Osteochondral defects is a common clinical joint disease. The complexity of cartilage-bone interface and the poor self-repair capacity of cartilage are both reasons for current relatively limited clinical treatments. The introduction of tissue engineering provides a new treatment method for osteochondral repair. This paper reviews three main elements of cartilage-bone tissue engineering: seed cell source and culture method, cytokines regulation and synergistic effect, and scaffold components and type. We mainly focused on current status quo and future progress of cartilage-bone repair scaffolds. This paper provides some reference for the further development of osteochondral tissue engineering.
Objective To estimate the incidence of suicidal ideation of Chinese medical students in mainland China over the past ten years by meta-analysis, so as to provide references for suicide prevention and mental health education in Chinese medical students. Methods PubMed, CNKI, WanFang Data and CBM databases were searched for studies investigating the prevalence of suicidal ideation among Chinese medical students in mainland China from January 1st, 2007 to 31st May, 2017. After study selection according to inclusion and exclusion criterion, data extraction and quality assessment, meta-analysis was conducted using Stata 12.0 software. Heterogeneity was evaluated by performing subgroup analyses and meta-regression. We also used sensitivity analysis to determine the influence of individual studies on the overall prevalence estimates. Results A total of 30 studies with 58 757 participants were included, the individual-study incidence of suicidal ideation ranged from 0.84% to 41.35%, with significant between-study heterogeneity detected (I2=99.1%, P<0.001), and the pooled incidence by random-effects model was 12.51% with 95%CI 9.72% to 15.60%. Univariate and multivariate meta-regression revealed that instruments were related to heterogeneity (P<0.01), but other study-level covariates did not contribute to heterogeneity (P>0.1). Conclusion The incidence of suicidal ideation among medical students in mainland China is relatively high, calling more attention to this concern and actions in response for suicide prevention and mental health education in Chinese medical students.
With the development of evidence-based medicine, an increasing amount of clinical care experts are paying attention to recommendations in the guidelines and the application of guidelines in clinical nursing practice. The demand for clinical practice guidelines is becoming increasingly important. Based on characteristics of nursing, this paper focuses on primary steps in the formulation of nursing-clinical practice guideline, such as clinical problems, outcomes, nursing evidence retrieval and selection, evidence and recommendations classification, methods from evidence to recommendations, patients' preference and value, and provides suggestions for development of nursing-clinical practice guidelines.
Sodium alginate (SA) is a kind of natural polymer material extracted from kelp, which has excellent biocompatibility, non-toxicity, biodegradability and abundant storage capacity. The formation condition of sodium alginate gel is mild, effectively avoiding the inactivation of active substances. After a variety of preparation methods, sodium alginate microspheres are widely used in the fields of biomaterials and tissue engineering. This paper reviewed the common methods of preparing alginate microspheres, including extrusion, emulsification, electrostatic spraying, spray drying and coaxial airflow, and discussed their applications in biomedical fields such as bone repair, hemostasis and drug delivery.
In recent years, bone implant materials such as titanium and titanium alloys have been widely used in the biomedical field due to their excellent mechanical properties and good biocompatibility. However, in clinical practice, bacterial adhesion to the material surface and postoperative infection issues may lead to implantation failure. Based on the antibacterial mechanism, this review elaborated on the antibacterial surface design of titanium implants from the aspects of anti-bacterial adhesion, contact sterilization and photocontrol sterilization. Surface modification of titanium or titanium-based alloy implants with different techniques can inhibit bacteria and promote osseointegration. Thus, the application range of multifunctional titanium-based implants in the field of orthopedics will be expanded.
Objective The ultimate goal of developing guidelines is for using them in clinical practice. In this study, an implementation evaluation tool was developed to promote the overall evaluation of guidelines and to improve their promotion and implementation. Methods The research group set up a team to formulate and establish a guideline implementation evaluation tool, through preliminary research, interviews, a systematic review of relevant literature, two expert consensus meetings and two Delphi expert consensus meetings to evaluate the guideline implementation tool. Experts were invited to give opinions and grades on the fields, items and overall implementation evaluation method of the tool. Results The evaluation tool for the implementation of guidelines included 5 fields, accessibility, communicability, performability, recognizability and applicability, with a total of 7 items. The scale-level CVIs in two rounds of Delphi expert consensus were 0.91 and 0.93. We collected opinions and suggestions and made some revisions and insertions without deleting any items based on the parameter that no items fulfilled the standard if mean <3.5, coefficient of variation >15% and I-CVI<0.78. Conclusion In this study, in order to provide a standard and method for the evaluation of guideline implementation, a guideline implementation evaluation tool has been developed and evaluated by clinically-related physicians and guideline formulation methodology experts. The guideline implementation evaluation tool presents satisfactory face and content validity. Empirical research is needed to verify the tool’s performance in evaluating guideline implementation.
ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.