Preparation of functional polyhydroxyalkanoate microspheres and their antibacterial activity and osteogenic effect evaluation / 中国修复重建外科杂志

OBJECTIVE@#To construct polyhydroxyalkanoate (PHA) microspheres loaded with bone morphogenetic protein 2 (BMP-2) and human β-defensin 3 (HBD3), and evaluate the antibacterial activity of microspheres and the effect of promoting osteogenic differentiation, aiming to provide a new option of material for bone tissue engineering.@*METHODS@#The soybean lecithin (SL)-BMP-2 and SL-HBD3 were prepared by SL-mediated introduction of growth factors into polyesters technology, and the functional microsphere (f-PMS) containing BMP-2 and HBD3 were prepared by microfluidic technology, while pure microsphere (p-PMS) was prepared by the same method as the control. The morphology of microspheres was observed by scanning electron microscopy and the water absorption was detected; the release curves of BMP-2 and HBD3 in f-PMS were detected by ELISA kit. The antibacterial effect of microspheres in Staphylococcus aureus and Escherichia coli was tested with the LIVE/DEADTM BacLightTM bacterial staining kit; the biocompatibility of microspheres was tested using Transwell and cell counting kit 8 (CCK-8). The effect of microspheres on osteogenic differentiation was determined by collagen type Ⅰ (COL-1) immunofluorescence staining and alkaline phosphatase (ALP) concentration.@*RESULTS@#In this experiment, the f-PMS and p-PMS were successfully constructed. Morphological characteristics showed that p-PMS surface was rough and distributed with micropores of 1-3 μm, while f-PMS surface was smooth and existed white granular material. There was no significant difference in water absorption between the two groups (P>0.05). The release curves of BMP-2 and HBD3 in the f-PMS and p-PMS were basically the same, showing both early sudden release and late slow release. The antibacterial activity of f-PMS was significantly higher than that of p-PMS in the test that against Staphylococcus aureus and Escherichia coli (P<0.05), but there was no significant difference in biocompatibility between the two groups (P>0.05). The results of osteogenic differentiation of human BMSCs showed that the fluorescence intensity of osteogenic specific protein COL-1 of f-PMS was significantly higher than that in p-PMS, and the activity of ALP in f-PMS was also significantly higher than that in p-PMS (P<0.05).@*CONCLUSION@#The p-PHA have good antibacterial activity and biocompatibility, and can effectively promote the osteogenic differentiation of human BMSCs, which is expected to be applied to bone tissue engineering in the future.

Influence of modified catheter thrombolytic regimen on clinical efficacy and safety of patients with acute DVT / 中国基层医药

Objective:To investigate the influence of modified catheter thrombolytic regimen on clinical efficacy and safety of patients with acute deep vein thrombosis (DVT).Methods:From March 2016 to March 2018, 86 patients with acute DVT were chosen in the Central Hospital of Yuncheng and randomly divided into two groups by random drawing method, with 43 cases in each group.The control group received routine catheter thrombolytic regimen, and the observation group received modified catheter thrombolysis regimen.The postoperative detumescence rate, postoperative lower limb circumference difference, venous patency score before and after operation, postoperative venous patency rate, operation time, thrombolytic costs, urokinase dosage, reduction amount of hemoglobin after operation and incidence of complications after operation of the two groups were compared.Results:There were no statistically significant differences in the postoperative detumescence rate, postoperative lower limb circumference difference, venous patency score after operation, postoperative venous patency rate between the two groups[(81.52±3.05)% vs.(84.66±4.29)%; (1.10±0.34)cm vs.(1.24±0.39)cm; (2.40±0.53)points vs.(2.51±0.59)points; (63.16±6.98)% vs.(64.81±7.15)%; t=0.58, 0.70, 0.16, 0.25, all P>0.05]. The operation time and reduction amount of hemoglobin after operation of the observation group were significantly more than those of the control group[(42.81±6.17)min vs.(20.86±3.02)min; (12.84±3.96)g/L vs.(4.13±1.02)g/L; t=4.26, 3.51, P<0.05]. The thrombolytic costs and urokinase dosage of the observation group were significantly less than those of the control group[(4 129.25±584.57)CNY vs.(7 251.49±695.70)CNY; (79.17±10.79)×10 4U vs.(217.13±38.76)×10 4U; t=7.14, 10.26, all P<0.05]. There was no statistically significant difference in the incidence of complications after operation between the two groups (11.63% vs.9.30%, χ 2=0.82, P>0.05). Conclusion:Compared with routine catheter thrombolytic regimen, modified catheter thrombolytic regimen in the treatment of patients with acute DVT has the same clinical effects and safety, and can efficiently reduce the treatment costs and the urokinase dosage, but may also increase the operation time and bleeding volume.

Influence of different types of balloon dilatation on clinical efficacy and safety in patients with lower extremity arteriosclerosis obliterans / 中国医师进修杂志

Objective:To investigate the influence of plain old balloon angioplasty (POBA) and drug-coated balloon (DCB) dilatation on clinical efficacy and safety in patients with lower extremity arteriosclerosis obliterans.Methods:Seventy patients with lower extremity arteriosclerosis obliterans from February 2016 to February 2018 in Central Hospital of Yuncheng City, Shanxi Province were chosen. The patients were divided into control group (35 patients) with POBA dilatation and observation group (35 patients) with POBA and DCB dilatation by random sampling method. The target vessel patency rate, target lesion revascularization rate, minimum lumen diameter and ankle brachial index (ABI) level before and after surgery, Rutherford classification in follow-up after surgery, late lumen loss after surgery and perioperative complications incidence of 2 groups were compared.Results:The target vessel patency rate 6 and 12 months after surgery in observation group was significantly higher than that in control group: 85.71% (30/35) vs. 62.86% (22/35) and 80.00% (28/35) vs. 48.57% (17/35), and there was statistical difference ( P<0.05). The target lesion revascularization rate in observation group was significantly lower than that in control group: 8.57% (3/35) vs. 28.57% (10/35), and there was statistical difference ( P<0.05). The minimum lumen diameter 6 and 12 months after surgery in observation group was significantly more than that in control group and before surgery: (3.20 ± 0.66) mm vs. (1.53 ± 0.38) and (0.45 ± 0.09) mm, (2.97 ± 0.60) mm vs. (1.40 ± 0.35) and (0.45 ± 0.09) mm, and there was statistical difference ( P<0.05). The ABI 6 and 12 months after surgery in observation group was significantly higher than that in control group and before surgery: 0.86 ± 0.17 vs. 0.63 ± 0.09 and 0.24 ± 0.06, 0.82 ± 0.14 vs. 0.60 ± 0.08 and 0.24 ± 0.06, and there was statistical difference ( P<0.05). The proportion of late lumen loss and Rutherford classification >3 12 months after surgery in observation group were significantly less than those in control group: (0.42 ± 0.10) mm vs. (1.59 ± 0.32) mm and 17.14% (6/35) vs. 57.14%(20/35), and there were statistical differences ( P<0.05). The perioperative complications incidence in observation group was significantly lower than that in control group ( P<0.05). Conclusions:Compared with POBA dilatation, DCB dilatation in the treatment of patients with lower extremity arteriosclerosis obliterans possesses better clinical efficacy and safety.

Open surgery vs endovascular repair for popliteal artery aneurysms / 中华普通外科杂志

Objective To compare the safety and efficacy of surgical and endovascular management for popliteal artery aneurysms.Methods The clinical data of 28 patients with popliteal artery aneurysm admitted to our department from December 2009 to March 2015 was analyzed retrospectively.12 patients underwent open surgery,and 16 did endovascular repair.Results In the surgical operation group (12 cases),the mean length of hospital stay was 18 ± 3 days,with 1 case suffering from delayed wound healing,and 1 case of anastomotic pseudoaneurysm The vascular graft patency rate was 100％ at 1 year (12/12),and 75％ (9/12) at 2 years.In the endovascular repair treatment group(16 cases),the average time of hospitalization was (10 ± 2) days.The patency rate of vascular stent was 93.3％ (14/15) at 1 year,and 86.7％ (13/15) at 2 years (all P ＞ 0.05).Surgical operation had longer hospitalization and more complications than endovascular repair.Conclusions Endovascular repair provides similar shortterm patency rate to that of surgical operation treatment,but with shorter hospitalizations and less complications in patients with popliteal artery aneurysms.Viabahn stenting helps improve the patency rate.

Relations between timing of treatment in stanford B acute aortic dissection vascular repair and prognosis / 中国基层医药

Objective To investigate clinical relevance of the acute Stanford B aortic dissection vascular repair time for treatment and prognosis.Methods A retrospective clinical data of our hospital treated 1 10 cases of vascular repair of acute aortic dissection type Stanford B were analyzed according to the onset to treatment time.They were divided into three groups:group A (onset to treatment time of 7 days),group B (onset to treatment time 14) and group C (onset to treatment time than 14 days);the three groups were observed after aortic repair status and prognosis related indicators.Results The true lumen false lumen diameter and maximum diameter ratio in group A was the largest (1.8 ±0.5),which was significantly higher than that of group B and group C (1.3 ±0.3)and (1.3 ± 0.2),the difference was statistically significant (F=7.352,P<0.05).Ratio of preoperative minimum true lumen diameter and the maximum diameter of the false lumen,ratio of postoperative maximum true lumen diameter and the maximum diameter of the false lumen were associated with the onset of the endovascular repair time,showed a negative correlation (r=-0.452,-0.281,all P<0.05).postoperative complication rate of group A was 12.8%,complica-tion rate of group B was 29.5%,complication rate of group C was 33.3%,data of group A was significantly lower than those of group B and group C,the difference were statistically significant (χ2 =4.024,4.721,all P<0.05).group A died three cases,group B had 1 patient died and in group C there was no deaths.Hospital stay and hospital costs of group A were significantly lower than those of group B and group C,the difference werestatistically significant (F=4.125,7.375,all P<0.05).Conclusion As soon as possible to implement acute aortic dissection stanford B aortic vascular repair could better improve outcomes,and reduce the cost of hospitalization and treatment.At the same time, it can reduce the incidence of complications and improve clinical safety.