Objective To investigate surgical treatment strategies and analyze clinical outcomes of cardiac tumors. Methods Clinical data of 181 patients with cardiac tumors who underwent surgical treatment in Xinqiao Hospital of Third Military Medical University from January 1980 to December 2010 were analyzed retrospectively. There were 79 malepatients and 102 female patients with their age of 10 months-76 years （45.22±18.21 years） . A total of 179 patients underwent180 tumor resection surgeries under cardiopulmonary bypass （CPB）. Two patients with malignant tumors did notreceive surgical resection but exploratory thoracotomy. All the tumor specimens were examined by pathologists. ResultsThere were 169 patients （93.4%） with primary cardiac tumors, including 144 patients （79. 6%） with myxoma, 20 patients （11.0%） with other types of primary benign cardiac tumors, and 5 patients （2.8%） with primary malignant cardiac tumors. There were 12 patients （6.6%） with secondary cardiac tumors. There were 2 perioperative deaths （1.1%） in patients with primary cardiac tumors，including 1 patient with low cardiac output syndrome and another patient with postoperative multipleorgan dysfunction syndrome. All the 5 patients with primary malignant tumors died in postoperative 12 months. Patients with benign cardiac tumors were followed up for 6 months-15 years （2.41±1.08 years） without tumor recurrence. Among patients with secondary cardiac tumors，there was 1 perioperative death because of postoperative multiple organ dysfunction syndrome，2 patients died within postoperative 1 year, and 3 patients died in the 3rd postoperative year during follow-up. Conclusion Myxoma is the most common cardiac tumor. Complete surgical resection is the best treatment strategy forpatients with cardiac tumors. Clinical outcomes of patients with benign cardiac tumors are significantly better than those with malignant cardiac tumors. Prognosis of patients with primary malignant cardiac tumors is poor.
Objective To establish the three-dimensional (3D) finite element model of the knee joint including posterolateral complex (PLC), and to simulate the reconstruction biomechanical analysis in this model. Methods The knee of a 26-year-old healthy man was scanned by MRI to obtain the image data of the knee in the coronal, sagittal, and axial position. First, Mimics10.01 and Hyperworks 8.0 softwares were used to extract each slice profile data of the knee joint in a two-dimensional image data respectively and to establish 3D geometric model of bone, meniscus, articular cartilage, and ligament. Second, Unigraphics software NX 4.0 was used to establish a 3D finite element model of knee joint, which had the functions of Mesh, material properties, component connection, and contact definition. Third, displacement measurement on the model and reconstructing biomechanical analysis for PLC simulation were performed. Results The 3D finite element model of the knee joint including PLC was established successfully. Under 134 N forward force, the tibia forward displacement was 4.83 mm. PLC simulation reconstruction biomechanical analysis of the 3D finite element model of the knee joint showed that under 10 N·m varus and external rotation torque conditions, the knee varus and external rotation angles of simulation reconstruction were greater than those of the intact knee, and less than those of PLC missing. Conclusion The 3D finite element model of the knee joint including PLC can be established by the reverse engineering, and it is valid and can be used as the basis for the biomechanical properties to analog reconstruction of PLC.
Objective To prepare Pluronic F-127 composite gel loaded with transforming growth factor β3 (TGF-β3) and bone marrow mesenchymal stem cells (BMSCs) and observe its osteogenesis and angiogenesis effects in vivo and in vitro. Methods BMSCs were isolated from the tibial and femoral bone marrow of New Zealand white rabbits and passaged, and the 3rd generation cells were used for subsequent experiments after identification of osteogenic and adipogenic induction. Pluronic F-127 powder and TGF-β3 were dissolved in L-DMEM medium to prepare Pluronic F-127 gel, TGF-β3+Pluronic F-127 gel, BMSCs+Pluronic F-127 gel, and TGF-β3+BMSCs+Pluronic F-127 gel. The 3rd generation of BMSCs were cultured with L-DMEM medium (group A), osteogenic induction medium (group B), osteogenic induction medium containing Pluronic F-127 gel (group C), and osteogenic induction medium containing TGF-β3+Pluronic F-127 gel (group D), respectively. After 14 days of culturing, alkaline phosphatase (ALP) staining and Alizarin red staining were used to observe the osteogenesis. In addition, the BMSCs were cultured with L-DMEM medium containing Pluronic F-127 gel (experimental group) and L-DMEM medium (control group) for 1, 2, 3, and 4 days, respectively. And the cell proliferation was detected by MTT assay. Ten New Zealand white rabbits were taken to prepare the maxillary sinus lift models, and Pluronic F-127 gel (group A), TGF-β3+Pluronic F-127 gel (group B), BMSCs+Pluronic F-127 gel (group C), and TGF-β3+BMSCs+Pluronic F-127 gel (group D) were injected into the bone defects, respectively. On the 8th week, imaging examination and HE staining were used to observe the formation of new bone, immunohistochemical staining was used to observe the expression of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2) in bone tissue, and Western blot was used to detect the relative expressions of VEGF, oncostatin M (OSM), and BMP-4 proteins in bone tissue. Results Osteogenic and adipogenic induction identified the isolated and cultured cells as BMSCs. In vitro staining showed that ALP activity and Alizarin red concentration in group D were significantly higher than those in other groups (P<0.05). MTT assay showed that the absorbency (A) value of the two groups increased gradually, and there was no significant difference between the groups at each time point (P>0.05). In vivo experimental imaging examination showed that the bone mineral density and osteogenic continuity of group D were the best, and the proportion of new bone volume was superior to other groups (P<0.05). HE staining showed that compared with other groups, bone trabeculae in group D were dense and arranged regularly, on which a large number of osteoblasts and osteoclasts were distributed, and a large number of new bone formation could be seen. Immunohistochemical staining showed the strong positive expressions of BMP-2 and VEGF in group D (P<0.05); Western blot detection showed that the relative expressions of VEGF, OSM, and BMP-4 proteins in group D were significantly higher than those in other groups (P<0.05). Conclusion The BMSCs in Pluronic F-127 composite gel loaded with TGF-β3 and BMSCs can be induced to differentiate into osteoblasts, and the composite gel has no toxic effect on cells, and has obvious osteogenesis and angiogenesis in the maxillary sinus of rabbits.