Objective To review the appl ication of collagen and biodegradable polymer composite scaffolds in vascular tissue engineering, and describe the multi-layering vascular scaffolds of collagen-based material in recent years. Methods The l iterature concerning collagen composite scaffold production for scaffold of vascular tissue engineering was extensively reviewed and summarized. Results As one of the structural proteins in natural blood vessel, collagen is widely used in vascular tissue engineering because of good biocompatibil ity, biodegradabil ity, and cell recognition signal. The vascular scaffolds with biological activity and good mechanical properties can be made by collagen-polymer composite materials. In addition, the structure and function of the natural blood vessel can be better simulated by multi-layering vascularscaffolds. Conclusion Collagen-polymer composite material is the hot spot in the research of vascular scaffolds, and multilayering vascular scaffolds have a brill iant future.
Objective To explore the relationship between periodontitis and postmenopausal osteoporosis.Methods Databases were electronically searched from PubMed (1966 to December, 2010), EMbase (1974 to December, 2010), CBM (1978 to December, 2010), VIP (1989 to December, 2010), CNKI (1979 to December, 2010) and WanFang Data (January, 2007 to December, 2010), and the references listed in all papers were also retrieved. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently; the methodology quality was evaluated after data abstraction; and then the RevMan 5.0 software was used for meta-analyses. Results Four trials were included. Among the total 678 patients involved, 263 were postmenopausal osteoporosis patients, while the other 415 were non-osteoporosis patients. The results of meta-analyses showed that: a) Clinical attachment loss (CAL) of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.60, 95%CI 0.23 to 0.96); b) The level of gingival recession of the postmenopausal osteoporosis patients was significantly higher than that of the non-osteoporosis patients (WMD=0.78, 95%CI 0.41 to 1.14); c) There were no significant differences in plaque index (PI), gingival index (GI) and periodontal probing depth (PPD) between the two groups (WMD=0.17, 95%CI 0.00 to 0.35; WMD=0.05, 95%CI –0.09 to 0.19; and WMD=–0.08, 95%CI –0.24 to 0.09); d) The results of one study indicated that the rate of periodontitis in the postmenopausal osteoporosis patients was higher than that of the non-osteoporosis patients (OR=2.45, 95%CI 1.38 to 4.34, Plt;0.01); the severe alveolar crest height loss was related to osteoporosis (OR=4.20, 95%CI 1.57 to 11.22, Plt;0.01). Conclusion Postmenopausal osteoporosis patients are more prone to suffer from periodontitis or turn to the worse stage of periodontitis. In consideration of the factors such as small scales and incomplete measure indexes of the included studies, which have influences on the intensity and comprehensiveness of this conclusion, more high-quality studies are required.
【摘要】 目的 评价64层螺旋CT低剂量冠状动脉血管成像的价值。 方法 2009年1-6月157例患者随机分为3组，常规剂量组（A组）管电流量采用1 000 mAs，两个低剂量组（B、C组）分别采用800、600 mAs。对3组的图像质量、噪声、CT剂量指数（CTDI）、剂量长度乘积（DLP）和有效剂量（ED）进行评估。 结果 A、B、C组图像噪声分别为20.50±3.23、23.02±3.05和26.28±2.58，组间差异均无统计学意义（Pgt;0.05）；A、B、C组的CTDI分别为（58.7±0.23）、（46.98±2.27）、（35.28±3.56） mGy，DLP分别为（1 050.88±89.63）、（846.21±57.86）、（641.13±32.15） mGy?cm，ED分别为（14.78±2.56）、（11.85±1.87）、（8.98±1.15） mSv，B、C组的CTDI、DLP、ED均明显低于常规剂量A组（Plt;0.05），C组的CTDI、DLP、ED均为3组中最低值。 结论 64层螺旋CT冠状动脉血管检查，采用600 mAs管电流量获得的冠脉图像既可满足诊断需要，又可使患者接受的辐射剂量降低。【Abstract】 Objective To evaluate the best tube current for low-dose radiation CT in coronary artery imaging by 64-slices multi-detector CT. Methods From January to June 2009, a total of 157 consecutive patients were randomly divided into 3 groups: group A (conventional group): 1 000 mAs; group B: 800 mAs; group C: 600 mAs. The image quality, noise, CT dose index (CTDI), dose length product (DLP) and effective dose (ED) in each group were measured and compared respectively. Results The image noise scores in group A, B, and C were (20.50±3.23), (23.02±3.05) and (26.28±2.58), respectively. There was no statistically significant difference among the three groups in the two indexes (Pgt;0.05). The CTDI in group A, B and C were (58.7±0.23), (46.98±2.27), and (35.28±3.56) mGy, respectively; the DLP in each were (1 050.88±89.63), (846.21±57.86), and (641.13±32.15) mGy?cm, respectively; the Ed were (14.78±2.56), (11.85±1.87), and (8.98±1.15) mSv, respectively. All of the differences among the three groups in CTDI, DLP and ED were statistically significant (Plt;0.05). Conclusion The image with 600 mAs as tube current in the coronary artery imaging of 64-slices multi-detector CT could fulfill the need of the diagnosis, and the radiation dose is apparently lower than the conventional scan.
Objectives To assess the effectiveness and safety of any form of therapy compared with glucocorticoid for the treatment of oral lichen planus. Method The Cochrane Library (Issue 4, 2007), MEDLINE (1966-2007), EMbase (1966-2007), CBM (1978-2005), CNKI (1989-2007), and VIP (1989-2007) were searched for randomized controlled trials or quasi-randomized controlled trials. Quality assessment and data extraction were performed by two reviewers independently. Meta-analysis was performed for the results of homogeneous studies by RevMan 4.2.9 software.Results Finally, 14 studies involving 9 therapy methods were included. Four studies were concerned with cyclosporine.We performed a meta-analysis of 3 studies. The results showed there was no statistically significant difference in the curative effect of cyclosporine and the steroid with RR 2.94 and 95%CI 1.03 to 9.97. The results showed that the curative effect of total glucosides of paenia plus topical application of triamcinolone acetonide (RR0.21, 95%CI 0.10 to 0.44),tacrolimu (RR 0.18 and 95%CI 0.05 to 0.72), and pimecrolimus (WMD –0.50 and 95%CI –0.85 to –0.15) were better than glucocorticoid. There was a statistically significant difference between fluocinolone acetonide and retinoic acid in terms of curative effect with RR 3.20 and 95%CI 1.03 to 9.97. The curative effect of mesalazine (RR 0.42 and 95%CI 0.05 to 3.54), Mycostatin paste plus desamethasone paste (RR 1.23 and 95%CI 0.93 to 1.61), triamcinolone acetonide plus vitamin B12 ( RR 0.50 and 95%CI 0.05 to 4.94), chitin (RR 1.30 and 95%CI 0.86 to 1.96) was similar with that of glucocorticoid.Conclusion Statistical analysis showed the curative effect of total glucosides of paenia combined with triamcinoloneacetonide is better than glucocorticoid. Due to the mistakes of theincluded studies designs,,further high-quality,largescale randomized controlled trials are required to confirm the effectiveness and safety of this therapy method.
ObjectiveTo systematically review the clinical efficacy of indirect and direct resin composite restorations in permanent posterior teeth.MethodsThe Cochrane Library (Issue 12, 2016), PubMed, EMbase, WanFang Data, CBM and CNKI databases were searched for randomized controlled trials (RCTs) about indirect and direct resin composite restorations in permanent posterior teeth from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsNine RCTs involving 671 patients and 1 012 teeth (544 in indirect restorations group and 468 in direct restorations group) were included. The results of meta-analysis indicated that: there was no significant difference in the overall failure rate between direct and indirect resin composite restorations (RR=0.91, 95%CI 0.52 to 1.58, P=0.73). In further analysing the reasons of failure, there were no significant differences between both groups on fractured restorations (RR=1.71, 95%CI 0.76 to 3.84, P=0.19) and fractured remaining cusp (RR=1.27, 95%CI 0.62 to 2.59, P=0.52). In addition, the secondary caries in the direct composite restorations group was higher than that in the indirect group (RR=0.33, 95%CI 0.13 to 0.85, P=0.02). Subgroup analysis according to molars and premolars restored indicated that there was no statistical difference in the restorations failure rate between two groups.ConclusionThe clinical efficacy of indirect and direct resin composite restorations in permanent posterior teeth are equivalent. Due to the limitation of quality and quantity of the included RCTs, the above conclusions are needed to be verified by more high quality and large sample RCTs.
ObjectivesTo systematically review the efficacy of resorbable membrane and non-resorbable membrane in dental implant to guide bone regeneration.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, VIP, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of resorbable membrane and non-resorbable membrane in dental implant to guide bone regeneration from inception to February 20th, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 RCTs involving 1 995 patients were included. The results of meta-analysis showed that: the resorbable membrane group was superior to non-resorbable membrane group in terms of repair success (RR=1.21, 95%CI 1.17 to 1.26, P<0.000 01), the bone thickness (MD=0.40, 95%CI 0.36 to 0.43, P<0.000 01), bone graft thickness(MD=0.40, 95%CI 0.35 to 0.46, P<0.000 01), patient satisfaction (RR=1.19, 95%CI 1.04 to 1.36, P=0.009), histological evaluation in bone contact (MD=4.82, 95%CI 0.14 to 9.50, P=0.04) and the total mineralized tissue (MD=3.73, 95%CI 0.32 to 7.14, P=0.03). They also had lower adverse reaction rate(RR=0.28, 95%CI 0.20 to 0.39, P<0.000 01) and changes of bone defect width from preoperative to 6 months postoperatively (MD=−0.62, 95%CI −0.93 to −0.31, P<0.000 01) with statistically significant differences. However, there was no significant difference in histological evaluation of non-mineralized tissue(MD=−2.48, 95%CI −5.81 to 0.85, P=0.14) between two groups.ConclusionsCurrent evidence shows that the resorbable membrane has better repairing effects, for which helps to promote the development of bone and bone graft, reduce the incidence of adverse reactions, which has good safety and effectiveness. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
Objective To evaluate the effects of peripheral venous remaining needle sealing with heparin vs. saline in China. Methods A comprehensive, systematic bibliographic search of medical literature from databases of CNKI (1994 to December, 2009) and Wanfang (1990 to December, 2009) was conducted to identify randomized controlled trials (RCTs) related to catheter sealing with saline vs. heparin. The remaining time of venous needle, the incidence of phlebitis and the catheter blockage were compared, and the quality of RCTs was assessed and meta-analyses were conducted by RevMan 5.0 software. Results Nine RCTs involving 1 770 patients were included. The results of meta-analyses showed that: a) There was a significant difference between heparin sealing and saline sealing in catheter blockage (OR=0.44, 95%CI 0.32 to 0.62, Plt;0.05). The heparin sealing was much better to prevent catheter blockage; b) There was no significant difference between saline sealing and heparin sealing in the incidence of phlebitis (OR=1.26, 95%CI 0.64 to 2.50, Pgt;0.05); and c) The average remaining time of venous catheter between saline sealing and heparin sealing had significant difference (WMD=0.24, 95%CI 0.04 to 0.43, Plt;0.05). Heparin sealing had better effect than saline sealing. Conclusion The meta-analyses of current medical literature in China show that heparin sealing can reduce the incidence of catheter blockage and prolong the remaining time of catheter, although there is no significant effect in the aspect of the incidence of phlebitis.
Objective To investigate the cellular compatibil ity of polyvinyl alcohol (PVA)/wild antheraea pernyisilk fibroin (WSF), and to explore the feasibil ity for tendon tissue engineering scaffold in vitro. Methods The solutions of WSF (11%), PVA (11%), and PVA/WSF (11%) were prepared with 98% formic acid (mass fraction) at a mass ratio of 9 : 1. The electrospinning membranes of WSF, PVA, and PVA/WSF were prepared by electrostatic spinning apparatus. The morphologies of scaffolds were evaluated using scanning electronic microscope (SEM). The tendon cells were isolated from tail tendon of 3-dayold Sprague Dawley rats in vitro. The experiment was performed using the 3rd generation cells. The tendon cells (1 × 106/mL) were cocultured with PVA and PVA/WSF electrospinning film, respectively, and MTT test was used to assess the cell adhesion rate 4, 12 hours after coculture. The tendon cells were cultured in PVA and PVA/WSF extraction medium of different concentration (1, 1/2, and 1/4), respectively; and the absorbance (A) values were detected at 1, 3, 5, and 7 days to evaluate the cytotoxicity. The composite of tendon cells and the PVA or PVA/WSF scaffold were observed by HE staining at 7 days and characterized by SEM at 1,3, 5, and 7 days. Results The solution of WSF could not be used to electrospin; and the solution of PVA and PVA/WSF could be electrospun. After coculture of tendon and PVA or PVA/WSF electrospinning membranes, the cell adhesion rates were 26.9% ±0.4% and 87.0% ± 1.0%, respectively for 4 hours, showing significant difference (t=100.400, P=0.000); the cell adhesion rates were 35.2% ± 0.6% and 110.0% ± 1.7%, respectively for 12 hours, showing significant difference (t=42.500, P=0.000). The cytotoxicity of PVA/WSF was less significantly than that of PVA (P lt; 0.05) and significant difference was observed between 1/2 PVA and 1/4PVA (P lt; 0.05). HE staining and SEM images showed that the tendon cells could adhere to PVA and PVA/WSF scaffolds, but that the cells grew better in PVA/WSF scaffold than in PVA scaffold in vitro. Conclusion PVA/WSF electrospinning membrane scaffold has good cell compatibility, and it is expected to be an ideal scaffold of tendon tissue engineering.
The shortage of medical resources promotes medical treatment reform, and smart healthcare is a promising strategy to solve this problem. With the development of Internet, real-time health status is expected to be monitored at home by using flexible healthcare systems, which puts forward new demands on flexible substrates for sensors. Currently, the flexible substrates are mainly traditional petroleum-based polymers, which are not renewable. As a natural polymer, cellulose, owing to its wide range of sources, convenient processing, biodegradability and so on, is an ideal alternative. In this review, the application progress of nanocellulose in flexible sensors is summarized. The structure and the modification methods of cellulose and nanocellulose are introduced at first, and then the application of nanocellulose flexible sensors in real-time medical monitoring is summarized. Finally, the advantages and future challenges of nanocellulose in the field of flexible sensors are discussed.
Objective To identify risk factors for death in patients with rhabdomyolysis-induced acute kidney injury (RI-AKI) treated with continuous renal replacement therapy (CRRT), then to develop and validate the efficacy of prediction models based on these risk factors. Methods Clinical data and prognostic information of patients with RI-AKI requiring CRRT from 2008 to 2019 were extracted from the MIMIC-IV 2.2 database. The enrolled patients were divided into a training set and a test set at a ratio of 7∶3. LASSO regression, random forest (RF) and extreme gradient boosting (XGBoost) were used to identify the risk factors affecting patients’ 28-day survival in the training set, then to develop logistic model, RF model, support vector machine (SVM) model and XGBoost model. The accuracy of above prediction models and the area under the receiver operating characteristic curve (AUC) were calculated in the test set. Results A total of 175 patients were included. Lactic acid, age, Acute Physiology Score Ⅲ, hemoglobin, mean arterial pressure and body mass index measured at intensive care unit admission were identified as the six risk factors affecting 28-day survival of enrolled patients by LASSO regression, RF and XGBoost. The accuracy of the logistic model, RF model, SVM model and XGBoost model in the test set was 0.75, 0.79, 0.79 and 0.81, with the AUC of 0.82, 0.85, 0.87 and 0.87, respectively. Conclusion The XGBoost model, incorporating six risk factors including lactic acid, age, Acute Physiology Score Ⅲ, hemoglobin, mean arterial pressure, and body mass index assessed at the time of admission to the intensive care unit, demonstrates superior clinical predictive performance, thereby enhancing the clinical decision-making process for healthcare professionals.