ObjectiveTo review the literature on the research status of vascularization of tissue engineered peripheral nerve so as to provide the theoretical basis for the vascularization of tissue engineered peripheral nerve.MethodsThe literature related to the vascularization of peripheral nerve tissue engineering in recent years was reviewed and summarized according to the five aspects of promoting vascularization: local microenvironment and blood supply characteristics of peripheral nerve regeneration, scaffold material modification, seed cells, autologous vascular bundle implantation, and pro-vascular factors.ResultsTissue engineered peripheral nerve has brought a new hope for the repair of peripheral nerve injury, but the repair effect of large nerve defects is not good, which is mainly related to the degree of vascularization of the nerve grafts. So it is particularly important to promote the early vascularization of tissue engineered peripheral nerve. Previous studies have mainly focused on the four aspects of scaffold material modification, seed cells, autologous vascular bundle implantation, and angiogenesis related factors. Recent studies show that the combination of the above two or more factors in the tissue engineered peripheral nerves can better promote the vascularization of tissue engineered peripheral nerves.ConclusionPromoting early vascularization of tissue engineered peripheral nerves can provide timely nutritional support for seed cells on the scaffold, promote axon growth and nerve regeneration, and facilitate the repair of large peripheral nerve defects in clinical practice.
ObjectivesTo evaluate the intention of having a second child among females of childbearing age after the implementation of China’s universal two-child policy so as to provide evidence for further studies.MethodsCNKI, VIP, WanFang Data, CSSCI, PubMed, EMbase and ScienceDirect databases were electronically searched to collect cross-sectional studies on the intention of females of childbearing age to have a second child from January 1st, 2016 to August 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R software.ResultsA total of 15 studies involving 18 820 cases were included. The results of meta-analysis showed that the fertility rate for the second child of females of childbearing age was 0.42 (95%CI 0.37 to 0.47), and the result was stable. Subgroup analysis showed that the fertility rate of second child in eastern region was higher than that in western region (0.44 vs. 0.40), in rural areas was higher than that in non-rural areas (0.46 vs. 0.35), females aged 18 to 34 was higher than those aged above 35 (0.49 vs. 0.29), and non-working females was higher than that among working females (0.48 vs. 0.40). The fertility rate of the sex of the first child being female was higher than the sex of the first child was male (0.48 vs. 0.39). The fertility rate of the couple who were both the non-only child was higher than the couple who were both the only child and who was only child while the other was non-only child (0.46 vs. 0.41 vs. 0.40).ConclusionsSince the implementation of the “universal two-child policy” in China, the fertility rate of females of childbearing age with the intention of having a second child is lower, especially those females who are from the western regions and non-rural areas, aged above 35 and the sex of the first child is male and non-dual-non-couples. Due to the quantity and quality of the included studies, more high quality studies are required to verify the above conclusions in future.
Objective To systematically review the relationship between preoperative platelet-to-lymphocyte ratio (PLR) and prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). Methods Studies on the relationship between preoperative PLR and prognosis of PDAC patients were retrieved from China National Knowledge Infrastructure, Chongqing VIP, SinoMed, Wanfang, PubMed, Embase, Web of Science, and Cochrane Library, with a search period from databases establishment to December 2023. A meta-analysis was conducted using RevMan 5.3 software. Results A total of 7 studies were included, including 1273 patients. The meta-analysis results showed that the postoperative overall survival [hazard ratio (HR)=1.69, 95% confidence interval (CI) (1.24, 2.30)] and disease-free survival [HR=1.83, 95%CI (1.49, 2.24)] of PDAC patients with high preoperative PLR were shortened (P<0.05). The results of subgroup analysis showed that when the cut off of PLR was<200, preoperative high PLR was associated with shortened overall survival (HR=1.91, P<0.05), but when the cut off of PLR was ≥200, there was no significant correlation between preoperative PLR and overall survival (P>0.05). When followed up for<3 years, preoperative high PLR was associated with shortened overall survival (HR=2.05, P<0.05), but when followed up for ≥3 years, there was no significant correlation between preoperative PLR and overall survival (P>0.05). Conclusion Current evidence suggests that preoperative high PLR may be a risk factor for poor prognosis in PDAC patients.
ObjectiveTo investigate the inhibitory effect of T lymphocyte transplantation of EphrinAl-Caspase-3 on the growth of breast cancer.MethodsSix-week-old BALB/c nude mice were used to inoculate breast cancer cells to construct a nude mouse model of breast cancer. They were randomly divided into 3 groups according to random number table: PBS group received intratumoral injection of 10 μL PBS, and negative control group received intratumoral injection of 1×106 T lymphocytes uninfected with adenovirus, 1×106 EphrinAl-Caspase3-T lymphocytes were injected intratumorally into the infected group, and the tumors size (0, 3, 6, 9, 12 and 15 d) were measured with vernier calipers every 3 days until end of experiment. The content of EphrinAl-Caspase-3 in the tissues of the nude mice was measured. The presence of T lymphocytes expressing green fluorescent protein and the ratio of Caspase-3-positive and Ki-67-positive cell were observed by pathological examination.ResultsOn the day 0 and day 3, there were no significant difference in tumor volume between the 3 groups (P>0.05). On the 6th day and later, the difference between the infected group and the PBS group/negative control group were statistically significant (P<0.05), but there were no significant difference in tumor volume between the PBS group and negative control group at each time point (P>0.05). The presence of scattered green fluorescent protein-labeled EphrinAl-Caspase-3-T lymphocytes was observed in the tumor tissues of the infected group, while the presence of green fluorescent protein were not detected in the PBS group and the negative control group. In the infected cells, ratio of Caspase-3-positive cell was up-regulated and ratio of Ki-67-positive cell was down-regulated. The expression of EphrinAl-Caspase-3 could be detected on the 3rd day in the infected group, and at the peak on the 6-day, then the amount of secretion gradually decreased. The expression of EphrinAl-Caspase-3 were not detected in the PBS group and the negative control group at each time point.ConclusionEphrinAl-Caspase-3 can significantly inhibit the growth of breast cancer cells and promote apoptosis.
ObjectiveTo systematically review the relationship between Glasgow prognostic score (GPS) and prognosis of gastric cancer (GC) patients. MethodsPubMed, Web of Science, The Cochrane Library, CNKI, CBM and VIP databases were electronically searched to collect cohort studies on the relationship between GPS and prognosis of GC patients from inception to April, 2022. 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 and Stata 16.0 software. ResultsA total of 9 cohort studies involving 2 395 patients were included. The results of meta-analysis showed that GPS was significantly associated with poor overall survival of GC patients (HR=2.01, 95%CI 1.55 to 2.61, P<0.000 01). It also was associated with deeper depth of tumor, positive lymph node metastasis, more advanced TNM stages, positive distant metastasis and older age. ConclusionCurrent evidence shows that GPS is associated with survival prognosis and clinical pathological features of GC patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective Bone marrow mesenchymal stem cells (BMSCs), as replacement cells of Schwann cells, can increase the effect of peripheral nerve repair. However, it has not yet reached any agreement to add the appropriate number of seeded cells in nerve scaffold. To investigate the effect of different number of BMSCs on the growth of rat dorsal root gangl ia(DRG). Methods Three 4-week-old Sprague Dawley (SD) rats (weighing 80-100 g) were selected to isolate BMSCs, whichwere cultured in vitro. Three 1- to 2-day-old SD rats (weighing 4-6 g) were selected to prepare DRG. BMSCs at passage 3 were used to prepare BMSCs-fibrin glue complex. According to different number of BMSCs at passage 3 in fibrin glue, experiment was divided into group A (1 × 103), group B (1 × 104), group C (1 × 105), and group D (0, blank control), and BMSCs were cocultured with rat DRG. The axon length of DRG, Schwann cell migration distance, and axon area index were quantitatively evaluated by morphology, neurofilament 200, and Schwann cells S-100 immunofluorescence staining after cultured for 48 hours. Results Some long cell processes formed in BMSCs at 48 hours; migration of Schwann cells and axons growth from the DRG were observed, growing in every direction. BMSCs in fibrin glue had the biological activity and could effect DRG growth. The axon length of DRG and Schwann cell migration distance in groups A, B, and C were significantly greater than those in group D (P lt; 0.05). The axon length of DRG and Schwann cell migration distance in group C were significantly less than those in group B (P lt; 0.05), but there was no significant difference between group A and group C, and between group A and group B (P gt; 0.05). The axon area index in groups A and B was significantly greater than that in group D (P lt; 0.05), but there was no significant difference between group C and group D (P gt; 0.05); there was no significant difference in groups A, B, and C (P gt; 0.05). Conclusion In vitro study on DRG culture experiments is an ideal objective neural model of nerve regeneration. The effect of different number of BMSCs in fibrin glue on the growth of DRG has dose-effect relationship. It can provide a theoretical basis for the appropriate choice of the BMSCs number for tissue engineered nerve.
Objective Poly (propylene carbonate) (PPC), a newly reported polymer, has good biodegradabil ity and biocompatibil ity. To explore the feasibil ity of using electrospinning PPC materials in nerve tissue engineering, and to observe the effect of al igned and random PPC materials on axonal growth of rat dorsal root gangl ions (DRGs) in vitro. Methods Either al igned or randomly oriented sub-micron scale polymeric fiber was prepared with an electrospinning process. DRGs were harvested from 3 newborn Sprague-Dawley rats (female or male, weighing 4-6 g), and were incubated into 12-pore plate containing either al igned (the experimental group, n=6) or randomly oriented sub-micron scale polymeric fiber (the control group, n=6). The DRGs growth was observed with an inverted microscope; at 7 days immunofluorescent staining and scanning electronic microscope (SEM) observation were performed to quantify the extent of neurite growth andSchwann cells (SCs) migration. Results Either al igned or random fibers were fabricated by an electrospinning process. The diameter of the individual fiber ranged between 800 nm and 1 200 nm. In al igned PPC material, 90% fibers arranged in long axis direction, but the fibers in random PPC material arranged in all directions. The DRGs grew well in 2 PPC materials. Onthe al igned fiber film, the majority of neurite growth and SCs migration from the DRGs extended unidirectionally, parallel to the al igned fibers; however, neurite growth and SCs migration on the random fiber films oriented randomly. The extents of neurite growth were (2 684.7 ± 994.8) μm on the al igned fiber film and (504.7 ± 52.8) μm on the random fiber films, showing significant difference (t= —5.360, P=0.000). The distances of SCs migration were (2 770.6 ± 978.4) μm on the al igned fiber film and (610.2 ± 56.3) μm on the random fiber films, showing significant difference (t= —5.400, P=0.000). The extent of neurite growth was fewer than the distances of SCs migration in 2 groups. Conclusion The orientation structure of sub-micron scalefibers determines the orientation and extent of DRGs neurite growth and SCs migration. Al igned electrospinning PPC fiber is proved to be a promising biomaterial for nerve regeneration.
Objective Native extracellular matrix (ECM) is comprised of a complex network of structural and regulatory proteins that are arrayed into a tissue-specific, biomechanically optimal, fibrous matrix. The multifunctional nature of the native ECM will need to be considered in the design and fabrication of tissue engineering scaffolds. To investigate the extraction techniques of naturally derived nerve ECM and the feasibil ity of nerve tissue engineering scaffold. Methods Ten fresh canine sciatic nerves were harvested; nerve ECM material was prepared by hypotonic freeze-thawing, mechanicalgrinding, and differential centrifugation. The ECM was observed by scanning electron microscope. Immunofluorescencestaining was performed to detect specific ECM proteins including collagen type I, laminin, and fibronectin. Total collagen and glycosaminoglycan (GAG) contents were assessed using biochemical assays. The degree of decellularization was evaluated with staining for nuclei using Hoechst33258. The dorsal root gangl ion and Schwann cells of rats were respectively seeded onto nerve tissue-specific ECM films. The biocompatibil ity was observed by specific antibodies for cell markers. Results Scanning electron microscope analysis revealed that nerve-derived ECM consisted of a nanofibrous structure, which diameter was 30-130 nm. Immunofluorescence staining confirmed that the nerve-derived ECM was made up of collagen type I, laminin, and fibronectin. The histological staining showed that the staining results of sirius red, Safranin O, and toluidine blue were positive. Hoechst33258 staining showed no DNA within the decellularized ECM. Those ECM films had good biocompatibil ity for dorsal root gangl ion and Schwann cells. The cotents of total collagen and GAG in the nerve-derived ECM were (114.88 ± 13.33) μg/ mg and (17.52 ± 2.34) μg/mg, showing significant difference in the content of total collagen (P lt; 0.01) and no significant difference in the content of GAG (P gt; 0.05) when compared with the contents of normal nerve tissue [(54.07 ± 5.06) μg/mg and (25.25 ± 1.56) μg/mg)]. The results of immunofluorescence staining were positive for neurofilament 200 after 7 days and for S100 after 2 days. Conclusion Nerve-derived ECM is rich in collagen type I, laminin, and fibronectin and has good biocompatibil ity, so it can be used as a nerve tissue engineering scaffold.
Objective To explore the effect of controlled release of nerve growth factor (NGF) on peripheral nerve defect repaire by acellular nerve graft. Methods The microspheres of NGF were prepared with drug microsphere technologyand fixed with the fibrin glue to make the compl icated controlled release NGF. Twenty healthy male SD rats weighing 280-300 g were adopted to prepare acellular xenogenous nerve, 52 male Wistar rats weighing 250-300 g were adopted to prepare the 10 mm defect model of left sciatic nerve. and thereafter were randomly divided into 4 groups: autograft group(group A), acellular nerve allograft combined with the double controlled release NGF (group B), acellular nerve allograft (group C) and acellular nerve allograft combined with fibrin glue (group D). Without any operation, the right sciatic nerve was regarded as control group. General observation was conducted after operation. The nerve axon regeneration length was measured 2 weeks after operation. The effects of peripheral nerve regeneration were evaluated by neural electrophysiology, the recovery rate of triceps surae muscular tension and weight and histological assessment 16 weeks after operation. Results All the animals survived till the end of experiment. The length of nerve regeneration was measured at 2 weeks after transplantation. The regeneration nerve of group A was longer than that of other groups (P lt; 0.05), group B longer than groups C and D (P lt; 0.05), and there were no difference between group C and group D (P gt; 0.05). At 16 weeks after operation, the recovery rates of nerve conduction velocity of groups A and B (73.37% ± 7.82% and 70.39% ± 8.45%) were larger than that of groups C and D (53.51% ± 6.31% and 55.28% ± 5.37%) (P lt; 0.05). The recovery rates of the triceps surae muscular tension in group A (85.33% ± 5.59%) were larger than that in groups B, C and D (69.79% ± 5.31%, 64.46% ± 8.49％ and 63.35% ± 6.40%) (P lt; 0.05). There were no significant differences among groups B, C and D (P gt; 0.05). The recovery rates of the triceps surae weight in group A (62.54% ± 8.25%) werelarger than that in groups B, C and D (53.73% ± 4.56%, 46.37% ± 5.68% and 45.78% ± 7.14%, P lt; 0.05). There was significant difference between group B and groups C, D (P lt; 0.05) and no significant differences between group C and group D (P gt; 0.05). The histological observation indicated that axon number and myel in thickness in group B were larger than those in group C and group D (P lt; 0.05). The axonal diameter in group B was significantly less than that in group A (P lt; 0.05). Conclusion Acellular nerve graft combined with the controlled release NGF is a satisfactory alternative to repair the peripheral nerve defect.
Objective To investigate the accuracy and safety of percutaneous screw fixation for pelvic and acetabular fractures with remote navigation of orthopedic robot based on 5G technology. Methods Between January 2021 and December 2021, 15 patients with pelvic and/or acetabular fractures were treated with percutaneous screws fixation which were placed by remote navigation of orthopedic robot based on 5G technology. There were 8 males and 7 females. The age ranged from 20 to 98 years, with an average of 52.1 years. The causes of trauma included traffic accident injury in 6 cases, falling from height injury in 6 cases, fall injury in 2 cases, and heavy object smashing injury in 1 case. The time from injury to operation ranged from 3 to 32 days, with an average of 10.9 days. There were 8 cases of simple pelvic fractures, 2 simple acetabular fractures, and 5 both pelvic and acetabular fractures. There were 7 cases of pelvic fractures of Tile type B2, 2 type B3, 1 type C1, and 3 type C2; 4 cases of unilateral anterior column fracture of the acetabulum, 2 bilateral anterior column fractures, and 1 anterior wall fracture. CT images within 5 days after operation were collected for screw position assessment. The screw planning time and guidewire placement time were recorded, as well as the presence of intraoperative adverse events and complications within 5 days after operation. Results All patients achieved satisfactory surgical results. A total of 36 percutaneous screws were inserted (20 sacroiliac screws, 6 LC Ⅱ screws, 9 anterior column screws, and 1 acetabular apical screw). In terms of screw position evaluation, 32 screws (88.89%) were excellent and 4 screws (11.11%) were good; there was no screw penetrating cortical bone. The screw planning time ranged from 4 to 15 minutes, with an average of 8.7 minutes. The guidewire placement time ranged from 3 to 10 minutes, with an average of 6.8 minutes. The communication delayed in 2 cases, but the operation progress was not affected, and no serious intraoperative adverse events occurred. No delayed vascular or nerve injury, infection, or other complications occurred within 5 days after operation. No cases need surgical revision. ConclusionThe fixation of pelvic and acetabular fractures by percutaneous screw with remote navigation of orthopedic robot based on 5G technology is accurate, safe, and reliable.