ABSTRACT
Regeneration of rotator cuff tendon-bone interface is crucial in rotator cuff repair. The tendon-bone interface consists of four continuous and gradual regions: the tendon region, the unmineralized fibrocartilage region, the mineralized fibrocartilage region, and the bone region. The development and regeneration of various regions in the tendon-bone interface is regulated by growth factors, inorganic ions, mechanical stimulation, and hypoxic environment. Inspired by factors affecting the development and regeneration of the tendon-bone interface, many researchers have designed gradient scaffold systems that promote regionalized regeneration of the tendon-bone interface. The gradient distribution of these scaffolds includes inorganic ion gradients and growth factor gradients. According to different gradients of the scaffold system, osteogenesis, chondrogenesis and tendon differentiation of cells at the tendon-bone interface are promoted, and the healing of the tendon-bone is synchronously completed to realize the repair and regeneration of the rotator cuff tendon-bone interface. Current studies indicated that gradient multiphase scaffolds had high academic research value and guided significance for future clinical applications in the reconstruction of the tendon-bone interface. In this paper, the factors affecting the development and regeneration of the tendon-bone interface are reviewed, and the effects of these factors on osteogenesis, chondrogenesis and tendon formation of various regions in promoting rotator cuff tendon-bone interface repair are summarized. The properties and effects of reported gradient multiphase scaffolds for rotator cuff injury are discussed, including gradient scaffolds containing inorganic ions and growth factors. Finally, the problems and future development opportunities of gradient multiphase support in rotator cuff repair are summarized.
ABSTRACT
【Objective】 To investigate changes in thalamus structure and function and their associations with cognitive impairment in patients with amyotrophic lateral sclerosis (ALS). 【Methods】 3D high-resolution structural imaging and resting-state fMRI were applied in 78 ALS patients and 49 healthy volunteers. The shape of the thalamus was assessed using a vortex analysis and functional connectivity between the thalamus subregion and cortex was evaluated by a seed-based correlation analysis. Partial correlation analysis was used to evaluate the correlation between focal thalamus alterations and clinical assessments. 【Results】 Compared with the control group, vertex analysis showed significant atrophy in the prefrontal and temporal subregions of bilateral thalamus in the ALS group. Patients exhibited increased functional connectivity of motor-sensory ROI with the right motor cortex, of temporal ROI with the bilateral lateral occipital cortex, precuneus and right temporal subregion. In contrast, decreased function connectivity was found mainly between temporal ROI and paracingulate gyrus, left dorsomedial prefrontal lobe and left caudate. Partial correlation analysis showed that the functional connectivity of the precuneus, paracingulate cortex, left caudate nucleus and left prefrontal lobe was correlated with multiple cognitive performances. 【Conclusion】 Selective damage of thalamic structure and function in ALS plays an important role in cognitive and behavioral disorders.
ABSTRACT
【Objective】 To explore the characteristics of white matter degeneration in amyotrophic lateral sclerosis (ALS) patients with different onset and spreading patterns by using diffusion tensor imaging (DTI). 【Methods】 We enrolled 86 ALS patients and 44 healthy controls. The patients were divided into bulbar- and spinal-onset subgroups according to their onset site, as well as horizon, vertical, interpose/skip, and caudal-rostral subgroups based on the spreading direction of the involved regions. The white matter fiber tracts corresponding to the motor network were set as the region of interest. We used tract-based spatial statistics to evaluate differences between the above groups and the normal controls, with family-wise error (FWE) correction and P<0.05 as statistical significance. 【Results】 The white matter degeneration of ALS patients with bulbar onset was mainly limited to the corona radiation part of the corticospinal tract, while those with spinal onset showed extensive degeneration of corticospinal tract and corpus callosum Ⅲ area (FWE correction, P<0.05). In patients with horizontal and vertical dissemination, decreased integrity of the entire corticospinal tract was found, with patients in the latter group showed extra degeneration in the Ⅲ part of the corpus callosum. Restricted degeneration of the corticospinal tract within bilateral corona radiata was detected in patients with caudal-rostral and interposed/skip spreading pattens (FWE correction, P<0.05). 【Conclusion】 Different onset and disease spread patterns of ALS patients correspond to divergent brain degeneration patterns. The diagnosis, treatment, and management of ALS should fully consider the heterogeneity of the disease.
ABSTRACT
Pump thrombosis after ventricular assist device implantation is a major limiting factor in its long-term clinical application. Early identification and timely intervention for pump thrombosis complications are great important for the curative effect after ventricular assist device implantation. This paper summarizes the predictive factors and risk factors of pump thrombosis after ventricular assist device implantation, and discusses the monitoring of pump thrombosis.
ABSTRACT
Radiofrequency ablation concomitant with open-heart procedures is one of the most common surgical methods to treat organic heart disease complicated with atrial fibrillation .However, the recurrence of atrial fibrillation still bothers both doctors and patients.There are different views on the main factors influencing the long-term effects of sinus rhythm maintenance after ablation.We reviewed past related clinical observations and researches to summarize the factors influencing recurrence of long-term atrial fibrillation after radiofrequency ablation concomitant with open-heart procedures.
ABSTRACT
Objective To explore the efficacy and clinical value of texture analysis of conventional MRI image for the preoperative classification of meningiomas. Methods The MR images of 101 meningioma cases were retrospectively analyzed, all of them underwent routine MRI before operation, and confirmed by surgery and pathology,of whom 81 cases in WHO Ⅰ,19 cases in Ⅱand 1 case in Ⅲ.The maximum diameter of the tumor in MRI images was outlined as ROI by the Image J software.The histograms and grey-level co-occurrence matrix(GLCM)were used to measure the texture parameters,such as maximum value,minimum value,standard deviation(SD),skewness,kurtosis,angular second moment,contrast,inverse different moment, entropy, correlation and so on, and compared with postoperative pathological grading results.The independent sample t test or the Mann-Whitney U test was used to compare the difference of the histogram and the gray level co-occurrence matrix parameter of the MRI images between low-grade and high-grade meningiomas. ROC curves for statistically significant parameters were used to confirm their efficacy in predicting the preoperative grade of meningiomas.Results (1)In histogram parameters,the SDs of T2WI,FLAIR,ADC(SDT2WI,SDFLAIR,SDADC)of low grade meningioma were 14.764(10.928,17.932),9.753 (7.385,13.618) and 12.171 (9.138,19.691), the high grade meningiomas were 19.252 (13.580,25.715), 13.568 (8.936,17.108) and 16.636 (13.166,21.498), respectively. The difference between the two groups was statistically significant(Z values were-2.863,-2.250,-2.247,P respectively 0.004,0.024,0.025).The skewness values (SkeADC, SkeFLAIR) of ADC sequence and FLAIR sequence of low-grade meningiomas were 1.377 ± 1.172 and-1.327 ± 0.930, respectively, and the high-grade meningiomas were 2.503 ± 1.613 and-0.827±0.834,respectively.The differences between the two groups were statistically significant (t values were-2.196,-3.129, P values were 0.002,0.030, respectively). (2) In the GLCM parameters, entropy (EntT1WI, EntT2WI, EntFLAIR, EntADC) of the enhanced T1WI, T2WI, FLAIR and ADC sequences of low grade meningiomas were 6.881(6.174,7.305),6.534±0.598,6.019±0.588,6.040±0.588,high-grade meningiomas were 7.079 (6.742,7.739), 7.014 ± 0.514,6.370 ± 0.703,6.576 ± 0.450, respectively. And the difference between the two groups was statistically significant (Z=-2.007, t values were-3.294,-2.327,-3.245, P values were 0.045,0.001,0.022,0.002,respectively).(3)The ROC curves of EntADCand SkeADCwere plotted, and the area under the curve(AUC)was 0.768 and 0.710,respectively.Combined EntADC,SkeADCand EntT2WI were the best for the classification of meningiomas,and AUC was 0.799.Conclusion Texture analysis can provide more quantification information, which can be more accurately distinguishing high grade meningiomas and low grade meningiomas before surgery.