Ligamento Amarelo/patologia , Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem , Canal Vertebral/diagnóstico por imagem , Vértebras Torácicas/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Pesos e Medidas
9.
Oncotarget ; 8(52): 90176-90184, 2017 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-29163819

RESUMO

Aims: To explicit cell apoptosis trend in PC12 oxygen-glucose-serum deprivation/restoration (OGSD/R) model and provide experimental bases for neural cell simulation in ischemia reperfusion injury in vitro. Methods: OGSD/R model was constructed using the passage PC12 cells in vitro. The profile of cell apoptosis was estimated by DAPI staining, Annexin V-FITC and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay, as well as the levels of apoptosis-related proteins, including procaspase-3 and caspase-12. Results: PC12 apoptosis was induced by OGSD and aggravated after restoration. CCK8 assay indicated that cell activity reached minimum after 1h of oxygen-glucose-serum restoration (OGR). DAPI staining suggested that apoptosis was the most serious after 1h of OGR, causing apoptotic cell nucleus pyknosis, particle spot formation, and fracture of cells with serious apoptosis forming pieces, and nucleus disintegration. The percentage of apoptotic cells exhibited increased trend after restoration, and reached the highest at 1h of OGR. Moreover, the expression of procaspase-3 and caspase-12 were extremely enhanced after OGD, especially 1h after OGR. Conclusions: PC12 apoptosis is induced by OGSD and aggravated after restoration. The apoptosis of PC12 reaches the highest at 1h after OGR, which may provide experimental bases for spinal cord ischemia reperfusion injury treatment.

10.
J Orthop Surg Res ; 12(1): 105, 2017 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-28693540

RESUMO

BACKGROUND: The objectives of this study are to investigate the clinical curative effect of Gallie technique and atlantoaxial screw-rod constructs (SRC) on atlantoaxial sagittal instability and determine the indication of Gallie technique. METHODS: Data of 49 patients with atlantoaxial sagittal instability from February 2008 to May 2015 were analyzed retrospectively. The visual analog scale (VAS) score and the neck disability index (NDI) were used to evaluate the curative effect. Postoperative radiological outcomes were used to evaluate the stability of atlantoaxial joint and bone fusion. Perioperative parameters such as blood loss, operation time, radiographic exposure times, and hospital expense were also recorded and analyzed. RESULTS: Forty-nine patients (36 men and 13 women) were included in this study. The mean age was 41.4 ± 8.9 (range from 19 to 64). All patients were followed up for 24-67 months. Among these patients, 25 of these patients underwent Gallie surgery and 24 underwent SRC surgery. The pain in the occipitocervical area of all the patients has been relieved. NDI scores and VAS scores were lower in Gallie group than in SRC group in early postoperative period. The proportion of the patients who achieved good bone fusion within 3 months after operation was 88.0% (22/25) in the Gallie group and 100% (24/24) in the SRC group. The Gallie group is lower than the SRC group in blood loss, operation time, radiographic exposure times, and hospital expense. Statistical difference was observed between the two groups. CONCLUSIONS: For patients with atlantoaxial instability who has (1) the atlantodental interval (ADI) which is bigger than 5 mm on lateral flexion-extension X-ray, or Anderson-D'Alonzo type II odontoid fracture, (2) no asymmetry between odontoid process and lateral mass on open-mouth anterior-posterior X-ray, and (3) no dislocation of lateral mass joint on the CT 3D reconstruction, Gallie technique can be chosen as a safe and effective method if atlantoaxial reduction can be achieved preoperatively. Compared with SRC, Gallie technique can relieve the pain in the occipitocervical area earlier and it can shorten operation time and reduce intraoperative bleeding, radiographic exposure times, and hospital expense effectively. However, for patients with irreducible atlantoaxial dislocation, the Gallie technique should be used with caution.


Assuntos
Articulação Atlantoaxial/cirurgia , Instabilidade Articular/cirurgia , Procedimentos Ortopédicos/estatística & dados numéricos , Adolescente , Adulto , Articulação Atlantoaxial/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
11.
Sci Rep ; 7(1): 2983, 2017 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-28592849

RESUMO

Thoracic ossification of the ligamentum flavum (TOLF) complicated with dural ossification (DO) is a severe clinical disease. The diagnosis of DO preoperatively remains challenging. The current study retrospectively analyzed imaging features of 102 segments with TOLF from 39 patients and proposed a grading system for evaluating DO risk. Logistic regression results showed that unilateral spinal canal occupational rate (UCOR), tram track signs, and C-signs were all risk factors for DO (odds ratios of 5.393, 19.734 and 72.594, respectively). In validation analyses for the TOLF-DO grading system, sensitivity was 76.0% (19/25), specificity was 91.0% (70/77), and Youden's index was 0.66. Thus, implementation of the TOLF-DO grading system has the potential to improve the diagnosis of DO.


Assuntos
Dura-Máter/diagnóstico por imagem , Dura-Máter/patologia , Ligamento Amarelo/diagnóstico por imagem , Ligamento Amarelo/patologia , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/patologia , Feminino , Humanos , Masculino , Razão de Chances , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
12.
J Zhejiang Univ Sci B ; 18(4): 303-315, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28378568

RESUMO

Bone defects arising from a variety of reasons cannot be treated effectively without bone tissue reconstruction. Autografts and allografts have been used in clinical application for some time, but they have disadvantages. With the inherent drawback in the precision and reproducibility of conventional scaffold fabrication techniques, the results of bone surgery may not be ideal. This is despite the introduction of bone tissue engineering which provides a powerful approach for bone repair. Rapid prototyping technologies have emerged as an alternative and have been widely used in bone tissue engineering, enhancing bone tissue regeneration in terms of mechanical strength, pore geometry, and bioactive factors, and overcoming some of the disadvantages of conventional technologies. This review focuses on the basic principles and characteristics of various fabrication technologies, such as stereolithography, selective laser sintering, and fused deposition modeling, and reviews the application of rapid prototyping techniques to scaffolds for bone tissue engineering. In the near future, the use of scaffolds for bone tissue engineering prepared by rapid prototyping technology might be an effective therapeutic strategy for bone defects.


Assuntos
Osso e Ossos/fisiologia , Osso e Ossos/cirurgia , Engenharia Tecidual/métodos , Animais , Regeneração Óssea , Substitutos Ósseos , Transplante Ósseo , Humanos , Impressão Tridimensional , Engenharia Tecidual/instrumentação , Tecidos Suporte
13.
Medicine (Baltimore) ; 94(44): e1663, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26554765

RESUMO

The present study aimed to explore surgical treatments and assess the effects based on the features of cervical spine fracture in patients with ankylosing spondylitis (AS) and to summarize the experiences in perioperative management. Retrospective analysis was performed in 25 AS patients with cervical spine fracture treated in our hospital from January 2011 to December 2013. The patients were divided according to fracture segments, including 4 cases at C4 to C5, 8 cases at C5 to C6, and 13 cases at C6 to C7. Among them, 12 belonged to I type, 5 to II type, and 8 to III type based on the improved classification method for AS cervical spine fracture. The Subaxial Cervical Spine Injury Classification score for these patients was 7.2 ±â€Š1.3, and the assessment of their neurological function states showed 6 patients (24%) were in American Spinal Injury Association (ASIA) A grade, 1 (4%) in ASIA B grade, 3 (12%) in ASIA C grade, 12 (48%) in ASIA D grade, and 3 (12%) in ASIA E grade. Surgical methods contained simple anterior approach alone, posterior approach alone, and combined posterior-anterior or anterior-posterior approach. The average duration of patients' hospital stay was 38.6 ±â€Š37.6, and the first surgical methods were as follows: anterior approach alone on 6 cases, posterior surgery alone on 9 cases, and combined posterior-anterior or anterior-posterior approach on 10 patients. The median segments of fixation and fusion were 4.1 ±â€Š1.4 sections. Thirteen patients developed complications. During 2 to 36 months of postoperative follow-up, 1 patient died of respiratory failure caused by pulmonary infections 2 months after leaving hospital. At the end of the follow-up, bone graft fusion was achieved in the rest of patients, and obvious looseness or migration of internal fixation was not observed. In addition, the preoperative neurological injury in 12 patients (54.5%) was also alleviated in different levels. AS cervical spine fracture, an unstable fracture, should be treated with operation, and satisfactory effects will be achieved after the individualized surgical treatment according to the improved classification method for AS cervical spine fracture.


Assuntos
Vértebras Cervicais/lesões , Fixação Interna de Fraturas/métodos , Fraturas da Coluna Vertebral/cirurgia , Fusão Vertebral/métodos , Espondilite Anquilosante/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/diagnóstico , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/cirurgia
14.
Zhonghua Yi Xue Za Zhi ; 94(19): 1494-8, 2014 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-25143172

RESUMO

OBJECTIVE: To evaluate the efficacies of transgenetic bone mesenchymal stem cells (BMSCs) carring basic fibroblast growth factor (bFGF) gene on repairing severe ligament injury. METHODS: The genes of bFGF and enhanced green fluorescent protein (eGFP) were transfected into BMSCs through adenovirus vector. According to different cell transplantations, the operated rabbits were divided into 3 groups of transgenetic BMSCs, BMSCs and no cells. And group 4 was normal ligament group. The distribution of transgenetic BMSCs in ligament injury area, the expression of bFGF and ligament specific extracellular matrix, i.e. type I collagen, type III collagen, fibronectin, alpha-smooth muscle actin and vimentin, histology and biomechanics of ligament healing were recorded at different timepoints. RESULTS: The transgenetic BMSCs could be observed in injury area within one month. The expression of bFGF in the transgenetic BMSCs group was significantly higher than that in the control groups at Days 3-14 (P < 0.001) and peaked at Day 7. In the transgenetic BMSCs group, the gene expression of ligament specific extracellular matrix was significantly higher than that in the control groups within one month (P < 0.001). And immunohistochemistry showed strong positive expression. After 3 months, in group 1, hematoxylin and eosin staining showed the arrangement and density of collagen fibers of healing area were better than that in the control groups. And biomechanical testing showed that tensile load were stronger than that in the control groups (P < 0.05). CONCLUSION: Transgenetic BMSCs carrying bFGF gene can obviously promote ligament injury healing and increase ligament healing strength.


Assuntos
Fator 2 de Crescimento de Fibroblastos/genética , Ligamentos/lesões , Transplante de Células-Tronco Mesenquimais , Cicatrização , Animais , Modelos Animais de Doenças , Feminino , Masculino , Coelhos , Transfecção , Transgenes
15.
ACS Appl Mater Interfaces ; 6(14): 11459-69, 2014 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-24983917

RESUMO

Currently used small molecular magnetic resonance (MR) imaging contrast agents (CAs) in clinics have relatively short half-lives, which has limited the acquisition of high-resolution organ and angiographic images. Therefore, development of a facile strategy for the synthesis of long-circulating CAs with the transforming potential for MR imaging still remains a great challenge. Here we communicate the design and synthesis of PEGylated polyethylenimine (PEI) and its application as enhanced T1 CA for the long-circulating blood pool as well as efficient organ and tumor imaging. In this study, PEI was covalently grafted with gadolinium (Gd(III)) chelator and mPEG-NHS, followed by acetylation of the remaining amines to improve biocompatibility and prolong circulation time. With the relatively long circulation time (3.8 h), the formed multifunctional PEI (PEI.NHAc-DTPA(Gd(III))-mPEG) can be used as an enhanced T1 CA for blood pool and major organ imaging, and could be cleared from the body 96 h post administration through the urinary system. Importantly, the PEI.NHAc-DTPA(Gd(III))-mPEG complexes displayed a strong T1 contrast effect for tumor imaging through the enhanced permeation and retention effect. These findings suggest that the synthesized PEI.NHAc-DTPA(Gd(III))-mPEG may be used as a promising CA for T1 MR imaging of various biological systems.


Assuntos
Meios de Contraste , Gadolínio , Imagem por Ressonância Magnética , Polietilenoglicóis , Polietilenoimina , Animais , Linhagem Celular , Meios de Contraste/química , Meios de Contraste/farmacocinética , Meios de Contraste/farmacologia , Gadolínio/química , Gadolínio/farmacocinética , Gadolínio/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos ICR , Polietilenoglicóis/química , Polietilenoglicóis/farmacocinética , Polietilenoglicóis/farmacologia , Polietilenoimina/química , Polietilenoimina/farmacocinética , Polietilenoimina/farmacologia
16.
Adv Healthc Mater ; 3(2): 182-6, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23983129

RESUMO

Amphiphilic biodegradable photoluminescent polymers (ABPLPs) composed of a biodegradable fluorescent polymer and methoxy poly (ethyleneglycol) demonstrate intrinsic bright, tunable, and stable fluorescence emission. ABPLP micelles elicit minor cellular toxicity and can be used for cell and tissue imaging both in vitro and in vivo.


Assuntos
Diagnóstico por Imagem/métodos , Fluorescência , Polímeros/química , Sistemas de Liberação de Medicamentos , Micelas
17.
Mol Med Rep ; 8(5): 1323-8, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24008926

RESUMO

Mesenchymal stem cells (MSCs) differentiate into numerous different cell types and thus have therapeutic potential for tissue engineering, anti­inflammatory and immunomodulatory purposes. FGF2 may affect the biological behavior of MSCs. MSCs were transduced with either adenovirus­null vector/green fluorescent protein (GFP) or a vector encoding for the overexpression of FGF2/GFP. The expression of FGF2 was demonstrated to be significantly higher in MSC (FGF2) compared with MSC (vector) by qPCR and western blot analysis. In order to investigate the function of FGF2 in MSCs over time, it was observed that FGF2 stimulates cell proliferation and induces cell differentiation by activating the mitogen­activated protein kinase (MAPK) signaling pathway. Following blockade of the FGF2­induced activation of the extracellular signal­regulated kinase pathway by overexpression of sprouty isoforms, the marker of differentiation markedly decreased. Altogether, the results demonstrated a novel cell biological mechanism that FGF2 differentiates into tenocytes and the MAPK pathway is key in differentiation.


Assuntos
Diferenciação Celular , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fator 2 de Crescimento de Fibroblastos/metabolismo , Células-Tronco Mesenquimais/citologia , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Tendões/citologia , Adulto , Western Blotting , Proliferação de Células , Células Cultivadas , MAP Quinases Reguladas por Sinal Extracelular/genética , Feminino , Fator 2 de Crescimento de Fibroblastos/genética , Humanos , Masculino , Células-Tronco Mesenquimais/metabolismo , Pessoa de Meia-Idade , Proteínas Quinases Ativadas por Mitógeno/genética , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais , Tendões/metabolismo
18.
PLoS One ; 8(5): e63713, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23691090

RESUMO

OBJECTIVE: To investigate the surgical outcome of a universal pedicle screw-V rod system and isthmic bone grafting for isthmic spondylolysis. METHODS: Twenty-four patients with isthmic spondylolysis at L5 and grade 0-I spondylolisthesis (Meyerding classification) received isthmic bone graft and stabilization using the universal pedicle screw-V rod system. Back pain was evaluated using the visual analog scale (VAS) and time to bone healing, improvement in spondylolisthesis and intervertebral space height at L5/S1 and L4/L5 were assessed. RESULTS: Twenty-one patients were followed up for 24 months and included in the analysis. Back pain was markedly improved at 3 months postoperatively with a statistical difference in VAS scores compared with preoperative VAS scores (P<0.001). The VAS scores were 0 to 3 at 6 months postoperatively in all patients and no back pain was reported in all patients except 2 patients who complained of back pain after prolonged sitting. X-ray examination showed a bone graft healing time of 3 to 12 months. Grade I spondylolisthesis improved to grade 0 in 4 patients and no noticeable change was observed in the remaining 17 cases. The intervertebral space height at L5/S1 was statistically increased (P<0.05) while no statistically significant change was seen at L4/L5. There was no statistically significant difference in the ROM of the intervertebral disks of L5/S1 and L4/5 before and after surgery. CONCLUSIONS: The universal pedicle screw-V rod system and isthmic bone grafting directly repairs isthmic spondylolysis and reduces back pain, prevents anterior displacement of the diseased segment and maintains intervertebral space height, thus offering a promising alternative to current approaches for isthmic spondylolysis.


Assuntos
Parafusos Ósseos , Transplante Ósseo/métodos , Vértebras Lombares/cirurgia , Espondilolistese/cirurgia , Dor nas Costas/patologia , Humanos , Fixadores Internos , Vértebras Lombares/patologia , Estudos Retrospectivos , Espondilolistese/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento
19.
Zhonghua Wai Ke Za Zhi ; 50(9): 772-5, 2012 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-23157949

RESUMO

OBJECTIVE: To observe the short-term clinical results of the adjacent segment degeneration after the implantation of Coflex system at the interspinous space of adjacent segment to lumbar fusion. METHODS: Fifty patients with grade III disc (Thompson MRI classification) of adjacent segment to lumbar fusion were included and divided alternately into two groups according to the order of hospitalization from January to November 2009. Coflex system was implanted at the interspinous space of adjacent segment to lumbar fusion in 25 patients as Coflex group, the other 25 patients did not have any surgical treatment were as control group. The followed up time was 2 years. Visual analogue scale (VAS) score of low back pain, changes of disc height and motion range of adjacent segment to lumbar fusion on X-ray imaging were evaluated by independent sample t-test or paired samples t-test. RESULTS: There were 22 patients in Coflex group and 21 patients in control group were followed up 2 years post-operation. The difference of VAS score between two groups was no significance (P > 0.05). In Coflex group, the change of postoperative disc height was no significance (P > 0.05), but the motion range was significantly reduced to 47% of the preoperative value (t = 7.99, P < 0.05). In control group, the postoperative disc height decreased slightly, without significant difference to the preoperative value (P > 0.05). Between the two groups, no differences of the disc height and motion range were found before operation, but the differences of the disc height changes (t = 6.7, P < 0.05) and motion rang (t = -14.5, P < 0.05) were significant in 2 years post-operation. No complications such as Coflex system loosen, immigration and spinal process fracture were occurred. CONCLUSIONS: Coflex system can obviously limit the motion range and maintain the disc space height of adjacent segment to lumbar fusion, and prevent its degeneration in some degree.


Assuntos
Fixadores Internos , Vértebras Lombares/cirurgia , Complicações Pós-Operatórias , Fusão Vertebral/efeitos adversos , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Fusão Vertebral/instrumentação , Fusão Vertebral/métodos , Resultado do Tratamento
20.
Neurosurgery ; 66(6): 1181-6, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20495433

RESUMO

OBJECTIVE: We performed a retrospective patient chart review to determine the feasibility and safety of en bloc resection of lamina and ossified ligamentum flavum in the treatment of thoracic ossification of ligamentum flavum (OLF). METHODS: From January 2000 to June 2006, 36 patients with thoracic OLF underwent en bloc resection of lamina and ossified ligamentum flavum by a burr-grinding technique. The range of resection included one lamina superior and one lamina inferior to the diseased segments. Ossified dura mater was removed if present, and simultaneous repair was carried out. RESULTS: The mean preoperative Japanese Orthopedic Association (JOA) score (an evaluation system for thoracic myelopathy with a total score of 11 points) was 5 points (range, 3-9 points). The mean JOA score at the last follow-up visit (mean follow-up period, 3.9 years) was 8.44 points (range, 6-11 points). The range of improvement was from 2 to 6 points, and the mean improvement rate was 60.5% (range, 33.3%-100%). No postoperative aggravation of neurological dysfunction, leakage of cerebrospinal fluid (CSF), wound infection, kyphosis, or recurrence occurred. A CSF cyst found in one patient 3 weeks postoperatively was absorbed automatically after 10 months. CONCLUSION: The en bloc resection technique described here is both safe and effective.


Assuntos
Laminectomia/métodos , Ligamento Amarelo/cirurgia , Ossificação Heterotópica/cirurgia , Estenose Espinal/cirurgia , Vértebras Torácicas/cirurgia , Adulto , Idoso , Descompressão Cirúrgica/métodos , Espaço Epidural/patologia , Espaço Epidural/cirurgia , Feminino , Humanos , Ligamento Amarelo/patologia , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/patologia , Estudos Retrospectivos , Canal Vertebral/patologia , Canal Vertebral/cirurgia , Compressão da Medula Espinal/patologia , Compressão da Medula Espinal/cirurgia , Estenose Espinal/patologia , Vértebras Torácicas/patologia , Resultado do Tratamento
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