Objective To review the fundamental research and the experimental study in the nerve tissue engineering of self-assembl ing peptide nanofiber scaffold (SAPNS). Methods The l iterature concerning basic and experimental studies on SAPNS in the nerve tissue engineering was extensively reviewed. Results SAPNS can promote the neural stem cell adhesion,prol iferation, differentiation and neuron axon outward growth and extension, promote extracellular matrix synthesis and inhibit gl ial cell adhesion and differentiation, and simulate the environment of a cell in the body. Conclusion SAPNS is an ideal matrix material and provides a new way for the repair of nerve tissue injury.
Objective To investigate the effect of notochordal cells (NCs) conditioned medium (NCCM) on theprol iferation and differentiation of bone marrow mesenchymal stem cells (BMSCs). Methods NCs and BMSCs wereisolated from the thoracolumbar intervertebral disc and the femurs of 4-week-old Japanese white rabbits, respectively. NCswere cultured with DMEM/F12 medium containing 15% FBS for 5 days to prepare NCCM. The experiment consisted of2 groups: BMSCs were cultured with NCCM in experimental group and with DMEM/F12 medium containing 15% FBSin control group. The prol iferation of BMSCs was assessed by cell counting kit-8 at 1, 3, 5, 7, 9, and 14 days after culture;the expression of proteoglycan and collagen type II were determined by immunofluorescence and real-time fluorescentquantitative PCR at 7 and 14 days after culture. Results NCs and BMSCs were successfully isloated. At 5, 7, 9, and 14days, the number of BMSCs in the experimental group was significantly more than those in the control group (P lt; 0.05).At 7 and 14 days, there was no expression or less expression of proteoglycan and collagen type II in the control group;however, there was a lot of expression of proteoglycan and collagen type II in the experimental group, and the expressionswere higher at 14 days than at 7 days. At 7 and 14 days after culture, the mRNA expressions of proteoglycan and collagentype II were significantly higher in the experimental group than in the control group (P lt; 0.05), and at 14 days than at 7days in the experimental group (P lt; 0.05). Conclusion NCCM can promote the prol iferation and the differentiation ofBMSCs into chondroyte-like cells, which provides the basis for NCs and BMSCs as seed cells in the treatment of degenerativedisc disease.
Objective To evalute the cl inical outcomes of two different surgical treatments for arachnoid cysts in sacral canal. Methods From January 2004 to March 2009, 55 cases of arachnoid cysts in the sacral canal were treated by traditonal simple sacral laminectomies with resection of the cysts (group A, 25 cases) and novel CT-guided percutaneous fibrin glue therapy of arachnoid cysts (group B, 30 cases). Of them, there were 23 males and 32 females, aging 15-66 years with an average of 42.6 years; the duration of symptoms was 6 months to 15 years with an average of 3.5 years. L5-S1 was involved in 22 cases, S1,2 in 25 cases, S2,3 in 12 cases, S2 in 8 cases, and presacral in 2 cases. The size of cysts was 1.5 cm × 1.0 cm to 6.0 cm × 2.8 cm. The MRI examination showed that all patients had cysts in the sacral canal. There were no significant difference (P gt; 0.05) in sex, ages, disease duration and cysts size between two groups. Preoperative data and postoperative lumbosacral pain and function improvement were analyzed and compared between two groups. Results All operations were performed successfully. The operative time, blood loss and hospital ization days of group B were significantly less than those of group A (P lt; 0.01). All 55 cases were followed up from 9 to 61 months (mean 23 months). In group A, postoperative cerebrospinal fluid leakage (25 cases), intracranial infection (2 cases), nerve injury (3 cases), and nerve root irritation (8 cases) occurred; in group B, mild meningitis (3 cases) and low grade fever (5 cases) occurred. Except for nerve injury, other compl ications were cured after symptomatic management. During the follow-up, 2 recurrent cases were found in group A and 1 case in group B. Of them, 2 recurrent cases were treated with CT-guided percutaneous fibrin glue therapy of arachnoid cysts, and cysts disappeared. For two groups, there were significant differences in Oswestry functional disabil ity index and visual analogue scale score between preoperation and postoperation (P lt; 0.01), and in the rate of score improvement between two groups (P lt; 0.01). According to the rating scale, the excellent and good rates of pain improvement were 64% in group A and 100% in group B; the excellent and good rates of function improvement were 24% in group A and 97% in group B. Conclusion CT-guided percutaneous fibrin glue therapy for arachnoid cysts in the sacral canal is a mini-invasive, safe, effective, and economical method, it may be better choices for the treatment of arachnoid cysts in the sacral canal.
ObjectiveTo investigate the mid-term effectiveness of three‐dimensional (3D) printed osteotomy guide plate and personalized prosthesis in knee‐preserving tumor resection. Methods The clinical data of 12 patients who underwent knee‐preserving tumor resection and reconstruction with 3D printed osteotomy guide plate and personalized prosthesis between September 2016 and October 2018 were retrospectively analyzed. There were 7 males and 5 females. The age ranged from 7 to 59 years, with a median of 44.5 years. There were 11 cases of osteosarcoma and 1 case of fibrosarcoma, all of which were Enneking grade ⅡB. The distance from the tumor to the joint surface was 5.5-8.2 cm, with an average of 6.94 cm. Incision healing, tumor recurrence, periprosthetic fracture, and aseptic loosening were observed after operation. The Musculoskeletal Tumor Society (MSTS) scoring system was used to evaluate the function of the patients, and the knee flexion range of motion was measured. ResultsThe 12 patients were followed up 41-66 months, with an average of 54.5 months. The length of osteotomy ranged from 14 to 26 cm, with an average of 22.08 cm. Except for 2 patients with superficial infection of incision tissue, no deep infection involving the prosthesis occurred, no patient underwent revision surgery because of prosthesis infection. During the follow-up, local recurrence occurred in 2 cases and distant metastasis occurred in 3 cases. The overall disease-free survival rate was 58.3%. Two patients died of lung metastasis, and the overall survival rate was 83.3%. One patient underwent amputation due to local recurrence, and 1 patient underwent total knee arthroplasty due to prosthesis rupture. No aseptic loosening of the prosthesis and periprosthetic fracture occurred during the follow-up, and the overall prosthesis survival rate was 83.3%. At last follow-up, 10 patients obtained satisfactory knee flexion range of motion that ranged from 95° to 125°, with an average of 110°. Two children could not cooperate with early rehabilitation treatment due to pain, and the knee flexion range of motion was not ideal (50°, 75°). All patients achieved acceptable lower limb function with MSTS scores ranged from 26 to 30, with an average of 28. All patients walked without crutches. ConclusionThe treatment of malignant bone tumors around the knee joint with 3D printed osteotomy guide plate and personalized prosthesis can preserve the articular surface, obtain good limb function, reduce the risk of aseptic loosening of prosthesis, and achieve better mid-term effectiveness.