Ligaments are dense fibrous connective tissue that maintains joint stability through bone-to-bone connections. Ligament tears that due to sports injury or tissue aging usually require surgical intervention, and transplanting autologous, allogeneic, or artificial ligaments for reconstruction is the gold standard for treating such diseases in spite of many drawbacks. With the development of materialogy and manufacturing technology, engineered ligament tissue based on bioscaffold is expected to become a new substitute, which can lead to tissue regeneration by simulating the structure, composition, and biomechanical properties of natural tissue. This paper reviewed some recently published in vitro and animal researches focusing on ligament tissue engineering, then evaluated the properties and the effects on tissue repair and reconstruction of fiber structure scaffolds, multi-phase interface scaffolds and bio-derived scaffolds designed by bionic principle and made of different materials, manufacturing techniques and biological factors. Finally, summarization followed by the prospection for future development direction of biological scaffolds in ligament tissue engineering research is given.
ObjectiveTo investigate the correlation between the anterior talofibular ligament (ATFL) injury and the pathological changes of the anterior tibiotalar fat pad (ATFP) based on MRI. Methods The clinical and imaging data of 217 patients with ankle sprain who met the selection criteria between January 2019 and March 2024 were retrospectively analyzed. There were 113 males and 104 females with an average age of 38.2 years ranging from 18 to 60 years. Patients were divided into mild group (n=106), moderate group (n=63), and severe group (n=48) according to the degree of ATFL injury. There was no significant difference in gender, side, and body mass index among the 3 groups (P>0.05). The age of the mild group was significantly older than that of the moderate and severe groups (P<0.05). The imaging parameters including the longest and shortest sagittal axis, the largest thickness, the longest and shortest transverse axis, the ATFP area, the area of ATFP high-signal region, and the anterior distal tibial angle (ADTA) were measured according to the MRI and X-ray films of patients. According to the morphology of ATFP, the patients were divided into type Ⅰ (n=128), type Ⅱ (n=73), and type Ⅲ (n=16) based on the severity of the lesions. The distribution of ATFP types, ATFP area, area of ATFP high-signal region, and the ratio of area of ATFP high-signal region to ATFP area at the same level were statistically analyzed and compared among different ATFL injury groups. Additionally, radiographic parameters were compared across different ATFP types. Spearman rank correlation analysis was used to assess the relationships between ATFP area, area of ATFP high-signal region, and the ratio of area of ATFP high-signal region to ATFP area at the same level with patient baseline data. Through analysis of the area under curve (AUC) of ROC, optimal variables were selected for quantification to predict ATFL injury. Results There were significant differences in ATFP types among different ATFL injury groups (P<0.05). The mild group had a higher proportion of type Ⅰ, the moderate group had a higher proportion of type Ⅱ, and the severe group had higher proportions of both typeⅡ and type Ⅲ. No significant difference was found in ATFP area among the different ATFL injury groups (P>0.05). However, the area of ATFP high-signal region and the ratio of area of ATFP high-signal region to ATFP area at the same level were significantly lower in the mild group compared to the moderate and severe groups (P<0.05). Except for the longest sagittal axis, maximum thickness, and longest transverse axis, which were significantly smaller in ATFP types Ⅱ and Ⅲ compared to type Ⅰ (P<0.05), there was no significant difference in the remaining radiographic parameters among the different ATFP types (P>0.05). Spearman rank correlation analysis revealed that ATFP area was negatively correlated with patient gender (P<0.05), while area of ATFP high-signal region and the ratio of area of ATFP high-signal region to ATFP area at the same level were negatively correlated with patient age (P<0.05). Through analysis of the AUC for the response variable ATFP injury, the combined diagnostic AUC of ROC for the reciprocal of the maximum thickness and the reciprocal of the area of ATFP high-signal region was 0.839 (asymptotic P<0.001). The corresponding cutoff value when the Youden index reached its maximum was 0.570 3. ConclusionAs the severity of ATFL injury increases, the ATFP undergoes gradual morphological and functional changes. Classification based on ATFP types can assist in assessing the level of ATFL injury, thereby aiding in the prevention of post-traumatic osteoarthritis.
Due to optimizing medical service resources and improving service efficiency, day surgery has attracted the attention of medical and management experts worldwide. In 2019, day surgery was included as one of the performance assessment indicators of tertiary public hospitals. In recent years, hospital-based day surgery centers have begun to plan and build. Although the basic facilities have been perfectly improved, but how to efficiently and safely operate and manage the centralized day surgery has become the primary problem to clinicians and managers. The purpose of this paper is to introduce how the Day Surgery Center of West China Hospital of Sichuan University uses scientific management tools and establishes a professional multidisciplinary team, so as to carry out efficient operation management and control of medical quality and safety risks of the Day Surgery Center. And then provide practical experience guidance and suggestions with strong feasibility and operability for peers.
Objective To improve hand hygiene executive ability of healthcare workers in medical institutions in Anhui Province by multi-modal interventions with the administrative intervention as the guide. Methods The PDCA management mode was adopted in a step-by-step implementation of plan, implementation, inspection, improvement, and effectiveness evaluation in Anhui Province from April 2014 to December 2016. The management indicators of hand hygiene before and after the intervention in 1 353 hospitals were investigated and evaluated. Results The overall evaluation of the hand hygiene at the end of the implemention showed that 85.29% (58/68) of the tertiary hospitals, 84.07% (227/270) of the second-class hospitals and 66.63% (595/893) of the primary-level hospitals had well-equipped hand hygiene facilities. About 92.65% (63/68) of the tertiary hospitals, 100.00% (270/270) of the second-class hospitals and 50.06% (447/893) of the primary-level hospitals had staff training of hand hygiene knowledge. The compliance of hand hygiene before and after intervention increased from 36.68% to 61.93%, the correct rate of hand washing increased from 37.60% to 89.28%, the awareness rate of related knowledge increased from 41.20% to 86.07%, and the dosage of hand disinfectant increased from 2.59 mL to 7.10 mL. Conclusion To take multi-model interventions with the administrative intervention as the guide, can effectively improve the quality of hand hygiene management and the executive force.
Objective To observe the vascular endthelial cellular apoptosis induced by transpupillary thermotherapy (TTT). Methods Vascular endothelial cells (VEC) cultured in vitro were treated with TTT, hyperthermia and TTT combined with indocyanine green (ICG) pretreatment. The cellular apoptosis was detected by doublelabelled flow cytometer (annexin Vfluroescein isothiocyanate and propidium iodide) analysis, fluorescent microscopy, nucleolus stainned with DNA dye hoechst 33258, DNA ladder detection and electron microscopy. Results Without significant rising of the temperature, TTT couldnprime;t increase the apoptosis of VEC. Pure hyperthermia and TTT combined with ICG pretreatment could increase apoptosis of VEC significantly, and the effect of the latter method was more obvious. The higher power of TTT was used and the longer duration the cells were cultured, the higher apoptosis rate of VEC was. Conclusion The induction of apoptosis of VEC might play an important role in the mechanism of the occlusion of CNV by TTT, and combining with ICG may obviously enhance the apoptosis rate at the same temperature, which may supply a theoretical basis for promoting the clinical effect of TTT.
Objective To review the current development in meniscus tissue engineering. Methods Recent literature concerning the development of the meniscus tissue engineering was extensively reviewed and summarized. Results Recent researches mainly focus on: selection of seed cells and research of their potential of differentiation into chondrocytes; selection of scaffold materials and research of their mechanical properties; cytokines and their mechanisms of action. Conclusion Many achievements have been made in meniscus tissue engineering. Most important topics in future research include: finding seed cells that are adapted to physiological process, are easy to culture, and have higher chondrogenic differentiation ability; looking for necessary cytokines and their mechanisms of action; finding scaffold meterials with b morphological plasticity, no antigenicity, good degradability, and mechanical property close to normal meniscus.
With the wide utilization of high-resolution computed tomography (HRCT) in the lung cancer screening, patients detected with pulmonary ground-glass nodules (GGNs) have increased over time and account for a large proportion of all thoracic diseases. Because of its less invasiveness and fast recovery, video-assisted thoracoscopic surgery (VATS) is currently the first choice of surgical approach to lung nodule resection. However, GGNs are usually difficult to recognize during VATS, and failure of nodule localization would result in conversion to thoracotomy or extended lung resection. In order to cope with this problem, a series of approaches for pulmonary nodule localization have developed in the last few years. This article aims to summarize the reported methods of lung nodule localization and analyze its corresponding pros and cons, in order to help thoracic surgeons to choose appropriate localization method in different clinical conditions.
Objetive To investigate the effect of elastic pivot stable biteplate on treating irredueible temporal bone displacement of the temporomandibular joint. Methods Twenty-eight cases of irredueible temporal bone displacement of the temporomandibular joint treated with the elasticpivot stable biteplate from 2000 to 2004 were summarized. The ages of the patients ranged from 15 to 58 yeras includding 11 men and 17 women.Results All the patients were treated for 1 month and followed up for 3 to 6 months. The effective rate was 87.51%. The patients who had shorter course of diseases obtained better effect than the patients who had longer courses of diseases. Conclusion Elastic pivot stable biteplate is an effective alternative for treating irredueible temporal bone displacement of the temporomandibular joint and it exerts better effect on the patients that have short courses of diseases.
Aortic dissection is one of the most devastating cardiovascular diseases. One of the most important pathological features of aortic dissection is local inflammatory response, including the infiltration of inflammatory cells, extracellular matrix degradation, and smooth muscle cell phenotype switch. Macrophages which are the core of the inflammatory response play an extremely pivotal role in the progression of inflammation and tissue remodeling. Macrophages can be artificially divided into M1 and M2 types, of which the M1-type promotes inflammation while the M2-type is associated with the regression of inflammation and tissue healing. Mastering the switch of phenotypic transformation of macrophages may be of great help in inhibiting the inflammation of aortic tissue and facilitating tissue healing, as well as the treatment of aortic dissection. In this paper, we focus on the polarization of macrophages and discuss the role of macrophages in aortic dissection, the polarization pathway and the effect of related polarizing agents on the treatment of aortic dissection.
Objective To identify genes associated with hepatocellular carcinoma (HCC) as candidate diagnostic markers in a genome-wide scale. Methods The gene expression profiles of 40 pairs of HCC tumor tissue and peripheral non-tumorous liver tissue were analyzed by using gene chip technology.The gene chips were fabricated at the National Cancer Institute (NCI). Each gene chip contained 9 180 genes. The fluorescent targets were prepared by a direct labeling approach using two kinds of fluorescences as following: 100 μg of total RNA from non-cancerous liver tissue was labeled with Cy3-dUTP and 200 μg of total RNA from HCC was labeled with Cy5-dUTP. The targets were mixed together and hybridized with genes on the gene chips. Unsupervised hierarchical clustering analysis was done by CLUSTER and TREEVIEW software using median centered correlation and complete linkage. Results A total of 10 genes were found up-regulated in over 80% of primary tumors comparing with that of their corresponding non-tumorous liver tissues at a two-fold filter with an unsupervised hierarchical clustering algorithm, including protocadherin-alpha 9, ESTs, Homo sapiens cDNA FLJ, KPNA2, RPS20, SNRPE, CDKN2A, UBD, MDK and ANXA2.Conclusion These genes are supposed to be candidates for the diagnosis of HCC. Further investigation of these genes in a large scale of patients with HCC and patients with non-malignant hepatic diseases will be needed to disclose whether they could be used clinically as novel diagnostic tumor markers for HCC.