Objective To investigate the synergetic effect and possibil ity of repairing spinal cord injury (SCI) by transplantation of olfactory ensheathing cells (OECs) and chondroitinase ABC (ChABC) in adult rats. Methods Three adult male SD rats were used to isolated olfactory bulb and primarily cultured OECs. In the 8th or 9th day, OECs were transplanted, the concentration of cells was modulated to 1 × 105/μL. Fifty-four SD rats were made the models of T8 spinal cord crush injury and divided into 4 groups. In group A (control, n=36), injured site was not treated; in groups B, C and D (n=6), OECs, ChABC and OECs+ChABC were injected into injured site, respectively. At 1, 2, 3, 7 and 14 days after injury, the BBB score system was used to evaluate the motion function. At 0, 1, 2, 3, 7, 14 days in group A and at 14 days in groups B, C, D after injury, the maximal transverse diameter and gross area of necrosis were evaluated on HE stained sections. The immunofluorescence double label ing staining for gl ial-fibrillary acidic protein (GFAP)/CS56, GFAP/growth associated protein 43(GAP-43) and GFAP/neurofilament 160(NF160) was carried out to evaluate the regeneration of nerve fiber. Results At 14 days after injury, there were significant difference in the BBB scores between group A and groups B, C, D (P lt; 0.05), and between groups B, C and group D (P lt; 0.05), HE staining showed that the formation of cavity was observed in each group at 14 days after injury. There were significant difference in the maximal transverse diameter and gross area of necrosis between groups B, C, D and group A (P lt; 0.01), and between groups B, C and group D (P lt; 0.01). The immunofluorescence staining indicated that expression of GFAP were more intense in group A than in other groups, and the cavity of the lesion site was apparent, but it was moderate in groups B and C. The expression of GAP-43 was more intense in group D than in groups B and C. The expression of NF160 was more intense in group D. Conclusion Transplantation strategy of OECs combined with ChABC was effective in the repair of SCI in some extent.
Objective To formulate a rational adjuvant therapeutic evidence-based nursing plan for a patient with grade II red and swelling type phlebitis. Methods According to the condition of the patient and using the PICO principle, we put forward clinical problems. Then we comprehensively searched the National Guideline Clearinghouse (NGC), ACP Journal Club, The Cochrane Library, DARE, PubMed, MEDLINE, CNKI and Google Scholar from 2000 to 2012. Relevant clinical guidelines, evidence summaries, systematic reviews/ meta-analyses, randomized controlled trials (RCTs), and high quality reviews on adjuvant therapy of grade II red and swelling type phlebitis were collected and their authenticity, importance and applicability were evaluated. Results One systematic review, four meta-analyses, five RCTs, and one review were totally included. According to current evidence as well as the patient’s clinical conditions and preference, a comprehensive and effective adjuvant therapeutic and nursing programme was given to the patient. For grade II red and swelling type phlebitis with blisters and severe pain, paretic infusion should be immediately stopped on the lesion-side limb, and venous indwelling needle should be extracted. Then, mucopolysaccharide polysulfate cream should be applied on the skin impaired by vein inflammation, and the local area should be gently massaged for 3 min, twice daily (once in the morning and evening, respectively). After four-day treatment and nursing care, the patient with phlebitis had already recovered. Conclusion Evidence-based medicine approaches could help us develop comprehensive therapeutic plans for patients which promote recovery of patients with phlebitis, alleviate pain, improve health, and increasepatients’ quality of life.
Objective To systematically evaluate the effects of magnesium sulfate on postoperative pain and complications after general anesthesia. Methods A literature search was conducted in following databases as The Cochrane Library, EMbase, PubMed, EBSCO, Springer, Ovid, CNKI and CBM from the date of establishment to September 2011 to identify randomized controlled trials (RCTs) about intravenous infusion of magnesium sulfate during general anesthesia. All included RCTs were assessed and the data were extracted according to the standard of Cochrane systematic review. The homogenous studies were pooled using RevMan 5.1 software. Results A total of 11 RCTs involving 905 patients were included. The results of meta-analyses showed that compared with the control group, intravenous infusion of magnesium sulfate during general anesthesia significantly reduced the visual analog scale (VAS) scores at the time-points of 2, 4, 6, 8, 16, and 24 hours, respectively, after surgery, the postoperative 24 hours morphine requirements, and the incidents of postoperative nausea and vomiting (RR=0.61, 95%CI 0.40 to 0.91, P=0.02) and chilling (RR=0.29, 95%CI 0.14 to 0.59, P=0.000 7). Although the incidents of bradycardia (RR=1.93, 95%CI 1.05 to 3.53, P=0.03) increased, there were no adverse events or significant differences in the incidents of hypotension and serum concentration changes of magnesium. Conclusion Intravenous infusion of magnesium sulfate during general anesthesia may obviously decrease the pain intensity, and the incidents of nausea and vomiting and chilling after surgery, without increasing cardiovascular adverse events and risk of hypermagnesemia. The results still need to be confirmed by more high-quality and large-sample RCTs.
ObjectiveTo observe the ability of osteogenesis in vivo using the injected absorbable polyamine acid/calcium sulfate (PAA/CS) composites and assess their ability to repair bone defects. MethodWe selected 48 New Zealand white rabbits, and half of them were male with a weight between 2.0 and 2.5 kg. Bone defect models were made at the rabbit femoral condyle using electric drill, and the rabbits were divided into two groups. One group accepted implantation of the material at the defect, while nothing was done for the control group. After four, eight, twelve and sixteen weeks, the animals were killed. The line X-ray and hard tissue slices histological examination (HE, MASSON staining) were observed to assess the situation of degradation, absorption and bone formation of the material. ResultsFour weeks after operation, bone defect of the experimental group had no obvious callus growth on X-ray imaging. Histology showed that the material began to degrade and new immature trabecular bone grew. The bone defect of the experimental group had a small amount of callus growth on X-ray imaging after eight weeks. And histology showed that the material continued to degrade and new immature trabecular bone grew continually. There was an obvious callus growth after twelve weeks, and the bone defect area had smaller residual low-density shadow on X-ray imaging. Histology showed that most of the materials degraded and parts of woven bone grew into lamellar bone. After sixteen weeks, the composites were absorbed completely, replaced by new bone tissues, and the new bone was gradually changed from woven bone into mature plate of bone. There was no significant change in bone defect in the control group within twelve weeks, and part of bone defect hole became smaller, and partial edge repair could be detected. ConclusionsThe PAA/CS composites can be completely degraded and absorbed, with a certain activity of bone formation, expected to be used as bone repair materials.
Objective To evaluate the osteogenic effect of dextran sulfate/recombinant human bone morphogenetic protein 2/chitosan (DS/rhBMP-2/CS) combined with coralline hydroxyapatite (CHA) in repairing large segmental bone defects by radiographic feature. Methods Fifty-seven 24-week-old male New Zealand rabbits were prepared for establishing right radius bone defect model of 20 mm in length. In which 54 rabbits were randomly divided into 3 groups (n=18), and the CHA, DS/rhBMP-2/CS/CHA, and rhBMP-2/CHA artificial bone grafts were implanted into the bone defect in groups A, B, and C respectively; the remaining 3 rabbits were implanted nothing as blank control group. After operation, the gross condition of the animals was observed; at 4, 8, and 12 weeks after operation, X-ray film observation, Micro-CT scanning, and three-dimensional reconstruction were performed to obtain the volume of the new bone. Results The experimental animals recovered well and were in normal condition. X-ray observation showed that the bone healing in group B was better than that in groups A and C at each time point. At each time point after operation, the X-ray scores of group B were significantly higher than that of group A and group C (P<0.05); the scores of group C at 8 and 12 weeks after operation were significantly higher than that of group B (P<0.05). Micro-CT scanning and three-dimensional reconstruction observation showed that at each time point after operation in group A, the bone defect area had less bone formation and poor osteogenesis; in group B, there were many new bone tissues in bone defect area, and the bone remodeling was well, and gradually closed to normal bone morphology at 12 weeks; in group C, there were many new bone tissues in bone defect area, but the bone formation was general. The new bone volume of group B was significantly higher than that of group A and group C (P<0.05) at each time point after operation, and the score of group C was higher than that of group A at 8 weeks after operation (P<0.05). Conclusion The osteogenic effect of DS/rhBMP-2/CS/CHA sustained-release artificial bone is much better than that of single CHA and rhBMP-2/CHA, which can provide a new idea for treating bone defect by using bone tissue engineering in the future.
Objective To evaluate collagen（Col）hyaluronan (HA) chondroitin sulfate (CS) tri-copolymer as a new biomimetic biodegradable polymer scaffold for application of the articular cartilage tissue engineering. Methods The Col-HACS tricopolymer was prepared by freezing and lyophilization and was cross-linked by 1-ethyl-3(3-dimethy inaminoproyl) carbodiimide (EDC). The morpholog icalcharacteristics of the matrices were evaluated by the SME and HE stainings. The rabbit chondrocytes were isolated and seeded in the tricopolymer scaffold. Morphology, proliferation and differentiation of glycosaminoglycan (GAG), and phenotypic expression of the rabbit articular chondrocytes cultured within the tricopolymer scaffold were indicated by the histological examination, SEM, biochemica l analysis, and reverse transcriptase PCR for collagen typeⅡ（ColⅡ）. Results The chondrocytes proliferated and differentiated well, and th ey preserved the phenotypic expression of ColⅡ in the Col-HA-CS scaffold. After the 21day cell culture within the Col-HA-CS scaffolds, the cartilage-specific morphologyand the structural characteristics such as lacunae appeared，and DNA and GAG conten ts increased with the time. In addition, DNA and GAG contents were significantly higher in the Col-HA-CS matrix than in the collagen matrix alone (Plt;0.05 ). Conclusion These results show that the Col-HA-CS tri-copolymer matrices can provide an appropriate environment for the generation of cartilage-like tissues and have a potential application in the cartilage tissue engineering scaffold field.
In recent years, the diversity of gut microbiota and the role of its metabolites in cardiovascular disease (CVD) have attracted widespread attention. Gut microbiota metabolites not only play an important role in maintaining gut health, but may also influence cardiovascular health through a variety of mechanisms. As one of the important products of gut microbiota metabolism, sulfate’s biosynthetic pathway, metabolic dynamics and potential effects on cardiovascular system have become the focus of research. However, the current research on the relationship between sulfate and cardiovascular disease still has some shortcomings, including the mechanism is not clear, and clinical data are limited. This article reviewed the biosynthesis of sulfate and its mechanism of action in cardiovascular diseases, and combined with the existing clinical research results, aimed to provide new perspectives and ideas for future research, in order to promote the in-depth exploration and development of this field.
Objective To investigate the clinical effect of medical grade calcium sulfate(Osteoset) as a bone graft substitute. Methods From December 2004 to May 2005, 9 cases of bone defect(limb group)were repaired with Osteoset pellets; bone defect was caused by benign tumor inlimbs, including 3 cases of fibroma xanthomas in humerus(1 case) and acetabulum (2 cases), 2 cases of bone cysts in humerus(1) and radius(1), 1 case of nonossifying fibroma, 1 case of ossifying fibroma and 2 cases of osteofibrous dysplasia in femurs. Five cases of lumbar posterolateral fusion (spine group) were treated with Osteoset pellets as autograft volume expander, including 2 cases of lumbar spinal stenosis, 2 cases of lumbar spondylolisthesis and 1 case of lumbar spondylolysis. Radiological method was used to evaluate the repair effect of Osteoset pellets. Results The mean follow-up time was 6.2 months (3to 9 months). Osteoset pellets began to be absorbed after 1 to 3 months of operation, and were totally absorbed and replaced by osseous tissue after 4 to 6months. No local recurrence was detected in limb group and the function of limbs was normal. At 6 months after operation, all patients in spine group got bony fusion. Conclusion Medical grade calcium sulfate (Osteoset) isan ideal bone graft substitute with excellent bone repair effect.
ObjectiveTo evaluate the effect of poly-amino acid/nano-hydroxyapatite/calcium sulfate (PHC) Cage in lumbar interbody fusion of the goat. MethodsEighteen mature female goats (weighing 29-33 kg) were divided into 3 groups randomly: PHC Cage group (group A), titanium Cage group (group B), and ilium group (group C). A left extraperitoneal approach was used to establish the animal model of discectomy and interbody fusion with Cage or ilium. The general situation was observed for 24 weeks after operation. X-ray films were taken to measure disc space height (DSH) before operation and at 4, 12, and 24 weeks after operation. CT three dimensional reconstuction was performed at 24 weeks after operation to evaluate the interbody fusion according to modified Brantigan grading. The specimens of L3, 4 were harvested for mechanical test, histological, and scanning electron microscope (SEM) observation at 24 weeks after operation. ResultsAll goats survived to the end of experiment. DSH at 4 weeks after operation increased when compared with preoperative one in each group, and then decreased;DSH was significantly lower at 12 and 24 weeks after operation than preoperative one in group C (P<0.05). There was no significant difference in DSH among 3 groups at preoperation and 4 weeks after operation (P>0.05);at 12 and 24 weeks after operation, DSH of groups A and B was significantly higher than that of group C (P<0.05), but no significant difference was found between groups A and B (P>0.05). CT three dimensional reconstuction showed that bony fusion was obtained in all goats of groups A and C, and in 3 goats of group B;according to modified Brantigan grading, the scores of groups A and C were significantlly higher than that of group B (P<0.05), but no significant difference between groups A and C (P>0.05). The biomechanical test showed that there was no significant difference in range of motion between group A and group B (P>0.05), which were significantly lower than that of group C (P<0.05). Microscopy and SEM observations showed that the interface between the Cage and vertebral body in group A was compact without obvious gap, and most conjunctive region was filled with osseous tissue;the interface was filled with soft tissue, and the connection was slack with obvious gap in some region in group B;the interface connection was compact, most region was filled with osseous tissue in group C. ConclusionThe interbody fusion with PHC Cage is effective in goat lumbar interbody fusion model. The interface connection is compact between the Cage and the host bone followed by micro-degradation of PHC Cage, but the long-term degradation need further observation.
Objective To evaluate the tissue response induced by three kinds of bone transplantation materials implanted in rat so as to provide proper evidence for their cl inical appl ication. Methods Thirty-six healthy mature Sprague- Dawly mice, weighing from 229 g to 358 g, were randomly assigned to groups A and B (n=18). Three kinds of materials wereimplanted into muscles of rats. Calcium sulfate (CS) granular preparations and allogeneic demineral ized bone matrix (DBM) were transplanted into the left (group A1) and right (group A2) thigh muscle pouches of group A. Respectively, whereas xenogenic DBM were transplanted into the left (group B1) thigh muscle pouches of group B and the right (group B2) sites were taken as control without implant. The samples (n=6) were collected to make the observation of gross and histology and to analyze histological score after 2, 4, and 6 weeks. Results The gross observation: implanted materials were gradually absorbed at late stage in group A1. No obvious degradation and absorption, but fibrosis of tissues were observed in group A2 and B1. The inflammatory reactions were more severe in groups A2 and B1. In group B2, only the changes of scar were seen at operative site. The histological observation: no obvious inflammatory reactions were seen in group A1, CS were gradually absorbed and completely absorbed at 6 weeks, while fibrosis of tissues increased at late stage. Inflammatory reactions in group A2 and group B1 were alleviated gradually, no obvious absorption and degradation were observed. The different two DBM could induce granulation tissues and bone formation at different sites and secondary fibrosis with no obvious immune response was observed. In group B2, there was an increase in collagen fiber density and angiogenesis at late stage. The scores of inflammatory infiltration were significantly higher in groups A2, B1 than in groups A1, B2 (P lt; 0.05), and the scores of fibrosis was larger in groups A1, A2 and B1 than in group B2 (P lt; 0.05). Conclusion CS has rapid dissolution and good biocompatibil ity. It is a good replaceable packing materials of bone defects in some upper l imb’s or acute bone fracture. Both of two DBM have biocompatibil ity and osteoinductive potential, which dissolution are very slow. Due to these capacity, they can be served as an ideal materials in treatment of lower l imb’s bone defect and nonunion.