Objective To compare effects of intra-articular injection of corticosteroid or viscoelastic agent alone or a combination of the two drugs for treatment of temporomandibular joint disorders. Methods A prospective quasirandomized controlled trial was conducted to compare 3 treatment protocols of intra-articular injections in the upper compartment of the joint immediately following arthrocentesis repeatedly every 10 days: ① triamcinolone 8 mg alone for 3 times, ② 1% hyaluronate 1 ml alone for 4 times, and ③ triamcinolone 8 mg for 2 times then 1% hyaluronate 1 ml for 2 times. Clinical examinations were done at baseline, 1, 12, and 24 months after end of the treatments. According to improvement of the symptoms and clinical signs, the effectiveness was graded in 3 classes: excellent, better, no change, or worse. The first two were classified as effective. Effective rates of the treatments and subgroups were compared statistically. Results Five hundred and sixty four patients with temporomandibular disorders were included and randomly allocated to 3 groups with 188 patients in each group. The rate of lost follow up at 24 months was 6.9% to 10.1%. At one month after treatment, the triamcinolone group had a better effective rate at 92.0%. At 12 and 24 months of follow up, effective rates of the hyaluronate group were better than those in the triamcinolone alone group (84.6% vs. 54.1% and 83.4% vs. 40.4%). Effective rates of combining triamcinolone and hyaluronate group at 12 and 24 months were 90.4% and 66.3% respectively. Conclusion Intra-articular injection of corticosteroid has better results in a short term and hyaluronate has better results in a long term in the treatment of temporomandibular joint disorders.
目的 探讨盐酸氨基葡萄糖胶囊联合透明质酸钠注射液治疗髋骨关节炎的临床疗效。 方法 纳入疼痛门诊2010年7月－2011年7月收治的髋骨关节炎患者60例，随机分为透明质酸钠关节腔内注射联合口服盐酸氨基葡萄糖胶囊组（A组）和单独透明质酸钠关节腔内注射组（B组），每组30例。透明质酸钠关节腔内注射均为2.5 mL/次，每周1次，连续5周为1疗程。盐酸氨基葡萄糖胶囊口服，0.75 g/次，2次/d，6周为1个疗程。评估两组患者治疗后6周后髋关节疼痛视觉模拟评分（VAS评分）及Lequesne指数评定髋关节休息痛、运动痛、局部压痛、关节活动度、晨僵及行走能力，并观察两组不良反应发生情况。 结果 治疗6周后A组Lequesne功能指数及VAS评分较B组显著降低（P＜0.05），两组不良反应比较差异无统计学意义（P＞0.05）。 结论 治疗髋骨关节炎患者时，联合应用透明质酸钠及盐酸氨基葡萄糖胶囊疗效优于单独应用透明质酸钠者，且并未增加不良反应的发生。
Objective To explore the possibility of constructing tissue engineered cartilage complex three-dimensional nano-scaffold with collagen type II and hyaluronic acid (HA) by electrospinning. Methods The three-dimensional porous nano-scaffolds were prepared by electrospinning techniques with collagen type II and HA (8 ∶ 1, W ∶ W), which was dissolved in mixed solvent of 3-trifluoroethanol and water (1 ∶ 1, V ∶ V). The morphology were observed by light microscope and scanning electron microscope (SEM). And the porosity, water absorption rate, contact angle, and degradation rate were detected. Chondrocytes were harvested from 1-week-old Japanese white rabbit, which was disgested by 0.25% trypsin 30 minutes and 1% collagenase overlight. The passage 2 chondrocytes were seeded on the nano-scaffold. The cell adhesion and proliferation were evaluated by cell counting kit 8 (CCK-8). The cell-scaffold composites were cultured for 2 weeks in vitro, and the biological morphology and extracelluar matrix (ECM) secretion were observed by histological analysis. Results The optimal electrospinning condition of nano-scaffold was 10% electrospinning solution concentration, 10 cm receiver distance, 5 mL/ h spinning injection speed. The scaffold had uniform diameter and good porosity through the light microscope and SEM. The diameter was 300-600 nm, and the porosity was 89.5% ± 25.0%. The contact angle was (35.6 ± 3.4)°, and the water absorption was 1 120% ± 34% at 24 hours, which indicated excellent hydrophilicity. The degradation rate was 42.24% ± 1.51% at 48 days. CCK-8 results showed that the adhesive rate of cells with scaffold was 169.14% ± 11.26% at 12 hours, and the cell survival rate was 126.03% ± 4.54% at 7 days. The histological and immunohistochemical staining results showed that the chondrocytes could grow well on the scaffold and secreted ECM. And the similar cartilage lacuma structure could be found at 2 weeks after co-culture, which suggested that hyaline cartilage formed. Conclusion The collage type II and HA complex three-dimensional nano-scaffold has good physicochemical properties and excellent biocompatibility, so it can be used as a tissue engineered cartilage scaffold.
ObjectiveTo review the registration and technical data for sodium hyaluronate facial derma fillers. MethodsRecent literature concerning registration for sodium hyaluronate facial derma fillers was reviewed and analyzed. ResultsThe aspects on registration for sodium hyaluronate facial derma fillers include nominating the product, dividing registration unit, filling in a registration application form, preparing the technical data, developing the standard, and developing a registration specification. ConclusionThe main difficulty in registration is how to prepare the research data of that product, so the manufacturers need to enhance their basic research ability and work out a scientific technique routing which could ensure the safety and effectiveness of the product, also help to set up the supportive documents to medical device registration.
Objective To observe and explore the effects of adipose-derived stem cells (ADSCs)-hyaluronic acid (HA) composite on heal ing of wound combined with radiation injury. Methods The ADSCs were harvested from the fat tissue in groin of 10 inbred Sprague Dawley (SD) rats and were isolated and cultured by enzyme digestion. The ADSCs-HA composite wasprepared with ADSCs (5 × 106 cells/mL) at passage 6 and HA (10 mg/mL). Thirty inbred SD rats, 15 males and 15 females, were randomly divided into groups A (n=10), B (n=10), and C (n=10). A 2 cm × 2 cm full-thickness skin defect was made on the rat back before 20 Gy 60Co radiation exposure. One week after debridement, wounds were treated by petrolatum gauze in group A as the control group, by HA (0.4 mL) and petrolatum gauze in group B, and by ADSCs-HA composite (0.4 mL) and petrolatum gauze in group C. The microvessel density (MVD) and the distribution of CD90 positive cells were observed at 1st, 2nd, 3rd, and 4th weeks. Results The wound heal ing was slower, and wound did not heal at 4th week and still filled with granulation tissue in group A; the wound heal ing of group B was faster than that of group A, and the wound did not heal completely with depression in the center at 4th week; the wound healed completely with epidermil izated surface and no obvious depression at 4th week in group C. The histological observation showed that MVD was significantly higher in group C than in groups A and B at the 1st, 2nd, and 3rd weeks (P lt; 0.05), and in group B than in group A at the 3rd week (P lt; 0.05); MVD was significantly higher in groups B and C than in group A (P lt; 0.05), but no significant difference was found between groups B and C (P gt; 0.05) at 4th week. No CD90 positive cell was found in groups A and B; CD 90 positive cells were observed in group C and gradually decreased with time. Conclusion ADSCs-HA composite can accelerate heal ing of wound combined with radiation injury by promoting and controll ing wound angiogenesis.
Objective To evaluate the feasibility of Seprafilm anti-adhesion membrane, a hyaluronic acid (HA) derivative, on prevention of adhesion in acute injured tendon. Methods Eighteen 4-month-old Chinese white rabbits (half males and half females, weighing 2.0-2.5 kg) were made the laceration models of the bilateral second and third toes of hindpaw. According to different treatments, the rabbits were randomly divided into 4 groups (n=18). The second toe of right hindpaw was wrapped with Seprafilm anti-adhesion membrane (group A); the third toe of right hindpaw was wrapped with polylactic acid membrane (group B); the second toe of left hindpaw was coated with sodium hyaluronate gel (group C); and the third toe of left hindpaw did not treated, as control group (group D). The general condition was observed; the range of motion (ROM) of distal interphalangeal joint was measured; the gross observation and histological observation were performed at 1, 2, and 4 weeks, then the degree of adhesion was graded. Results All rabbits survived to the end of the experiment. There was no significant difference in ROM of distal interphalangeal joint between groups A and B at 1, 2, and 4 weeks (P gt; 0.05). ROM of group A was superior to that of groups C and D at 2 and 4 weeks (P lt; 0.05). The gross and histological observations showed the same result in the grading of adhesion. At 1 week, there was no significant difference in the grading of adhesion among 4 groups (P gt; 0.05); at 2 and 4 weeks, the grading of adhesion in group A was similar to that in group B (P gt; 0.05), and the grading of adhesion in group A was significantly slighter than that in groups C and D (P lt; 0.05). Conclusion Seprafilm anti-adhesion membrane composed of HA derivative can prevent tendon adhesion and improve the joint function in acute tendon injury of rabbits.
Objective To study the effect of sodium hyaluronate hydrogel in treating residual cavity on body surface after abscess drainage so as to provide new method to speed up the heal ing of residual cavity after body surface abscess drainageand reduce the frequency of dressing change and cl inic nursing workload. Methods From June 2007 to March 2008, 60 outpatients with body surface abscess drainage were randomly divided into hydrogel group (group A, 30 cases) and the control group (group B, 30 cases). In group A, there were 16 males and 14 females aged (49.5 ± 6.1) years, the disease course was (3.8 ± 0.6) days, and the volume of residual cavity was (4.19 ± 1.31) mL. In group B, there were 18 males and 12 females aged (50.2 ± 7.6) years, the disease course was (4.3 ± 0.5) days, and the volume of residual cavity was (4.04 ± 1.22) mL. There was no significant difference between two groups in gender, age, disease course and volume of residual cavity (P gt; 0.05). Residual cavity was smeared with 1 mL/cm2 sodium hyaluronate hydrogel in group A and drained by sal ine gauze in group B, the dressing was changed every two to three days. Residual cavity volume was recorded every four days, and the residual cavity volume, the frequency of out-patient dressing and the heal ing time residual of cavity were compared. Results The volume of residual cavity was (3.11 ± 1.12), (1.75 ± 0.95) and (0.55 ± 0.56) mL in group A, and was (3.39 ± 1.12), (2.64 ± 0.99) and (1.81 ± 0.81) mL in group B at 4, 8 and 12 days after treatment respectively, showing no significant differences at 4 days (P gt; 0. 05), but significant difference at 8 and 12 days (P lt; 0.01). Residual cavity heal ing time was (12.70 ± 2.78) days in group A and (20.27 ± 3.89) days in group B, and the frequency of dressing change was 5.53 ± 1.33 in group A and 9.13 ± 1.81 in group B, indicating significant differences between two groups (P lt; 0.01). Conclusion Sodium hyaluronate hydrogel can promote residual cavity heal ing, reduce the frequency of dressing change of out-patient and decrease the cl inic nursing care workload.
Objective To compare the effect of decimeter wave with sodium hyaluronate product (SHP) on preventing and treating peritendinous adhesion and promoting tendon heal ing. Methods Totally 96 healthy male white 6-month-old Leghorn chickens weighing (2.24 ± 0.07) kg were randomized into group A ( decimeter wave therapy group, n=32),in which decimeter wave therapy was appl ied 1 to 21 days after operation at a frequency of 915 MHz, a power of 8 W, radiation distance of 10 cm, for 10 minutes once per day; group B (SHP group, n=32), in which 5 mL and 1.2% SHP was appl ied; and group C (control group, n=32), in which injury received no treatment. The III and IV toes of left feet of all chickens were made into tendon injury model. The general condition of animal was observed after operation; gross and histological observations were made 7, 10, 14, 18, 21 and 28 days after operation, and the biomechanical analysis was done 14 and 28 days after operation. Results Operative incision healed well, no infection and death occurred. Peritendinous adhesions in groups A, B were looser, and tendon heal ing was better than that of group C 14 and 28 days after operation. More fibroblasts with active metabol ism and more collagen formation in groups A, B than that in group C. The Pmax of group A was better than that of group B 14 and 28 days after operation (P lt; 0.05); the δmax of group A was better than that of group B 18 and 21 days after operation (P lt; 0.05), and the W0 of group A was better than that of group B 18, 21 and 28 days after operation (P lt; 0.05). There was no significant difference between group A and group B at the other time points. Conclusion Topical decimeter wave therapy and appl ication of SHP after flexor tendon repair can promote intrinsic heal ing, meanwhile they can prevent the adhesion of tendon and reduce extrinsic heal ing. Decimeter wave therapy can improve the qual ities of tendon’s wound heal ing.
Objective To explore the efficacy and safety of bioactive material(combest) which is combinated with bioglass and hyaluronan on burn wound healing．Methods From March to September 2006, 20 patients were treated; including 16 males and 4 females, aging 18-58 years(40 years on average)．The wounds were classified as deep degrees Ⅱ in 7 cases, granulated wounds in 9 cases and graft site wounds in 4 cases. Twenty wounds in one side were repaired with Combest as the test group and 20 wounds in the other side with blank cream as the control group. The wounds in size ranged from 2.0 cm×1.5 cm to 40.0 cm×20.0 cm. The wound healing rate was observed, and the blood test and the indices of hepatic and renal function were determined on the 1st, 3 rd,6 th, 11 th, 16 th and 21 st days of treatment．Results Wound healed within 3 weeks in 11 cases of the test group (3 cases on the 11 st day, 4 on the 16 th day, and 4 on the 21 st day) , but no wound healing was observed within 3 weeks in the control group. The healing size accounted for 2/3 of wounds in 18 cases of the test group and in 1 case of the control group. The excellent and good rates were 95%(18 cases and 1 case) in the test group and 50% (1 case and 9 cases) in the control group, showing significant difference (Plt;0.01). For all patients, no obvious changes were found in the blood test and hepatic or renal function indices. Conclusion Combest combinated with bioglass and hyaluronan is beneficial to the proliferation of the granulation and wound healing with good safety.
Objective To develop a scaffold material containing collagen Ⅰ and sodium hyaluronate for the cartilage tissue engineering and to evaluate its biocompatibility by using the rabbit chondrocytes derived from amandibular condylar process. Methods The porous matrices containing collagen Ⅰ and sodium hyaluronate were fabricated by the freezedrying technique and were crosslinked by using 1-ethyl-3(3-dimethyl aminopropyl) carbodiimide (EDC). The microstructure of the scaffold was observed under thescanning electron microscope (SEM), and the enzymatic degradation test was performed to compare the ability of the scaffold resistance to collagenase before and after the crosslinking. The chondrocytes from the rabbits’ condylar process were isolated and cultured before they were seeded into the scaffold, and cell attachment and proliferation were measured by the cell count 1, 3, 5, 7 and 10 daysafter the cell being seeded; then, the biocompatibility of the scaffold was evaluated by the light microscopic examination, histological examination, and the SEM exmination. Results The porous structure of the scaffold facilitated the penetration and attachment of the seeded cells. The porosity was 83.7% and the pore size was 100-120 μm. The cell number increased from 3.7×104 per scaffold 1 day after the cell being seeded to 8.2×104 per scaffold 10 days after the cell being seeded. The crosslinking treatment could significantly enhance the scaffold resistance to the collagenase activity. The examinations under the light microscope and SEM indicated that the chondrocyte adhered and spread well on the scaffold, and the extracellular matrices were also observed around the chondrocytes. Conclusion The porous scaffold composed of collagen Ⅰ and hyaluronan has anappropriate structure and a good biocompatibility for the attachment and proliferation of the chondrocytes, which can facilitate it to become a useful scaffold in the cartilage tissue engineering.