OCT and IVUS evaluating stent apposition and endothelialization after FD implantation in aneurysm animal models / 中华神经医学杂志

Objective:To investigate the application value of optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in evaluating flow diverter (FD) apposition and endothelialization in aneurysm animal models, and analyze the effect of incomplete stent apposition (ISA) on aneurysm lumen healing and stent endothelialization.Methods:Lateral common carotid artery aneurysm models in swines were established by surgical method and then FD was implanted. Immediately after surgery, OCT and IVUS were used to evaluate the locations and degrees of ISA, and difference between these 2 methods in evaluating FD apposition was compared. DSA was performed at 12 weeks after surgery to evaluate the aneurysm occlusion (Kamran grading) and stent patency. OCT and IVUS were used again to observe the stent endothelial situation; by comparing with histopathologic results, effect of ISA on aneurysm healing and stent endothelialization was analyzed.Results:Lateral common carotid artery aneurysm models in 6 swines were established, and 6 Tubridge FDs were successfully implanted. Compared with IVUS (3 stents, 4 locus), OCT could detect more ISA (6 stents, 14 locus); and the vascular diameter change area (7 locus), aneurysm neck area (4 locus) and the head and tail of FD (3 locus) were the main sites of FD malapposition; average distance between stent wire and vessel wall was (560.14±101.48) μm. At 12 weeks after surgery, DSA showed that 1 patient had a little residual contrast agent at the aneurysm neck (Kamran grading 3), and the remaining 5 had complete aneurysm occlusion (Kamran grading 4). One FD had moderate lumen stenosis, and the other 5 FDs had lumen patency. OCT indicated mostly disappeared acute ISA; ISA proportion decreased to 21.4 % (3/14), including 2 in the aneurysm neck and 1 in the partial stent. Histopathological results showed bare stent woven silk, without obvious endothelial coverage; in one FD with luminal stenosis, intimal hyperplasia was mainly composed of vascular smooth muscle cells.Conclusion:In carotid artery aneurysm model with FD implantation, OCT can detect more ISA than IVUS; most acute ISA have good outcome at 12 th week of follow-up, while severe ISA can cause delayed FD endothelialization and delayed aneurysm occlusion.

Intra-operative optical coherence tomography in corneal lamellar graft reinforcement for Boston type I keratoprosthesis corneal melt

Corneal melt is a sight-threatening complication of Boston type 1 keratoprosthesis (KPro). Severe corneal melt may result in hypotony, choroidal hemorrhage, and even spontaneous extrusion of the KPro, which may lead to a poor visual prognosis. Lamellar keratoplasty is one surgical option for the management of mild corneal melt, especially when a new KPro is not available. Herein, we present a new surgical technique application, intra-operative optical coherence tomography (iOCT) for the management of cornea graft melt after Boston type 1 KPro implantation. The visual acuity and the intra-ocular maintained stable at 6 months post-operatively, and the KPro remained in place without corneal melting, epithelial ingrowth, or infection. iOCT may prove to be a real-time, non-invasive, and accurate treatment for corneal lamellar dissection and suturing beneath the anterior plate of the KPro, which can effectively help the surgeon to make surgical decisions and reduce post-operative complications.

Enterprise 1 stent and Enterprise 2 stent in treating symptomatic intracranial atherosclerosis stenosis: a comparative study / 中华神经医学杂志

Objective:To compare the efficacies of Enterprise 1 stent and Enterprise 2 stent in treating symptomatic intracranial atherosclerotic stenosis (ICAS).Methods:From January 2018 to April 2021, 76 patients with symptomatic ICAS treated by Enterprise 2 stent (implanting Enterprise 2 stents, EP2 group) and 52 patients with symptomatic ICAS treated with Enterprise 1 stent (implanting Enterprise 1 stents, EP1 group) were chosen from Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University. DSA was performed immediately after stent implantation and residual vascular stenosis rate was analyzed and compared between the 2 groups. Stent apposition of the 2 groups were evaluated according to reconstruction images of high-resolution flat detector CT; patients were divided into incomplete stent apposition (ISA) group and complete stent apposition group, accordingly; their clinical data were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for ISA. Incidences of perioperative complications and short-term in-stent restenosis (6 months after implantation) in the EP2 group and EP1 group were observed.Results:Intracranial stent was successfully implanted in all patients, with technical success rate of 100%. Significant difference was noted in EP1 group between pre-implanted vascular stenosis rate (80.85±12.14)% and post-implanted residual vascular stenosis rate ([21.44±8.11]%, P<0.05); significant difference was noted in EP2 group between pre-implanted vascular stenosis rate (81.83±12.85)% and post-implanted residual vascular stenosis rate ([21.53±7.76]%, P<0.05); no significant difference was noted in pre-implanted vascular stenosis rate, post-implanted residual stenosis rate, or angles of stent between EP1 group and EP2 group ( P>0.05). According to high-resolution flat detector CT scan, the ISA incidence in EP2 group (10.5%) was significantly lower than that in EP1 group (25.0%, P<0.05); compared with the complete stent apposition group, the ISA group had significantly higher post-implanted residual stenosis rate, higher proportions of patients with calcification at the stenosis, larger angles of stent, higher diameter ratio of anterior and posterior vessels of the stenosis lesions, and lower proportion of patients with Enterprise 2 stent implantation ( P<0.05). Multivariate Logistic regression analysis showed that the angle of stents, diameter ratio of anterior and posterior vessels of the stenosis lesions and Enterprise 2 stent implantation were independent influencing factors for stent apposition; and Enterprise 2 stent implantation was an proactive factor for complete stent apposition. Perioperative complication rate showed significant difference between EP1 group and EP2 group (1.3% vs. 7.7%, P<0.05). Short-term in-stent restenosis between EP2 group and EP1 group was significantly different (26.1% vs. 7.0%, P<0.05). Conclusion:Compared with Enterprise 1 stent, Enterprise 2 stent has better apposition, higher safety, and lower incidence of short-term in-stent restenosis, enjoying clinical application value in treating symptomatic ICAS.

Research progress in judgment criteria for reduction of femoral intertrochanteric fractures / 中华创伤骨科杂志

With accelerated aging process of the population, femoral intertrochanteric fractures have gradually become another major social health problem in China. Internal fixation is still the gold standard treatment for the fractures. Fracture reduction is the first step of the treatment and also the first element that affects the treatment efficacy. It is still controversial in clinical practice how to evaluate the quality of fracture reduction during internal fixation of the fractures. This article systematically expounds and analyzes the 7 systems of judging criteria for the reduction of intertrochanteric fractures from the aspects of fracture alignment, fracture apposition, difference in judgment criteria, and difference in imaging methods, in order to provide a reference for reaching consensus and improving curative effects.

Post-dilatation improves stent apposition in patients with ST-segment elevation myocardial infarction receiving primary percutaneous intervention: A multicenter, randomized controlled trial / 世界急诊医学杂志（英文）

BACKGROUND@# Stent failure is more likely in the lipid rich and thrombus laden culprit lesions underlying ST-segment elevation myocardial infarction (STEMI). This study assessed the effectiveness of post-dilatation in primary percutaneous coronary intervention (pPCI) for acute STEMI.@*METHODS@# The multi-center POST-STEMI trial enrolled 41 consecutive STEMI patients with symptom onset <12 hours undergoing manual thrombus aspiration and Promus Element stent implantation. Patients were randomly assigned to control group (n=20) or post-dilatation group (n=21) in which a non-compliant balloon was inflated to >16 atm pressure. Strut apposition and coverage were evaluated by optical coherence tomography (OCT) after intracoronary verapamil administration via thrombus aspiration catheter, post pPCI and at 7-month follow-up. The primary endpoint was rate of incomplete strut apposition (ISA) at 7 months after pPCI.@*RESULTS@# There were similar baseline characteristics except for stent length (21.9 [SD 6.5] mm vs. 26.0 [SD 5.8] mm, respectively, P=0.03). In post-dilatation vs. control group, ISA rate was lower (2.5% vs. 4.5%, P=0.04) immediately after pPCI without affecting final TIMI flow 3 rate (95.2% vs. 95.0%, P>0.05) or corrected TIMI frame counts (22.6±9.4 vs. 22.0±9.7, P>0.05); and at 7-month follow-up (0.7% vs. 1.8%, P<0.0001), the primary study endpoint, with similar strut coverage (98.5% vs. 98.4%, P=0.63) and 1-year rate of major adverse cardiovascular events (MACE).@*CONCLUSION@# In STEMI patients, post-dilatation after stent implantation and thrombus aspiration improved strut apposition up to 7 months without affecting coronary blood flow or 1-year MACE rate. Larger and longer term studies are warranted to further assess safety (ClinicalTrials.gov identifi er: NCT02121223).

Comparative study of processed autogenous tooth bone and xenogeneic bovine bone in repairing an alveolar bone defect / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study was conducted to counter the osteogenesis effects of processed autogenous tooth bone and xenogeneic bovine bone following tooth extraction and to provide an experimental basis for clinical applications.</p><p><b>METHODS</b>Central incisors were extracted with general anesthesia on both sides of a maxillary arch in 12 rabbits, which were randomly divided into three groups, thereby containing four rabbits in each group. Three rabbits were assigned to the experimental groups and one was for the control group. In the experimental groups, the xenogeneic bovine bone was applied to the left incisor socket, whereas the processed autogenous tooth bone was applied to the right incisor socket. The blank control group only extracted the teeth and did not implant any bone powder. The three groups died after 4, 8, and 12 weeks, respectively. A mineralization degree of new bone tissues was observed by fluorescence staining and the formation of a new bone was observed by histology.</p><p><b>RESULTS</b>The sedimentary mineralization rate was greater in the processed autogenous tooth bone than in the xenogeneic bovine bone (P<0.05). The trabecular bone of the xenogeneic bovine bone was sparse and slender. The left sockets, which were filled with the xenogeneic bovine bone, had more woven and less lamellar bones than the right sockets, which were filled with the processed autogenous tooth bone.</p><p><b>CONCLUSIONS</b>The processed autogenous tooth bone offers more advantages as a bone-grafting material than the xenogeneic bovine bone in terms of bone increment.</p>

Marcadores de formación y resorción ósea y su utilidad para determinar el final del periodo de aposición ósea / Bone formation and resorption markers to evaluate the end of bone apposition

El pico de masa ósea (PMO) se alcanza entre los 20 y 35 años, pero la aposición ósea continúa hasta alcanzar el pico de fortaleza ósea (PFO). Se crea así una ventana entre ambos picos que podría ser evaluada mediante marcadores bioquímicos de recambio óseo, ya que durante dicho período la densidad mineral permanece constante. El objetivo fue determinar el final de la aposición ósea mediante marcadores bioquímicos óseos. Se evaluaron por décadas entre 20 y 49 años de edad 139 sujetos sanos de ambos sexos (69 hombres y 70 mujeres), determinando fosfatasa alcalina ósea (FAO), osteocalcina (OC), propéptido amino terminal del colágeno tipo 1 (P1NP) y telopéptido C-terminal del colágeno tipo 1 (CTX). Los marcadores correlacionan negativamente con la edad (OC: r= -0,3; p<0,01; P1NP: r= -0,4; p< 0,01 y CTX: r= -0,4; p<0,01), exceptuando FAO. En hombres de 20-29 años, P1NP y el CTX fueron significativamente mayores vs. 30-39 años (p<0,05 y p<0,001, respectivamente), y entre 30-39 años vs. de 40-49 años en P1NP y CTX (p<0,05; p<0,001, respectivamente). En mujeres de 20-29 años, P1NP y CTX fueron significativamente mayores vs. 30-39 años (p<0,0001 y p<0,01, respectivamente). Conclusión: los marcadores de remodelado óseo más sensibles y específicos permitirían determinar bioquímicamente el fin de la aposición ósea que se produce entre el PMO y el PFO. Si bien es necesario ampliar el número de sujetos evaluados, los datos que surgen de la presente investigación sentarían las bases para futuros estudios epidemiológicos referidos al fin de la aposición ósea. (AU)

Peak bone mass is achieved between 20-35 years; however bone apposition continues to reach an optimal skeleton strength. The window between peak bone mass and peak bone apposition may be evaluated by biochemical bone turnover markers. The objective of this study was to determine the end of bone apposition through biochemical bone markers in both sexes. A total of 139 subjects (69 men and 70 women) were divided by decades between 20 and 49 years of age. Bone alkaline phosphatase (BAL), osteocalcin (OC), type I collagen propeptide (P1NP) and type I collagen C-terminal telopeptide (CTX) were evaluated. Except BAL, the other bone markers negatively correlated with the age [OC (r= -0.3; p<0.01); P1NP (r= -0.4; p<0.01) and CTX (r= -0.4; p<0.01)]. Regarding men aged 20 to 29 years, P1NP and CTX were significantly higher vs. 30-39 years (p<0.05 y p<0.001, respectively) and. vs. 40-49 years (p<0.05; p<0.001, respectively). In women, the results were similar. Regarding 20-29 years, P1NP and CTX were higher vs. 30-39 years (p<0.001 y p<0.01, respectively). Bone remodeling rate decreases after the third decade, suggesting the end of the apposition period of peak bone mass. Conclusion: The most specific and sensitive bone markers would biochemically determine the end of bone apposition that extends between the peak of bone mass and the peak of bone strength. Although it is necessary to increase the number of subjects evaluated, the data that emerge from the present study would establish the bases for future epidemiological studies referring to the end of bone apposition. (AU)

Positive Peri-Stent Vascular Remodeling and Late-Acquired Incomplete Stent Apposition in Intravascular Ultrasound (IVUS) after Drug-Eluting Stent Implantation / 계명의대학술지

The peri-stent vascular changes after 2nd generation drug-eluting stent (2G DES) implantation have not been fully investigated compare to 1st generation DES (1G DES). From March 2003 to October 2010, patients receiving percutaneous coronary intervention (PCI) with either 1G or 2G DES were retrospectively included. All patients underwent intravascular ultrasound (IVUS) at post-procedure and 8-12 months after PCI. A total of 281 patients (1G DES: 201 patients with 217 lesions and 2G DES: 80 patients with 88 lesions) were enrolled. The incidence of positive peri-stent vascular remodeling (PPVR) and late-acquired incomplete stent apposition (LAISA) were investigated by IVUS images. Major adverse cardiac events (MACE) up to 3 years were also evaluated. The lesion and the stent length were shorter, and the stent size was larger in the 2G DES group. The incidences of PPVR and LAISA were lower in the 2G DES group before and after propensity score matching. However, the incidence of 3-year MACE were not different between the two groups. Independent predictors for PPVR or LAISA were stent length and 1G DES implantation. These results suggested that biocompatible stent system in 2G DES might have reduced peri-stent vascular changes.

Fisiología periodontal del movimiento dentario durante el tratamiento ortodóntico / Periodontal Physiology of tooth movement during orthodontic treatment

La movilización de los dientes durante el tratamiento ortodóncico involucra procesos químicos, físicos y mecánicos. A partir de la aplicación de una fuerza, se da inicio a una serie de acontecimientos que dan como resultado el traslado del órgano dental desde su posición original. Existen diversas teorías o hipótesis que intentan describir el proceso de activación del sistema de remodelado óseo, sin embargo, todavía se siguen realizando investigaciones a fin de comprenderlo más detalladamente. El movimiento dentario en sí, requiere del remodelado del hueso alveolar, el cual involucra fases de resorción y aposición ósea. En la siguiente revisión bibliográfica se exponen secuencial y resumidamente los procesos mencionados

The teeth mobilization during orthodontic treatment involves chemical, physical and mechanical processes. Since the force application, initiates a series of events that result in the removal of the dental organ from its original position. There are various theories or hypotheses that attempt to describe the activation process of bone remodeling, however, research is still being conducted to understand it in more detail. Tooth movement itself, requires the remodeling of alveolar bone, which involves resorption phases and bone apposition. In the following literature review outlines the summary and sequential processes

Experimental research of covered stent implanted in canine hepatic artery / 介入放射学杂志

50%) of the stent at 2 weeks follow-up,so did 3 cases at 12 weeks follow-up,and the total stenosis rate was 37.5% and 5 cases manifested full endothelialization(3 different locations of the sample all manifested full endothelialization) ,3 cased manifested partial endothelialization(at least 1 location of the sample didn't show full endothelialization) ,and the two terminal parts were easier to get endothelialization than the central part.Before and after the stent implantation,hepatic function of all cases didn't demonstrate any obvious changes.Conclusions Balloon-expandable covered stent can be implanted in canine hepatic artery successfully,with good apposition ability,full endothelialization,and no influence on hepatic function.

Cephalometric study of alveolar remodeling during incisor retraction / 实用口腔医学杂志

Objective:To investigate the remodeling of alveolar process following anterior teeth retraction. Methods: Cephalograms of pretreatment (T1), posttreatment (T2) and follow-up (T3) of 55 cases with four first premolars extracted were collected as the study samples. All the lateral head films were traced on the acetate. Palate best fit superimposition was used to transfer pretreatment SN to posttreatment and follow-up cephalograms and to evaluate the displacement of upper incisor teeth roots and the remodeling of alveolar bone. The average of the two measurements was processed by SPSS statistical package. Results:The CRE of upper incisor moved backward 1.8 mm(P05) in SN frame of reference. The width of alveolus on the labial side at the same level increased 0.2 mm (P