Objective To investigate the current situation and developing trend of antithrombotic function study of endothelium in vasculartissue engineering. Methods The effect of several elements onthe antithrombotic ability of endothelium, including the source of endothelium,the characteristic of the matrix materials, the cell culture methods, and the endothelium’s gene modification were analyzed. Results The normal antithrombotic function of tissue engineered vascular relied on the source ofendothelium, gene modification of seeding cells, the cell culture methods in vitro, and the characteristic of the scaffolds. Conclusion The establishment of an ideal antithrombotic functional tissue engineering vascular still requires further studies in various aspects including seeding cells, matrix materials, and cell culture methods. Gene modification of vascular endothelium, which improves the antithrombotic ability, deserves more attention.
OBJECTIVE: To investigate the selection and manufacture of ideal extracellular matrix materials in bone tissue engineering. METHODS: The recent literatures about biodegradable polymers served as culture scaffolds of osteoblasts were widely reviewed, the advantages and disadvantages of biodegradable synthetic polymers and natural polymers were analysed. RESULTS: The ideal extracellular matrix material in bone tissue engineering should be made up of inorganic materials, synthetic polymers and natural polymers, which possesses morphological structure of three-dimensional foam with self-mediated drug slow delivery system of bone growth factors. CONCLUSION: The design and manufacture of combined extracellular matrix materials in bone tissue engineering is a very important and urgent challenge.
This article discusses the new needs and development direction of medical testing technology under the hierarchical diagnosis and treatment system in China, outlines the principles and advantages of new medical testing technology based on smartphones, and briefly describes the development status and research results of smartphone testing technology in specific medical testing directions such as immune analysis, nucleic acid analysis, biochemical analysis and cell morphology analysis. In addition, the article also discusses the current problems of smartphone medical testing technology, such as poor compatibility with different models of smartphones, few detection indicators, low automation, lack of clinical verification. Finally, a prospect is made for the possible future development direction of smartphone medical examination technology, aiming to provide a certain reference for the promotion and more reasonable application of smartphone medical examination technology.
Objective To summarize the cl inical experience of repairing soft tissue defect in dorsal pedis with reversed fascia pedicled peroneal perforating branch sural neurofasciocutaneous flap, and to explore surgery matters needingattention and measures to prevent flap necrosis. Methods Between August 2000 and April 2009, 31 patients with soft tissue defects in dorsal pedis were treated with reversed fascia pedicled peroneal perforating branch sural neurofasciocutaneous flaps. There were 23 males and 8 females with a median age of 34 years (range, 3-65 years). Defects were caused by traffic accident in 20 cases, by machine in 2 cases, and by crush in 2 cases. The time from injury to admission was 1-32 days (mean, 15 days). And 6 cases had chronic ulcer or unstable scar excision with disease duration of 6 months to 10 years, and 1 case had squamous carcinoma with disease duration of 5 months. The wounds were located in medial dorsal pedis in 12 cases and lateral dorsal pedis in 19 cases; including 14 wounds near the middle metatarsal and 17 wounds beyond the middle metatarsal (up to the metatarsophalangeal joint in 10 cases). All cases accompanied with bone or tendon exposure. Five cases accompanied with long extensor muscle digits tendon rupture and defect, 1 case accompanied with talus fracture, 1 case accompanied with talus fracture and third metatarsal fracture. The size of the wounds ranged from 6.0 cm × 4.5 cm to 17.0 cm × 10.0 cm. The size of the flaps ranged from 8.0 cm × 5.5 cm to 20.0 cm × 12.0 cm. The donor sites were resurfaced by skin graft. Results Seventeen flaps survived uneventfully, wounds healed by first intention. Distal epidermal or superficial necrosis occurred in 6 flaps at 5-12 daysafter operation, wounds healed by dressing change or skin graft. Distal partial necrosis occurred in 8 flaps (7 in medial dorsal pedis and 1 in lateral dorsal pedis) at 7-14 days after operation, wounds healed by skin graft in 3 cases, by secondary suture in 3 cases, by local flap rotation in 1 case, and by cross leg flap in 1 case. All skin grafts at donor sites survived uneventfully, wounds healed by first intention. Twenty-nine patients were followed up 6-29 months (mean, 19 months). The appearance was sl ightly overstaffed, but wearing shoe function and gait were normal. The texture and color of the flaps in all cases were good. There was no pigmentation and suppuration relapse. There was neither ankle plantar flexion deformity nor hammer toe deformity in 5 cases accompanied with long extensor muscle digits tendon rupture and defect. All fractures healed at 3 months after operation in 2 cases. Conclusion The reversed fascia pedicled peroneal perforating branch sural neurofasciocutaneous flaps are suitable to repair most soft tissue defects in lateral dorsal pedis. When the flaps are used to repair soft tissue defects in medial dorsal pedis, avoiding tension in flaps and fascia pedicles should be noted so as to improve flap survival.
Objective To compare the diagnostic accuracy of different combination regimens of myocardial infarction markers in diagnosing acute myocardial infarction; and to estimate the effect of heart-type fatty acid-binding protein (H-FABP) in improving the diagnostic accuracy of the combinations. Methods Patients with acute onset of chest pain were included randomly. Serum concentrations of H-FABP and other biochemical markers for myocardial infarction (cTnI, Myo) were determined immediately, and then acute myocardial infarction (AMI) patients were defined according to the WHO criteria. ROC curves for three biochemical markers were established respectively, and the cutoff values of the three markers were determined accordingly. Three combination regimens of myocardial infarction markers for AMI diagnosis were designed: cTnI+Myo, cTnI+H-FABP, cTnI+H-FABP+Myo. Diagnostic accuracy of the three regimens were then calculated and compared. Results The AUCs for the three biochemical markers were AUCcTnI 0.938 (95%CI: 0.888-0.988), AUCMyo 0.743 (95%CI: 0.651-0.836), and AUCH-FABP 0.919 (95%CI: 0.873-0.964), respectively. AUCH-FABP was significantly larger than AUCMyo (Plt;0.01). The cutoff values of the three biochemical markers for diagnosing AMI were defined as CutoffcTnI 0.5 ng/mL, CutoffMyo 90 ng/mL, and CutoffH-FABP 5.7 ng/mL, respectively. The diagnostic accuracy of these markers and their combination regimens were calculated and presented as follows (cTnI, Myo, H-FABP, cTnI+Myo, cTnI+H-FABP, cTnI+Myo+H-FABP): sensitivity: 0.804, 0.674, 0.783, 0.957, 0.957 and 0.957; specificity: 0.966, 0.747, 0.954, 0.724, 0.92 and 0.724; diagnostic efficacy: 0.910, 0.722, 0.895, 0.805, 0.932 and 0.805, respectively. Compared with the combination of cTnI+H-FABP, the sensitivities of cTnI (Z=2.261, P=0.024), Myo (Z=3.497, Plt;0.001) and H-FABP (Z=2.478, P=0.013) were significantly lower; the specificities of Myo (Z=3.062, P=0.002), cTnI+Myo (Z=3.378, Plt;0.001) and cTnI+Myo+H-FABP (Z=3.378, Plt;0.001) were significantly lower; and the diagnostic efficacies of Myo (Z=4.528, Plt;0.001), cTnI+Myo (Z=3.064, P=0.002) and cTnI+Myo+H-FABP (Z=3.064, P=0.002) were significantly lower. Conclusion The combination regimen of cTnI+H-FABP which includes H-FABP as the sensitive marker seems to be more effective than the currently used combinations in diagnosing AMI in patients with acute onset of chest pain.
As precision medicine continues to gain momentum, the number of predictive model studies is increasing. However, the quality of the methodology and reporting varies greatly, which limits the promotion and application of these models in clinical practice. Systematic reviews of prediction models draw conclusions by summarizing and evaluating the performance of such models in different settings and populations, thus promoting their application in practice. Although the number of systematic reviews of predictive model studies has increased in recent years, the methods used are still not standardized and the quality varies greatly. In this paper, we combine the latest advances in methodologies both domestically and abroad, and summarize the production methods and processes of a systematic review of prediction models. The aim of this study is to provide references for domestic scholars to produce systematic reviews of prediction models.