Objective To investigate the currently-used biomaterials in reparative and reconstructive surgery and to clarify the relationship between the development of biomaterials and the progress of reparative and reconstructive surgery. Methods Based on the author’s many years’ scientific researches and combined with the literature available at home and abroad, the biomaterials used in the clinical practice, and their kinds and application fields were summarized. Results Based on the sufficient knowledge of the component structure of biomaterials and the patient’s pathological status, the matching biomaterials could be designed and developed. According to the analysis on some common defects occurring in the skin, bone, cartilage, vocalcord, nerve, and drum membrane, the methods of repairing the defects with biomaterials that we had developed, such as collagen, chitosan, and hyaluronate, achieved good results. Conclusion The rapid development of biomaterials can greatly promote progress of reparative and reconstructive surgery andthere exists a dependence relationship between the two. The related histological responses and the importance of biological estimation after implantation of biomaterials should be emphasized.
Objective To review and evaluate the extensive and further research and the application of the collagenbased biomaterials in the field of clinical medicine. Methods The clinical research and application of collagen-based biomaterials were comprehensively reviewed and evaluated on the basis of the up-to-date publications and our practical experiences in their studies and manufacturing. Results The following five aspects concerned with the collagen-based biomaterials were evaluated: biological property, quality control, formulation of substrate and clinical application, immunogenicity and clinical side effect, and potential of the market development. Conclusion Collgen-based biomaterials have a great potential and market space in their clinical application.
【Abstract】 Objective To broaden the cl inical uses of fibrin-based biomaterials and to develop further study incell biology and to comprehensively understand and master related knowledge with regard to the present development status of fibrin. Methods Many relevant domestic and international papers were reviewed to make a summary. Results Recognization was obtained from four aspects, which were structure and function of fibrinogen, cl inical use of fibrin, fibrin scaffold for tissue engineering, and compounding biomaterials of fibrin. It showed that every aspect had great research extension and practical appl ication. Conclusion Besides a surgical hemostat and sealant, fibrin has great potentials in playing roles of tissue engineering scaffold, drug del ivery vehicle, and compounding material.
Objective To carry out a comprehensive and objective evaluation of viscosupplementation, so as to provide the actual judgments of effectiveness, development trends, and direction. Methods The related l iterature was reviewed, and the keys were the assessments from the international relevant advisory bodies and insurance companies and the evidence-based medicine on cl inic. Results Viscosupplementation has been gradually accepted. Although there are many different cl inical views of the viscosupplementation in the molecular weight of hyaluronan, injection dose, and the indications, intra-articular injection of hyaluronan for the treatment of osteoarthritis is well accepted. ConclusionViscosupplementation is one of the methods of treating osteoarthritis. As it has been already verified that hyaluronan iseffective in treating osteoarthritis of the knee and the periarthritis of shoulder, the hip joint injection is gradually recognized,and other small joints are going gradually.
To evaluate the effect of deacetylation degree (DDA) on the gelation behavior of thermosensitive chitosan-β glycerol phosphate disodium salt pentahydrate (CH-GP) system and to compare their rheological behaviors before and after gelation. Methods A series of thermosensitive CH-GP samples with different DDAs (70%, 85%, 90%, 97%)were prepared by dissolving CH with 0.1 mol/L HCl solution, 5 samples for every single DDA, and then all these CH-GP solution samples processed the frequency sweep test and temperature sweep test (10-70℃ , 1℃ /min) on AR 2000ex rheometer, with pH value of 7.02. Also, all the results of hydrogel samples were processed a frequency sweep test. Results With CH concentration of 2% (w/v) and pH value of 7.02 , the gelating temperature of CH-GP systems with different DDAs (85%, 90%, 97%) were (59.90 ± 0.08), (48.10 ± 0.08), (37.10 ± 0.11) ℃ , respectively. While the gelating temperature of CH-GP system with 70% DDA was over 70℃ . There were statistically significant differences in temperature and time of gelation among groups with different DDAs (P lt; 0.05). Furthermore, storage modulus of such system raised from dozens Pa to a magnitude of several kPa during gelation , while loss modulus kept almost steady. Conclusion Gelating temperature and mechanical property of the system could be measured objectively by rheological characterization. Thus during designing tissue engineered scaffolds for various purposes, it is helpful applying selected CH with optimal DDA to different target tissues.
Objective To prepare carboxymethylchitin and study its properties. Methods Chitin was prepared from fresh shrimp shells and then carboxymethylchitin was prepared by the methods of alkalization and etherification as well as by the purification technique. The deacetylation degree of carboxymethylchitin was determined by the doublejump potentiometric titration method; the substitution degree was determined by the element analysis method; the carboxymethyl substitution position was analyzed by the Fourier transform infrared spectroscopy apparatus and the nuclear magnetic resonance spectroscopy apparatus; the relative molecular weight and its polydispersity were determined by the gel permeation chromatography with the multiple angle laser light scattering detection; the biological properties were tested according to the GB/T 16886 biological evaluation on medical devices. Results Carboxymethylchitin could be prepared by alkalization and etherification from chitin which was prepared from fresh shrimp shells by decalcification and deproteinization. The deacetylation degree of carboxymethylchitin was 13.76% according to the doublejump potentiometric titration; the degrees of deacetylation and substitution were 14.53% and 1.239 0 respectively according to the element analysis. The IR spectrum showed that the substitutive position was N,O-substitution, and the 13C-NMR spectrum showed that substitutive position of carboxymethylchitin was mostly primary substitution of 6-OH, and according to the substitutive proportion, the substitutive turns were in the following decreasing order: 6-OH, NH2, and 3-OH. The weightaveraged and the numberaveraged molecular weights and polydispersity were 6.25×105, 5.60×105 and 1.22, respectively. The results from the biological property test showed that carboxymethylchitin was a biomaterial that was sterile, pyrogen-free, acute toxicity-free, cytotoxicity-free, intracutaneous irritationfree, skin sensitization-free and biomaterial genotoxicity-free, with no side or adverse effects on the related tissues after implantation into the human body. Conclusion Carboxymethylchitin prepared from chitin by alkalization and etherification is amacromolecule biomaterial that has a low degree of deacetylation, a high degreeof substitution, and a good biocompatibility.
OBJECTIVE: To validate the hemostatic properties of collagen sponge made in China. METHODS: The experimental model of superficial cut of liver was established in 20 Sprague-Dawley adult rats, which were divided into two groups randomly. Collagen sponge or gelatin sponge was used to cover the cut respectively. Hemostatic result was observed. Afterwards, standard liver trauma model by resection left front liver lobe was made, wound was treated with collagen sponge or gelatin sponge respectively. Hemostatic result was observed. Concurrent hemostatic time and bleeding amount were noted. At 7, 14 and 20 days after operation, intra-abdominal adhension, infection and healing state of liver were observed by exploratory laparotomy. The histological changes of regenerate liver tissue were observed by microscopy. RESULTS: Collagen sponge adhered to wound well. Concurrent hemostatic time and bleeding amount in collagen sponge group were superior to those of gelatin sponge (P lt; 0.05). The histological examination showed that collagen sponge was absorbed and degraded rapidly, regenerative hepatocytes could be induced. CONCLUSION: Collagen sponge has fine hemostatic properties and can induce regeneration of hepatocytes effectively. It is worth popularizing for its convenience in clinical application and its properties of rapid degradation and absorption.
Objective To verify the technics of inactivating/removing pathogens in medical chitosan derived from shrimp shell. Methods Possible pathogen species were included according to the raw material of shrimp shell used in production, then bacillus cereus, porcine parvovirus (PPV) and pseudorabies virus (PRV) were selected as indicator pathogens.Pathogen solution was prepared in accordance with Technical Standard for Disinfection. The processing procedure of medical chitosan was analyzed to determine whether the alkal ization of chitin and the filter steril ization of chitosan were capable of inactivating/removing pathogens and their efficiencies were tested. Results Bacillus cereus was removed by 8 184 cfu/ mL after alkal ization and 30 818 cfu/mL after filter steril ization. The average logarithm inactivation value (LIV) of PPV and PRV after alkal ization were equal to or above 4.76 logTCID50/0.1 mL and 6.67 logTCID50/0.1 mL, respectively, and their average LIV after filter steril ization were 2.25 logTCID50/0.1 mL and 3.04 logTCID50/0.1 mL. The alkal ization of chitin inactivated/removed indicator pathogens effectively, while the filter steril ization of chitosan removed bacterial effectually but could not inactivate viruses completely. Conclusion The alkal ization of chitin can be used as the technics of inactivating/removing pathogens during the preparation process of medical chitosan to guarantee the safety of the product.
ObjectiveTo summarize the current research status of alginate derivatives based on biomedical materials, and analyze several key points as novel clinical products. MethodsThe general preparation and application methods of alginate derivatives based on biomedical materials at home and abroad were reviewed. The present status and problems were analyzed. ResultsThe derivation methods to prepare alginate derivatives include crosslink, sulfation, biological factors derivatization, hydrophobic modification, and graft copolymerization. With excellent bionic performance of structure and properties, many alginate derivatives are available for tissue engineering scaffolds, artificial organs, and drug delivery systems etc. However, more systematic applied basic research data should be collected and statistically analyzed for risk managements. ConclusionAlginate derivatives have good feasibility as novel medical products, meanwhile, systematic evaluation and verification should be executed for their safety, effectiveness, and suitability.
To develop a novel biodegradable collagen-chitosan-[poly(vinyl alcohol), PVA] composite artificial lacrimal canal iculus for treating tear overflowing (epiphora) caused by canal icular obstruction. Methods Homogeneously mixing solution composed of collagen, chitosan and PVA with different ratios was prepared. After several cycles of freezing/thawing process, the mixing solution was transferred into elastic hydrogel. Then the hydrogel was rinsed, punctured, dehydrated and trimmed, and three groups (T1, T2 and T3) of novel artificial lacrimal canal iculus were obtained. The appearance and diameter of all samples were observed under optical microscopy. The cross-section before and after drying as well as phase distribution of sample T2 was observed by SEM. The water absorption ratio and expanding ratio in PBS solution were calculated from three swell ing behavior curves. The degradabil ity of groups T1, T2 and T3 were prel iminary analyzed by degradation experiment in vitro. Results The micro-tubes with 0.5-0.7 mm in inner diameter, 0.9-1.5 mm in outer diameter and more than 20 mm in length were fabricated successfully through physical crossl inking without addition of toxic cross-l inker. SEM result showed that the sample had uniform phase distribution and smooth surface at dried state as well as interpenetrate network structure at hydrogel state. It was seen from the swell ing behavior curves that groups T1, T2 and T3 swelled rapidly within 10-30 minutes, and formed elastic composite hydrogel pipes. In addition, the expanding ratio of inner and outer diameter of the tube was 20%-30% and 100%-120% with swell ing, respectively. The equil ibrium water content of the hydrogel pipes increased with increase of collagen composition. Three groups of samples were immerged in PBS solution contained 2 mg/mL lysozyme at 37 for 1 month, their nozzle cracked, their wall became thin and more transparent. And also, there was small floc deposited on the tube surface. The samples were degraded into mash after they were soaked in PBS solution at 70 for 2 days. Conclusion The novel artificial lacrimal canal iculus with good mechanical property and high water absorption is in favor of operation, tear passing and anti-conglutination. It will be a potential candidate for treating the lacrimal passage occlusion.