Value of endoscopic ultrasound elastography versus contrast-enhanced computed tomography in the diagnosis of gastrointestinal stromal tumors / 中国基层医药

Objective:To investigate the clinical value of endoscopic ultrasound elastography versus contrast-enhanced computed tomography in the risk stratification of gastrointestinal stromal tumors (GISTs). Methods:Clinical and imaging data were obtained from 77 patients who were confirmed to have GISTs and underwent endoscopic or surgical treatment at Wenzhou Central Hospital between May 2019 and April 2021. Endoscopic ultrasound elastography based on a five-point scoring system and hypotonic gastrointestinal contrast-enhanced computed tomography were performed for preoperative risk stratification of GISTs. The two techniques were compared in terms of the accuracy of preoperative risk stratification of GISTs. The imaging features of the two techniques were summarized.Results:According to the postoperative pathological results, 13 patients were at high risk, 13 patients were at medium risk, 35 patients were at low risk, and 16 patients were at extremely low risk. These patients were divided into two groups according to postoperative pathological results: a low-risk group (low risk + extremely low risk) and a medium- and high-risk group (high + medium risk). In the low-risk group ( n = 51), 42 patients were identified by endoscopic ultrasound elastography to have low-risk GISTs and were recommended to receive endoscopic treatment, while the rest 9 patients were identified to have medium-risk GISTs. Contrast-enhanced computed tomography findings revealed that 30 patients had low-risk GISTs and were recommended to receive endoscopic treatment, and 21 patients had medium-risk GISTs. In the medium- and high-risk group ( n = 26), 4 patients were identified by endoscopic ultrasound elastography to have low-risk GISTs, and 22 patients had medium- or high-risk GISTs. Contrast-enhanced computed tomography findings revealed that 9 patients were identified to have low-risk GISTs, and 17 patients had medium- or high-risk GISTs. Endoscopic ultrasound elastography yielded an overall diagnostic accuracy of 83.11% (64/77), while contrast-enhanced computed tomography had an overall diagnostic accuracy of 61.04% (47/77). Endoscopic ultrasound elastography outperformed contrast-enhanced computed tomography in accurate risk stratification of GISTs ( χ2 = 4.66, P < 0.05). In terms of predicting high-risk GISTs, endoscopic ultrasound elastography had a sensitivity of 84.62% and a specificity of 82.35%, both were higher than those of contrast-enhanced computed tomography (sensitivity: 65.38%; specificity: 58.82%), but the differences in sensitivity and specificity between the two techniques were not significant (sensitivity: Fisher's exact test P = 0.590, specificity: χ2 = 0.93, P > 0.05). Conclusion:Endoscopic ultrasound elastography appears to have a better overall diagnostic accuracy in the risk stratification of GISTs compared with contrast-enhanced computed tomography. The combined use of these two techniques may offer a better comprehensive understanding of the perilesional structure and organ involvements and distant metastasis than a single technique, thereby providing a reliable reference for the choice of treatment for GISTs.

Exploratory study on noninvasive evaluation of renal histopathology by ultrasonic shear wave elastography / 中华肾脏病杂志

Objective:To determine a relationship between ultrasound shear wave elastography (SWE) and pathological lessions of renal tissues in children with chronic kidney disease (CKD).Methods:It was a cross-sectional observational study, involving children admitted to the Department of Pediatrics of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to December 2021 with definite pathological diagnosis through kidney biopsy. The SWE was used to determine the Young's modulus (elastic modulus) of the cortex and medulla of the upper, middle, and lower poles of the kidney. The renal histopathology was classified or graded. The statistical method was used to analyze the relationship between Young's modulus of the inferior polar cortex (YM cor) and medulla (YM med) of the right kidney and renal pathology. Results:The study included 110 children with definite pathological diagnosis through renal biopsy, aged (10.1±3.4) years old (2-17 years old), with 55 males (50.0%). The body mass index was (20.6±2.4) kg/m 2, and mean arterial pressure was (95±24) mmHg. There were 94 patients (85.4%) with CKD stage 1, 8 patients (7.3%) with CKD stage 2, and 8 patients (7.3%) with CKD stage 3. There was no significant difference of YM cor and YM med in the upper and middle poles of the right kidneys, and YM med in the lower poles of right kidneys in CKD patients with different stages (all P>0.05). Both YM cor [(15.75±3.36) kPa] and YM med [(13.50±2.43) kPa] of CKD stage 3 patients were significantly higher than those of CKD stage 1 patients [(12.94±2.45) kPa, (11.88±2.23) kPa](both P<0.05). There was no significant difference of YM cor and YM med in the lower poles of right kidneys between stage 1 and stage 2 CKD patients (both P>0.05). YM cor[(17.93±3.23) kPa] and YM med [(15.50±1.48) kPa] in patients with crescentic glomerulonephritis were higher than those in patients with focal segmental glomerulosclerosis [(12.71±2.42) kPa, (11.57±2.63) kPa] and mesangial proliferative glomerulonephritis [(12.73±2.04) kPa, (11.48±2.10) kPa](all P<0.05). There was no significant difference of YM cor and YM med between focal segmental glomerulosclerosis and mesangial proliferative glomerulonephritis (both P>0.05). YM cor [(16.30±2.63) kPa] and YM med [(15.54±1.59) kPa] of Lee's Ⅳ grade of IgA nephropathy were higher than those of Lee's Ⅲ grade [(13.32±2.70) kPa, (12.57±2.50) kPa](both P<0.05), while the International Study of Kidney Disease in Children grade of purpura nephritis had no significant correlation with YM cor and YM med (both P>0.05). YM cor [(15.41±2.37) kPa] and YM med [(13.82±2.59) kPa] of interstitial fibrosis/tubular atrophy (T1/T2) group of IgA nephropathy mixed with purpura nephritis were significantly higher than those of T0 group's [(12.99±2.40) kPa, (11.79±2.05) kPa] (both P<0.05). Moreover, crescent formation (C1) group had a higher YM cor [(14.21±2.77) kPa] and YM med [(12.80±2.47) kPa] than those in C0 group [(12.73±2.15) kPa, (11.59±1.97) kPa] (both P<0.05), while YM cor and YM med were unrelated to the mesangial hypercellularity (M), endocapillary cellularity (E), segmental sclerosis or adhesion (S) indicators (all P>0.05). In lupus nephritis patients, YM cor ( r=0.744, P=0.035) and YM med ( r=0.728, P=0.009) were favorably linked with the chronic index, but not with the activity index (both P>0.05). Conclusions:Renal interstitial fibrosis/tubular atrophy and crescentic development are connected with YM cor and YM med at the lower pole of the kidney as measured by SWE. SWE can be used to assess the chronic renal lesions in children with CKD in the early and middle stages. It may develop into a new noninvasive way to assess renal pathology.

Adventitial Collagen Cross-Linking by Glutaraldehyde Reinforcing Human Saphenous Vein - Implication for Coronary Artery Bypass Grafting

ABSTRACT Introduction: A weak venous wall is one of the major reasons contributing to vein graft failure after coronary artery bypass grafting (CABG). We investigated whether adventitial collagen cross-linking by glutaraldehyde reinforces venous wall, preserving the endothelium of veins during high-pressure distention. Methods: Human saphenous veins (SVs) were collected from 40 patients undergoing CABG, and adventitia cross-linking was performed with 0.3% glutaraldehyde for five minutes. The cross-linked SVs were accessed by biodegradation assay, immunofluorescent staining, and tensile test. Native SVs and cross-linked SVs from another 20 patients received the 200 mmHg pressure distention for two minutes. Pressure-induced injury of SVs were accessed by immunohistochemistry and electron microscopy. Results: Time to digestion was 97±13 minutes for native SVs and 720±0 minutes for cross-linked SVs (P<0.05). After adventitial cross-linking, the collagen I fibres of the vein remarkably presented with compact and nonporous arrangement. In the high-stretch region (stretch ratio 1.4-1.8), the Young's elastic modulus of stress-stretch ratio curve in cross-linked SVs was larger than that in native SVs (13.88 vs. 5.83, P<0.05). The cross-linked SVs had a lower extent of endothelial denudation without fibre fracture during high-pressure distension than native SVs. Comparing with the non-cross-linked SVs, the percentage of endothelial nitric oxide synthase staining length on the endothelium of cross-linked SVs was significantly preserved after high-pressure distension (85.2% vs. 64.7%, P<0.05). Conclusion: Adventitial collagen cross-linking by glutaraldehyde reinforced venous wall by increasing stiffness and decreasing extensibility of SVs and mitigated the endothelial damage under high-pressure distension.

Eye bank versus surgeon prepared Descemet stripping automated endothelial keratoplasty tissues: Influence on adhesion force in a pilot study

Purpose: To evaluate and compare the biomechanical properties of the eye bank?prepared and surgeon prepared Descemet stripping automated endothelial keratoplasty (DSAEK) tissues. Methods: In this laboratory study, corneal tissues for research were randomly allocated in the following groups: a) surgeon?cut DSAEK and b) eye bank?prepared (pre?cut and pre?loaded) DSAEK. Endothelial cell loss (ECL), immunostaining for tight junction protein ZO?1, elastic modulus, and adhesion force were investigated. Results: ECL was not found to be significantly different between surgeon?cut DSAEK (7.8% ±6.5%), pre?cut DSAEK (8.6% ±2.3%), and pre?loaded DSAEK (11.1% ±4.8%) (P = 0.5910). ZO?1 was expressed equally across all groups. Surgeon?cut DSAEK grafts showed a significantly higher elastic modulus compared to pre?cut and pre?loaded DSAEK groups (P = 0.0047 and P < 0.0001, respectively). Adhesion force was significantly greater in the surgeon?cut DSAEK compared to pre?cut (P < 0.0001) or pre?loaded DSAEK groups (P = 0.0101). Conclusion: The laboratory data on the biomechanics of DSAEK grafts suggests that surgeon?cut DSAEK grafts present higher elastic modulus and adhesion force compared to eye bank?prepared DSAEK grafts.

Finite Element Analysis and Clinical Research Progress of Tympanic Membrane Perforation and Tympanic Membrane Repair Materials / 医用生物力学

Tympanic membrane perforation is one of the common diseases in otolaryngology. The main causes of tympanic membrane perforation are otitis,trauma and etc. With the rapid development of finite element analysis method, this method is applied to clinical evaluation of tympanic membrane perforation and repair materials. By establishing the finite element model of the middle ear, the characteristics of tympanic membrane perforation and tympanic membrane repair materials were analyzed from the biomechanical aspect, with combination of clinical application results. In this review, the finite element analysis and clinic research progress of tympanic menbrane perforation and tympanic membrane repair materials were summarized.

Mechanical Properties of Calcification from Human Aortic Valve / 医用生物力学

Objective To measure mechanical properties of calcified tissues from human aortic valve by nanoindentation test. Methods Leaflets from 5 patients with aortic stenosis were collected. Elastic modulus and hardness of the calcified leaflets were obtained by nanoindentationtest. Results The elastic modulus and hardness of the calcified leaflets were (15.69±3.89) GPa and (0.59±0.15) GPa, respectively. Conclusions The elastic modulus and hardness of the calcified valve tissues can be obtained by nanoindentationtest, which provides experimental data for biomechanical research of the valve.

Effects of Liquid Medium Environment on Elastic Modulus of Breast Cancer Cells / 医用生物力学

Objective To study the effect of three kinds of commonly used liquid culture media for in vitro cell experiments on elastic modulus of breast cancer cells, so as to provide references for developing novel diagnosis and treatment approach of tumour based on mechanics principles. Methods The elastic modulus and adhesion force of breast cancer cells MCF7 to atomic force microscopy (AFM) probes in phosphate buffered solution(PBS), Dulbecco’s modified eagle media (DMEM) and DMEM+10% fetal bovine serum (FBS) were measured using AFM technology. Results The elastic moduli of breast cancer cells in PBS, DMEM and DMEM+10% FBS were 2.59, 2.11 and 1.59 kPa, respectively. The cell adhesion forces in the above three kinds of liquid medium environment were 63.81, 66.09 and 121.97 pN, respectively. Cell adhesion force in DMEM+10%FBS was significantly different from that of the other two kinds of liquid media. Conclusions There are significant differences in elastic modulus of breast cancer cells in three kinds of liquid media. The difference between DMEM and DMEM+10%FBS might be caused by the different adhesion force caused by serum proteins in the media, and the difference between DMEM and PBS might be attributed to the difference in pH of the media.

Preparation and characterization of dissolving microneedles with nano-enhanced mechanical properties / 药学学报

In this paper, the effects of the blend of nanoparticles and microneedle matrix materials on the mechanical properties of dissolving microneedles were studied mainly, so as to construct microneedles with excellent mechanical properties. Different kinds of nanoparticles (calcium carbonate, hydroxyapatite, silica), particle sizes (20, 60, 100 nm) and the proportion of prescription (2%, 6%, 10%) were blended with the matrix material [polyvinyl pyrrolidone (PVP), poly(1-vinylpyrrolidone-co-vinyl acetate)(PVP/VA)] to form dissolving microneedles. The effects of nanoparticles on the elastic modulus and hardness of the microneedles were investigated using a nanoindenter. The results showed that the elastic modulus and hardness of PVP microneedles were significantly improved by nano-calcium carbonate (P < 0.001), and the elastic modulus and hardness of PVP/VA microneedles were significantly improved by nano-hydroxyapatite (P < 0.001). When the particle size of hydroxyapatite was 20 nm, the elastic modulus of PVP/VA microneedles was (10.6 ± 1.0) GPa, and the hardness was (0.47 ± 0.06) GPa. As the size of the nanoparticles increases, the mechanical performance of the microneedles decreases. When the mass proportion of nano-hydroxyapatite increased from 2% to 6%, the elastic modulus and hardness of the microneedles were significantly improved (P < 0.001), but the effect of continue increasing the proportion of nanoparticles on the microneedles was not significant. The nano-enhanced PVP/VA dissolving microneedles has no irritant effect on intact skin and has a slight irritation to damaged skin, but they disappear completely after 72 h. Animal experiments have been approved by the Laboratory Animal Welfare and Ethics Committee of Zhejiang University of Technology. Therefore, the nano-enhanced dissolving microneedles has good biological safety. To sum up, it is necessary to select the appropriate kind of nanoparticle, particle size, and prescription ratio when microneedles constructing with a given matrix material, so as to effectively improve its mechanical performance.

Prediction Method of Elastic Modulus of Trabecular Bone Based on SE-DenseVoxNet / 中国医疗器械杂志

Osteoporosis is one of the common metabolic diseases, which can easily lead to osteoporotic fractures. Accurate prediction of bone biomechanical properties is of great significance for the early prevention and diagnosis of osteoporosis. Bone mineral density measurement is currently used clinically as the gold standard for assessing bone strength and diagnosing osteoporosis, but studies have shown that bone mineral density can only explain 60% to 70% of bone strength changes, and trabecular bone microstructure is an important factor affecting bone strength. In order to establish the connection between trabecular bone microstructure and bone strength, this paper proposes a prediction method of trabecular bone modulus based on SE-DenseVoxNet. This method takes three-dimensional binary images of trabecular bone as input and predicts its elastic modulus in the z-axis direction. Experiments show that the error and bias between the predicted value of the method and the true value of the sample are small and have good consistency.

Effect of antioxidant agents after dental bleaching on luting of ceramic laminates / Efeito de agentes antioxidantes pós-clareamento na cimentação de laminados cerâmicos

O objetivo deste estudo in vitro foi avaliar o efeito da aplicação de agentes antioxidantes após o clareamento dentário e previamente à cimentação de laminados cerâmicos na estabilidade cromática do conjunto restaurador, assim como nas propriedades mecânicas de nanodureza (HIT), módulo de elasticidade (Eit*), grau de conversão, resistência de união e morfologia da interface adesiva. Ademais, a neutralização de peróxido de hidrogênio e a caracterização superficial do esmalte, como ângulo de contato, energia de superfície, energia livre total de interação, microscopia eletrônica de varredura e espectroscopia de energia dispersiva do substrato submetido à ação das soluções antioxidantes e do agente clareador também foram analisados. Duzentos e quarenta e dois blocos de esmalte dentário (7x8x0,6mm) foram utilizados para o processo de cimentação e distribuídos em grupos experimentais de acordo com os métodos de procedimentos (grupo não clareado, grupo clareado com Whiteness HP Maxx 35%), tipos de antioxidantes adotados (controle; ácido ascórbico 10% e α-tocoferol 10%) e períodos de cimentação (após 24 horas e 14 dias do processo de cimentação) (n = 22). Foi utilizado o sistema adesivo Tetric N Bond Universal e o cimento resinoso Variolink Esthetic LC (Ivoclar Vivadent) como agentes cimentantes. Os dados foram submetidos a testes estatísticos de normalidade e analisados por ANOVA e teste de Tukey (α = 0,05). Os dados da morfologia da interface adesiva, obtidas pela microscopia confocal a laser, foram submetidas ao teste Kappa inter-examinadores e os dados foram submetidos aos testes Kruskal-Wallis e Dunn (α = 0,05). Os resultados mostraram que, de modo geral, a utilização da solução antioxidante α-tocoferol 10% pós-clareamento no período mediato promoveu resultados satisfatórios com relação à estabilidade cromática do conjunto restaurador, assim como para as propriedades mecânicas, grau de conversão, resistência de união e morfologia da interface adesiva comparado ao grupo clareado sem associação dos agentes antioxidantes, tanto para o período mediato, quanto para o período de 14 dias (p< 0,05). A solução de αtocoferol 10% apresentou maiores valores de neutralização do peróxido de hidrogênio e maiores valores de molhabilidade do esmalte em relação aos grupos controle e ácido ascórbico (p< 0,05). A energia de superfície e energia livre total de interação do esmalte dentário foi significativamente influenciada pelo tratamento clareador (p< 0,05). Dessa forma, conclui-se que o emprego da solução antioxidante α-tocoferol 10% promoveu resultados promissores, sugerindo que o mesmo poderia ser utilizado mediatamente após o clareamento dental na cimentação de laminados cerâmicos(AU)

The aim of this in vitro study was to evaluate the effect of antioxidant agents application after tooth bleaching and prior to luting of ceramic veneers on color stability of the restorative set, as well as on mechanical properties of nanohardness (HIT), elastic modulus (Eit*), degree of conversion, bond strength and morphology of the adhesive interface. Furthermore, the hydrogen peroxide neutralization and surface characterization of enamel, such as contact angle, surface energy, total free energy of interaction, scanning electron microscopy and energy-dispersive spectroscopy of the substrate submitted to the action of antioxidant solutions and bleaching agent were also analyzed. Two hundred forty two dental enamel blocks (7 x 8 x 0.6 mm) were used for the luting process and distributed into experimental groups according to the procedure methods (unbleached group, bleached group with Whiteness HP Maxx 35%), types of antioxidants adopted (control; 10% ascorbic acid and 10% α-tocopherol) and the luting periods (24 hours and 14 days after the luting process) (n = 22). Tetric N Bond Universal adhesive system and Variolink Esthetic LC resin cement (Ivoclar Vivadent) were used as luting agents. Data were submitted to statistical tests of normality and analyzed by ANOVA and Tukey tests (α = 0.05). The adhesive interface morphology data, obtained by confocal laser microscopy, were submitted to the interexaminer Kappa test and the data were submitted to Kruskal-Wallis and Dunn´s tests (α = 0.05). The results showed that, in general, the use of 10% α-tocopherol antioxidant solution after bleaching in mediate period promoted satisfactory results regarding the color stability of the restorative set, as well as for the mechanical properties, degree of conversion, shear bond strength and adhesive interface morphology compared to the bleached group without antioxidant agents association, both for the mediate and 14-day period (P < 0.05). The 10% αtocopherol solution showed higher hydrogen peroxide neutralization values and higher enamel wettability values compared to the control and ascorbic acid groups (P < 0.05). Surface energy and total free energy of interaction of tooth enamel were significantly influenced by the bleaching treatment (P < 0.05). Thus, it is concluded that the use of 10% αtocopherol antioxidant solution promoted promising results, suggesting that it could be used mediately after tooth bleaching on luting of ceramic laminates(AU)

In vitro biocompatibility of 3D printed polycaprolactone/nano-hydroxyapatite composite scaffold with bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND: Polycaprolactone/nano-hydroxyapatite composite is a new composite scaffold material prepared based on common bone tissue engineering materials using 3D printing technology. At present, little is reported on the in vitro biocompatibility of the composite material. OBJECTIVE: To investigate the cytocompatibility of 3D printed polycaprolactone/nano-hydroxyapatite composite scaffolds. METHODS: Polycaprolactone and polycaprolactone/nano-hydroxyapatite composite scaffolds were prepared by 3D printing technology to characterize the microstructure, porosity and mechanical properties of the two materials. Rat bone marrow mesenchymal stem cells were inoculated on the surface of the 3D-printed polycaprolactone and polycaprolactone/nano-hydroxyapatite composite scaffolds. Cell proliferation rate was detected by CCK-8 method. Cell growth on the scaffolds was observed by scanning electron microscopy and Live/Dead cell staining. RESULTS AND CONCLUSION: Two kinds of scaffolds had a three-dimensional network and interconnected structure. The fibers were arranged in a regular order and interlaced. There was no gap on the fiber surface, and the fiber spacing and diameter were relatively uniform. There was no significant difference in the porosity between two kinds of scaffolds (P > 0. 05). The elastic modulus of the composite scaffold was higher than that of the simple polycaprolactone scaffold (P < 0. 05). There was no significant difference in cell proliferation between two kinds of scaffolds after 1 day of culture. After 4 and 7 days of culture, cell proliferation on the composite scaffold was significantly faster than that on the simple polycaprolactone scaffold (P < 0. 05). Live/Dead cell staining showed that both polycaprolactone and polycaprolactone/nano-hydroxyapatite composite scaffolds had good cytocompatibility and high cell viability. A larger number of cells adhered to the polycaprolactone/nano-hydroxyapatite composite scaffolds. Scanning electron microscopy showed that cells grew well on two kinds of scaffolds and distributed on the surface and micropores of the scaffold. The secreted extracellular matrix appeared in filaments and surrounded the cells. These findings suggest that the polycaprolactone/nano-hydroxyapatite composite material prepared by 3D printing technology has abundant pores, exhibit good mechanical properties, and have good cytocompatibility and can be used as a scaffold material for tissue engineering.

Mechanical properties and cytoskeletal protein changes after anln deficiency / 中国组织工程研究

BACKGROUND: To date, ANLN has definite roles in altering cell shape, regulating cell-cell junction integrity in interphase and stabilizing actomyosin contractile rings in cytokinesis, but its effects on cell mechanical properties and on cytoskeletal proteins have rarely been reported. OBJECTIVE: To investigate the effect of ANLN deletion on the mechanical properties and cytoskeleton of interphase Hela cells. METHODS: Surface elastic modulus and membrane rupture force of normal untreated Hela cells and ANLN RNA stably knocked down Hela cells were measured by atomic force microscopy. We screened for the cells that stably expressed mCherry-Myosin II A, and observed the distribution characteristics of cytoskeletal proteins by laser scanning confocal microscopy. RESULTS AND CONCLUSION: (1) The elastic modulus of Hela cells with ANLN stably knocked down was significantly higher than that of normal Hela cells, and the elastic modulus of normal cells were more prone to polar distribution (gradually decreasing between the two poles) than that of ANLN knockdown Hela cells. However, there was no significant difference in the membrane rupture force at the long-axis edge region between the two groups. (2) Myosin IIA lowly expressed in the marginal region of ANLN knockdown cells. (3) The actin fibers tended to be scattered in the near-bottom cell-cell junction region of the ANLN knockdown group, and there were no obvious intracellular fibers bundles arranging along the long axis. The cell gap tended to enlarge in the middle layer. To conclude, ANLN knockdown cells have the greatest impact in the marginal region, the deficiency of ANLN leads to a more frequent remodeling in the cell marginal region, and the cells need to accumulate more cytoskeletal proteins and binding proteins to stabilize the cell state, resulting in higher modulus of elastics.

Structure and mechanical properties of high- and low-weight-bearing areas of hip cartilage at micro and nano levels / 中国组织工程研究

BACKGROUND: Articular cartilage has a high-weight-bearing area and a low-weight-bearing area. There are different macroscopic elastic moduli in the two regions, but the modulus of the two areas at the micro and nano levels is unknown. Such information is important for further understanding of cartilage micro and nano mechanics. Moreover, the micro and nano structures of the two areas, which influence the cartilage mechanical properties, should be discussed. OBJECTIVE: To investigate the mechanical properties and structure of high- and low-weight-bearing areas of the hip articular cartilage at the micro and nano levels. METHODS: Normal porcine femoral head cartilage was used. Atomic force microscopy with a spherical tip of 5 µm in diameter was used to measure the microscale compressive elastic modulus of different weight-bearing areas of the cartilage. The nanoscale compressive elastic modulus, nano structure, and collagen fiber diameter were measured using a ScanAsyst-Air probe with a radius of curvature of 5 nm. Scanning electron microscopy was employed to identify the microstructure of different weight-bearing areas of the cartilage. RESULTS AND CONCLUSION: The microscale elastic modulus of the high-weight-bearing area of the femoral head cartilage was (433.05±146.52) kPa, and the microscale elastic modulus of the low-weight-bearing area was (331.19±84.88) kPa. The nanoscale elastic modulus of the high- and low-weight-bearing areas of the femoral head cartilage was (1.24±0.42) GPa and (1.28±0.41) GPa, respectively. While no statistically significant differences were found in the elastic modulus of collagen fibers at the nano level (P=0.846 2). The collagen fibers of the high-weight-bearing area arranged more regularly than those of the low-weight-bearing area at the micro level. No significant differences between collagen fiber diameter of the two areas at the nano level were observed (P=0.926 4). To conclude, the collagen fibers of the high-weight-bearing area are cross-linked more regularly than those of low-weight-bearing area. Therefore, the compressive elastic modulus of the high-weight-bearing area at the micro level is significantly higher than that of the low-weight-bearing area, which is consistent with the macroscopic compressive elastic modulus trend. However, high-weight-bearing has no impact on individual collagen fibers at the nano level.

Study on mixing technology of post-crosslinking Daphnes Giraldii Cortex gel plaster based on rheological indexes / 中草药

Objective: To optimize the mixing technology of Daphnes Giraldii Cortex gel plaster (DGCGP) by using rheological parameters elastic modulus (G'), viscous modulus (G″), yield stress (τ0), creep compliance [J(t)] and loss coefficient (tanδ) as evaluation indexes. Methods: Using orthogonal design, L9(34) orthogonal design was used to screen out the best mixing technology of DGCGP and predict the suitable coating conditions by taking the temperature, rotating speed and mixing time of the mixed materials as influencing factors and the rheological parameters of the medicated compound as evaluating indexes. Results: The optimum DGCGP mixing process was as following: 70℃ at 10 r/min for 2 h. Under this condition, the viscoelasticity, temperature and shear resistance, deformation resistance and stability of the mixture were all good. Conclusion: DGCGP prepared by this optimized process had good appearance, soft texture, good adhesion with skin, good viscoelasticity and better quality.

Application Value of Transrectal Shear Wave Elastography Mode Combined with Elastic Modulus in the Diagnosis of Prostate Cancer / 中国医学科学院学报

To explore the value of trans-rectal shear wave elastic mode combined with elastic modulus in the diagnosis of prostate cancer and establish a new method for the evaluation of prostate with trans-rectal shear wave elastography(SWE). The typical findings of trans-rectal ultrasound(US)and SWE in 79 patients with prostate cancer(=41)and benign prostatic hyperplasia(BPH)(=38)confirmed by surgery or US-guided biopsy were analyzed retrospectively.Their diagnostic value were evaluated with the pathological results as the golden standards. Three or more malignant features detected by conventional trans-rectal US(=42.5,<0.001)and asymmetrical SWE mode(=54.2,<0.001)showed statistically significant difference in prostate cancer and BPH groups.The elastic modulus of Emean and Emax in the prostate cancer group were(92.8±21.5)and(114.2±29.8)kPa,which were significantly higher than those in the BPH group [(56.7±14.0)(=-8.8,<0.001)and(68.4±17.2)kPa(=-8.3,<0.001)].The receiver-operating characteristic(ROC)curve with Logistic regression showed that the elastic model combined elastic modulus had the largest area under ROC curve and the highest diagnosis efficiency of prostate cancer,with the cutoff value of 0.45.The diagnosis sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the combination were 95.1%,89.5%,90.7%,94.4%,and 92.4%,respectively. Combination of SWE mode and elastic modulus is more valuable than elastic modulus alone in the diagnosis of prostate cancer.

Correlation between Biomechanical Changes at the End of Left Ventricular Systole and Pathogenesis of Diastolic Heart Failure / 医用生物力学

Objective To analyze the correlation of the maximum myocardial stiffness (maxEav), maximum modulus of elasticity (Emax) with the E/A ratio of mltral annulus at the end of left ventricular systole for patients with essential hypertension. Methods 298 patients with essential hypertension were selected as research objects. The left ventricular mass index (LVMI) and relative wall thickness (RWT) of the patients were calculated. Based on LVMI and RWT indexes, the patients were divided into left ventricular normal (LVN) group, left ventricular concentric remodeling (LVCR) group, left ventricular eccentric hypertrophy (LVEH) group, left ventricular concentric hypertrophy (LVCH) group, respectively. In addition, 115 healthy subjects were selected into control group. The subjects were diagnosed by echocardiography, so as to analyze the correlation of maxEav, Emax with E/A. Results The maxEav, Emax and E/A in LVCR group, LVEH group and LVCH group were all negatively correlated. The differences of E/A between LVCR group, LVCH group and control group showed statistical significance. Compared with control groups, both the maxEav and Emax in hypertension group decreased, and the difference was statistically significant. Conclusions The maxEav and Emax are more sensitive and easy indexes to judge left ventricular diastolic function. The analysis on maxEav and Emax changes in patients with left ventricular remodeling and diastolic dysfunction in hypertension, as well as the exploration on pathogenesis of diastolic heart failure, can provide the theoretical basis for prevention and treatment of diastolic heart failure in the future.

Research progresses of ultrasound elastography evaluation on post-stroke spasticity / 中国医学影像技术

Ultrasonic elasticity (UE) is a new type ultrasonic diagnosis technology able to directly measure elastic modulus and reflect muscle stiffness,which has gradually been applied to quantitatively evaluate the degree of post-stroke spasticity (PSS) and guide treatment. The research progresses of UE for evaluation PSS were reviewed in this article.

Increased elastic modulus of the synovial membrane in a rat ACLT model of osteoarthritis revealed by atomic force microscopy

This study aimed to explore changes in nanoscale elastic modulus of the synovium using atomic force microscopy (AFM) in addition to investigate changes in synovial histomorphology and secretory function in osteoarthritis (OA) in a rat anterior cruciate ligament transection (ACLT) model. Sprague-Dawley rats were randomly assigned to sham control and ACLT OA groups. All right knee joints were harvested at 4, 8, or 12 weeks (W) after surgery for histological assessment of cartilage damage and synovitis in both the anterior and posterior capsules. AFM imaging and nanoscale biomechanical testing were conducted to measure the elastic modulus of the synovial collagen fibrils. Immunohistochemistry was used to visualize the expression of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase-3 (MMP-3) in the synovium. The OA groups exhibited progressive development of disease in the cartilage and synovium. Histopathological scores of the synovium in the OA groups increased gradually. Significant differences were observed between all OA groups except for the posterior 4W group. The synovial fibril arrangement in all OA groups was significantly disordered. The synovial fibrils in all ACLT OA groups at each time point were stiffer than those in the sham controls. OA rats displayed a significantly higher expression of IL-1β and MMP3 in the anterior capsule. In summary, synovial stiffening was closely associated with joint degeneration and might be a factor contributing to synovitis and increased production of proinflammatory mediators. Our data provided insights into the role of synovitis, particularly stiffening of the synovium, in OA pathogenesis.

Advances on research of physical environment affecting stem cell differentiation in ligament tissue engineering / 中国骨伤

Ligament tissue engineering is currently a novel approach to the treatment of ligament injury, which can replace the deficiency of autografts. Ligament tissue engineering consists of four basic elements:seed cells, nanoscaffolds, growth factors, and mechanical stimulation. At present, the main problem in ligament tissue engineering is how to control seed cells to ligament cells more controllly. The study found that each physical property of the natural bio ligament and mechanical stimulation (uniaxial stretching) plays an important role in the differentiation of stem cells into ligament cells. Therefore, the design of nanofiber scaffolds must consider the elastic modulus of the material and the material. Structure(material arrangement, porosity and diameter, etc.), elastic modulus and material structure in different ranges will guide cells to differentiate into different lineages. Considering that the ligament is the main force-bearing tissue of the human body, mechanical stimulation is also essential for stem cell differentiation, especially uniaxial stretching, which best meets the stress of the ligament in the body. A large number of studies have found the frequency and amplitude of stretching. And time will also lead the cells to differentiate in different directions. RhoA/ROCK plays a regulatory role in cytoskeletal remodeling and cell differentiation. It is also found that RhoA/ROCK protein participates in the process of nanofiber arrangement and uniaxial stretching to guide stem cells to differentiate into ligament cells, specifically how to influence stem cell differentiation. It is not clear at present that understanding the effects of physical properties on stem cell differentiation and understanding the mechanism of action of RhoA/ROCK protein will provide a new theoretical basis for further optimization of ligament tissue engineering.

Clorexidina melhora as propriedades mecânicas da dentina radicular / Chlorhexidine improves the mechanical properties of root dentin

Objetivo: avaliar a resistência máxima à flexão (MFS), módulo de elasticidade (E), microdureza Knoop (KHN) e rugosidade de superfície (Ra) da dentina radicular tratada com solução de clorexidina a 2% (CHX). Métodos: foram selecionados 50 incisivos bovinos com ápice fechado, e trinta raízes foram cortadas em barras de dentina (DB) e divididas em três grupos (n = 10): Controle (sem tratamento), G1 (NaOCl 2,5% + EDTA 17%) e G2 (CHX 2% + H2O). As DB foram submetidas ao ensaio de resistência flexural de três pontos, para se obter os valores de MFS e E. Vinte raízes foram cortadas longitudinalmente ao meio e inseridas em resina acrílica; as superfícies pulpares foram lixadas e polidas e, em seguida, irrigadas de acordo com o grupo (G1 ou G2; n = 20 metades por grupo) e submetidas aos testes de KHN e Ra. Foi realizada análise de MEV. Os dados foram analisados por meio dos testes de ANOVA de um e dois critérios, seguidos do teste de Tukey (α = 0,05). Resultados: os valores de MFS (p < 0,05) e E (p < 0,01) foram maiores para G2. A KHN foi reduzida após o tratamento com cada irrigante endodôntico (p < 0,001), sem diferenças entre eles (p = 0,115). A Ra foi maior para o G1 (p < 0,001). Conclusões: a solução de clorexidina a 2% melhora as propriedades mecânicas de MFS, E e Ra da dentina radicular. (AU)

Objective: To evaluate the maximum flexural strength (MFS), elastic modulus (E), Knoop microhardness (KHN), and surface roughness (Ra) of root dentin treated with 2% chlorhexidine (CHX) solution. Materials and methods: Fifty bovine incisors with closed apex were selected. Thirty roots were cut into dentin bars (DB) and divided into three groups (n=10): control (no treatment), G1 (2.5% NaOCl + 17% EDTA) and G2 (2% CHX + H2O). The DB were submitted to the three-point flexural strength test to obtain the MFS and E. Twenty roots were cut longitudinally into two half-halves and placed in acrylic resin. The pulp surfaces were sanded and polished. They were rinsed according to the group (G1 or G2; n = 20 per group) and subjected to the KHN and Ra tests. SEM analysis was made. Data were analysed by one- and two-way ANOVA and Tukey post hoc test (a = 0.05). Results: The values of MFS (P < 0.05) and E (P < 0.01) were higher for G2. The KHN reduced after both endodontic irrigation treatments (P < 0.001), with no differences between them (P = 0.115). Ra was higher for G1 (P < 0.001). Conclusions: 2% CHX improved the mechanical properties of MFS, E and Ra of root dentin (AU).