Trends in bronchopulmonary dysplasia and respiratory support among extremely preterm infants in China over a decade.

OBJECTIVE: Bronchopulmonary dysplasia (BPD) is one of the most serious complications affecting extremely preterm infants. We aimed to evaluate temporal trends in BPD and administration of respiratory support among extremely preterm infants in China over a decade. METHODS: This was a retrospective study using data from a multicenter database, which included infants born less than 28 weeks' gestation discharged from 68 tertiary neonatal care centers in China between 2010 and 2019. Changes in rates and severity of BPD, as well as modalities and duration of respiratory support, were evaluated. RESULTS: Among 4808 eligible infants with gestational age (GA) of 21+6/7  to 27+6/7 weeks and a mean (SD) birth weight of 980 (177) g, no significant change of median GA was found over time. Overall, 780 (16.2%) infants died before 36 weeks' postmenstrual age, 2415 (50.2%) were classified as having no BPD, 917 (19.1%) developed Grade 1 BPD, 578 (12.0%) developed Grade 2 BPD, and 118 (2.5%) developed Grade 3 BPD. The rate of BPD increased from 20.8% in 2010 to 40.7% in 2019 (aRR for trend, 1.081; 95% confidence interval, 1.062-1.099), especially for Grade 1 and Grade 2. Although survival to discharge improved over the decade, the overall survival without BPD did not change during the study period. The use of invasive mechanical ventilation (IMV) remained unchanged. However, the use of noninvasive ventilation (NIV) increased from 71.5% in 2010 to 89.8% in 2019. Moreover, the median duration of NIV increased over time, from 17.0 (4.8, 34.0) days in 2010 to 33.0 (21.0, 44.0) days in 2019, without significant change in the duration of IMV. CONCLUSIONS: Although survival increased over the decade and respiratory support practices changed significantly between 2010 and 2019 in China, with increased use and duration of NIV, there was an increased rate of BPD and survival without BPD has not improved.

Janus electro-microenvironment membrane with surface-selective osteogenesis/gingival healing ability for guided bone regeneration.

Guided bone regeneration is widely applied in clinical practice to treat alveolar bone defects. However, the rate of healing of severe alveolar bone defects is slow, and there is a high incidence of soft tissue wound dehiscence. In this study, we propose a barrier membrane with a Janus electro-microenvironment (JEM) to achieve side-selective bone regeneration and soft tissue healing. The JEM membrane was constructed using a polarized polyvinylidene fluoride ferroelectric membrane with different surface potentials on either side. It promoted osteogenic differentiation and bone regeneration on the negatively polarized side (JEM-) and soft tissue regeneration on the positively polarized side (JEM+). Further investigation revealed that the JEM-mediated promotion of bone formation was related to mitochondrial autophagy, as indicated by depolarization of the mitochondrial membrane potential and the expression of LC3, Pink I, and Parkin. Moreover, the gingival healing promoted by JEM+ was related to oxidative phosphorylation in mitochondria, as indicated by the upregulation of mitochondrial complexes I-V and an increase in ATP generation. The design concept of the JEM provides a new avenue for regulating tissue regeneration between different tissue interfaces.

Influence of P(VDF-TrFE) Membranes with Different Surface Potentials on the Activity and Angiogenic Function of Human Umbilical Vein Endothelial Cells.

During bone tissue regeneration, neovascularization is critical, and the formation of a blood supply network is crucial for bone growth stimulation and remodeling. Previous studies suggest that bioelectric signals facilitate the process of angiogenesis. Owing to their biomimetic electroactivity, piezoelectric membranes have garnered substantial interest in the field of guided bone regeneration. Nevertheless, the knowledge of their influence due to varying surface potentials on the progression of angiogenesis remains ambiguous. Therefore, we proposed the preparation of an electroactive material, P(VDF-TrFE), and investigated its effects on the activity and angiogenic functions of human umbilical vein endothelial cells (HUVECs). The HUVECs were directly cultured on P(VDF-TrFE) membranes with different surface potentials. Subsequently, cell viability, proliferation, migration, tube formation, and expressions of related factors were assessed through appropriate assays. Our results revealed that the negative surface potential groups exerted differential effects on the modulation of angiogenesis in vitro. The P(VDF-TrFE) membranes with negative surface potential exhibited the greatest effect on cellular behaviors, including proliferation, migration, tube formation, and promotion of angiogenesis by releasing key factors such as VEGF-A and CD31. Overall, these results indicated that the surface potential of piezoelectric P(VDF-TrFE) membranes could exert differential effects on angiogenesis in vitro. We present a novel approach for designing bioactive materials for guided bone regeneration.

Sonochemical Synthesis of Vaterite-Type Calcium Carbonate Using Steamed Ammonia Liquid Waste without Additives.

Herein, metastable spheroidal vaterite calcium carbonate (CaCO3) was prepared using a simple ultrasound technique. The fabricated material comprises an irregular nanoparticle aggregate when steamed ammonia liquid waste, that is, (CaCl2) and (NH4)2CO3, is used as the raw material at atmospheric temperature, without any surfactants. The effects of ultrasound amplitude, probe immersion depth, and solution volume on particle properties were investigated. The obtained samples were identified and characterized by X-ray diffraction, Fourier transform infrared spectroscopy, scanning electron microscopy, and the Brunauer-Emmett-Teller technique. Our experiments show that the probe immersion depth and the reaction volume are the key parameters that impact the diameter size and size distribution of the fabricated spheroidal vaterite CaCO3 particles. The ultrasound amplitude considerably affected the particle size and the specific surface area. A possible formation mechanism for pure vaterite is proposed herein, which suggests that simple vaterite CaCO3 is formed owing to the special properties of steamed ammonia liquid waste and the synergistic effects of the ultrasonic system. This study may provide a new method for vaterite CaCO3 synthesis.

Retraction of "Biological Effects of Titanium Surface Charge with a Focus on Protein Adsorption".

[This retracts the article DOI: 10.1021/acsomega.0c02518.].

The Cleaning Effect of the Photocatalysis of TiO2-Bï¼ anatase Nanowires on Biological Activity on a Titanium Surface.

BACKGROUND: Improvements in the early osseointegration of titanium implants require investigations on the bone-implant interface, which is a critical and complex challenge. The surface cleanliness of titanium implants plays an important role at this interface. However, the implant surface would inevitably absorb contamination such as organic hydrocarbons, which is not conductive to the establishment of early osseointegration. Herein, an optimized approach for removing contamination from titanium surfaces was studied. METHODS: The TiO2-Bï¼ anatase NWs (nanowires) were prepared on titanium substrates through a hydrothermal process. A methylene blue degradation experiment was performed to assess the photodegradation activity. The cleaning effect of the photocatalysis of TiO2-Bï¼ anatase NWs on a titanium surface and the cellular early response was determined by analyzing cell morphology, attachment, proliferation and differentiation. RESULTS: The results indicated that the photocatalysis of TiO2-Bï¼ anatase NWs could effectively remove hydrocarbons on titanium surfaces without sacrificing the favourable titanium surface morphology. The methylene blue degradation experiment revealed that the photocatalysis of TiO2-Bï¼ anatase NWs had powerful degradation activity, which is attributed to the presence of strong oxidants such as ·OH. In addition, compared to the merely ultraviolet-treated titanium surfaces, the titanium surfaces treated after the NWs photocatalytic cleaning process markedly enhanced cellular early response. CONCLUSION: The photocatalysis of TiO2-Bï¼ anatase NWs for the removal of contamination from titanium surfaces has the potential to enable the rapid and complete establishment of early osseointegration.

Biological Effects of Titanium Surface Charge with a Focus on Protein Adsorption.

The effect of changes in surface charge on the biological properties of implants is not clear. The objective of this study was to evaluate the biological properties of the surface of titanium sheets with different charges due to different treatment methods. Titanium sheets were sandblasted with large grit and underwent acid etching before being subsequently divided into the following groups: SLA, no further treatment; SLA-Ca2+, immersed in 1% CaCl2 solution; SLA-NaCl, immersed in saline; and SLA-Ca2+-NaCl, immersed in 1% CaCl2 solution followed by saline. Surface characteristics were evaluated using field-emission scanning electron microscopy with energy-dispersive spectrometry, surface profilometry, and contact angle assays. Additionally, we used a ζ-potential analyzer to directly measure the electrostatic charge on the different group surfaces. The effect of changes in the Ti surface on biological processes after different treatments was determined by analyzing fibronectin adsorption, osteoblast-like MG63 cell adhesion and proliferation, and the expression of osteogenesis-related genes. Compared to the SLA surface, the other three groups contained corresponding trace elements because they were soaked in different liquids; the contact angles of the three groups were not significantly different, but they were significantly smaller than that of the SLA group; and there was no change in the surface topography or roughness. Furthermore, the SLA-Ca2+ group had a significantly reduced negative charge compared to that of the other three groups. There were no differences between the SLA-NaCl and SLA-Ca2+-NaCl groups in terms of negative charge, and the SLA group surface carried the most negative charge. Fibronectin adsorption capacity and cytological performance testing further showed that the SLA-Ca2+ group had the most significant change, followed by the SLA-NaCl and SLA-Ca2+-NaCl groups; the SLA group had significantly lower capacity and performance than the other three groups. These results suggest that the surface charge of the titanium sheet changed when immersed in different liquids and that this treatment enhanced biocompatibility by reducing the electrostatic repulsion between biomaterials and biomolecules.

Effects of RGD-grafted TiO2 nanotubes on the adhesion and proliferation of MG63 osteoblasts / 口腔疾病防治

Objective@#To investigate the effect of pure titanium surface of large diameter TiO2 nanotubes modified by RGD peptide on the adhesion and proliferation of MG63 osteoblasts. to provide theoretical proof for developing titanium implants.@*Methods@#Commercially pure titanium discs were divided into four groups and treated with SLA to obtain a microrough surface (SLA group). Then, nanotubes were imposed on this microrough surface by anodization (SLA+80 group). The surface was then modified by dopamine (DOPA) (DOPA Group), after which bioactive RGD peptide layers were generated on the TiO2 nanotube surfaces via electrochemical and molecular self-assembly techniques (RGD group). The titanium surface morphology and elemental composition of each group were characterized by field emission scanning electron microscopy (FE-SEM) and X-ray photoelectron spectroscopy (XPS). MG63 cells were cultured in vitro to evaluate biological activities of titanium before and after treatment, including the evaluation of early-stage cell adhesion capacity by fluorescence microscopy, proliferation capacity by MTS assay, and mRNA expression of the cell osteoblast-related genes alkaline phosphatase (ALP) and osteocalcin (OCN) by qRT-PCR.@*Results@#FE-SEM and XPS showed that hierarchical micro/nanosurfaces decorated with TiO2 nanotubes were produced on titanium using sandblasting and large grit etching combined with anodization, dopamine was then self-polymerized to form a polydopamine film on the TiO2 nanotube surfaces, and RGD peptides were then conjugated to the polydopamine film, finally forming RGD peptide-modified bioactive layers. In vitro experiments showed that compared with the other three materials, the RGD-modified material was more conducive to cell adhesion and proliferation (P < 0.05). The expression levels of ALP and OCN mRNA in the RGD group were significantly higher than those in the SLA group and DOPA group (P < 0.05).@*Conclusion@#Hierarchical micro/nanosurfaces decorated with TiO2 nanotubes functionally modified with RGD peptides have good biocompatibility and could be used for developing titanium implants and further improving early osseointegration.

In vivo evaluation of a simvastatin-loaded nanostructured lipid carrier for bone tissue regeneration.

Alveolar bone loss has long been a challenge in clinical dental implant therapy. Simvastatin (SV) has been demonstrated to exert excellent anabolic effects on bone. However, the successful use of SV to increase bone formation in vivo largely depends on the local concentration of SV at the site of action, and there have been continuing efforts to develop an appropriate delivery system. Specifically, nanostructured lipid carrier (NLC) systems have become a popular type of encapsulation carrier system. Therefore, SV-loaded NLCs (SNs) (179.4 nm in diameter) were fabricated in this study, and the osteogenic effect of the SNs was evaluated in a critical-sized rabbit calvarial defect. Our results revealed that the SNs significantly enhanced bone formation in vivo, as evaluated by hematoxylin and eosin (HE) staining, immunohistochemistry, and a fluorescence analysis. Thus, this novel nanostructured carrier system could be a potential encapsulation carrier system for SV in bone regeneration applications.

The effects of hierarchical micro/nanosurfaces decorated with TiO2 nanotubes on the bioactivity of titanium implants in vitro and in vivo.

In the present work, a hierarchical hybrid micro/nanostructured titanium surface was obtained by sandblasting with large grit and acid etching (SLA), and nanotubes of different diameters (30 nm, 50 nm, and 80 nm) were superimposed by anodization. The effect of each SLA-treated surface decorated with nanotubes (SLA + 30 nm, SLA + 50 nm, and SLA + 80 nm) on osteogenesis was studied in vitro and in vivo. The human MG63 osteosarcoma cell line was used for cytocompatibility evaluation, which showed that cell adhesion and proliferation were dramatically enhanced on SLA + 30 nm. In comparison with cells grown on the other tested surfaces, those grown on SLA + 80 nm showed an enhanced expression of osteogenesis-related genes. Cell spread was also enhanced on SLA + 80 nm. A canine model was used for in vivo evaluation of bone bonding. Histological examination demonstrated that new bone was formed more rapidly on SLA-treated surfaces with nanotubes (especially SLA + 80 nm) than on those without nanotubes. All of these results indicate that SLA + 80 nm is favorable for promoting the activity of osteoblasts and early bone bonding.

[Value of amino-terminal pro-brain natriuretic peptide as a predictive marker of symptomatic patent ductus arteriosus in preterm infants].

OBJECTIVE: To study the value of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting symptomatic patent ductus arteriosus (sPDA) in preterm infants. METHODS: Preterm infants born at a gestational age (GA) of ≤ 32 weeks and diagnosed with patent ductus arteriosus (PDA) by echocardiography within 48 hours after birth between June 2014 and April 2015 were selected as subjects. Their clinical manifestations were observed, and serum NT-proBNP levels were measured and echocardiography was performed at 3 and 5 days after birth. The infants were divided into sPDA group and asymptomatic PDA (asPDA) group based on their clinical manifestations and the results of echocardiography. The correlations between serum NT-proBNP level and echocardiographic indices were analyzed. Serum NT-proBNP levels were compared between the two groups. The receiver operator characteristic (ROC) curve was applied to determine the sensitivity and specificity of serum NT-proBNP in the prediction of sPDA. RESULTS: A total of 69 preterm infants were enrolled in this study, with 13 infants in the sPDA group and 56 infants in the asPDA group. Serum NT-proBNP level was positively correlated with the diameter of the arterial duct (r=0.856; P<0.05)and the ratio of left atrial diameter to aortic root diameter (LA/AO) (r=0.713; P<0.05). At 3 and 5 days after birth, the serum NT-proBNP levels in the sPDA group were significantly higher than those in the asPDA group (P<0.05). The area under the ROC curve (AUC) for the prediction of sPDA by NT-proBNP levels at 3 days after birth was 0.949 (95% CI: 0.892-1.000; P<0.001), with a cut-off value of 27 035 pg/mL (sensitivity: 92.3%; specificity: 94.6%); the AUC for the prediction of sPDA by NT-proBNP levels at 5 days after birth was 0.924 (95% CI: 0.848-1.000; P<0.001), with a cut-off value of 6 411 pg/mL (sensitivity: 92.3%; specificity: 92.9%). CONCLUSIONS: NT-proBNP may be a quantitative index for shunt volume. The measurement of serum NT-proBNP levels on 3 and 5 days after birth may be useful to predict sPDA in preterm infants.

Local delivery of rhVEGF165 through biocoated nHA/coral block grafts in critical-sized dog mandible defects: a histological study at the early stages of bone healing.

Alveolar defects of a critical size cannot heal completely without grafting. Thus, they represent a major clinical challenge to reconstructive surgery. Numerous types of grafts have been used to improve bone regeneration. In the case of particle grafts, the capacity for volume rebuilding and space maintaining is still not ideal, particularly for critical-sized bone defects. Although porous block grafts can overcome the above problems of particle grafts, they are still not widely used for critical-sized alveolar defects, because of their reduced efficacy in blood vessel and bone formation. Thus, in the present study, nano-hydroxyapatite/coralline (nHA/coral) blocks were pre-vascularized by coating them with vascular endothelial growth factor (VEGF), and then implanted in dogs with critical-sized mandibular defects. This model has possible applications in orthopedic and implant surgery. In vivo results indicate that the nHA/coral blocks allow cell and collagen ingrowth because of their suitable pore size and interconnectivity of pores. In addition, pre-vascularization properties were obtained by coating the scaffolds with VEGF. Histological and immunohistochemical examinations, as well as fluorescence analysis, revealed that the local delivery of VEGF can significantly improve neovascularization and mineralization of newly formed bone at the early stages of bone healing in this dog implantation model. Our data collectively show that nHA/coral blocks have possible applications in bone tissue engineering, and excellent results can be achieved by pre-vascularization with VEGF.

[Terpenoids and sterols from Ricinus communis and their activities against diabetes].

Seven terpenoids and three sterols were isolated from the methanol extracts of the aerial parts of Ricinus communis by chromatography methods and their structures were identified by spectra analysis as ficusic acid( 1), phytol(2), callyspinol(3) , lupeol(4), 30-norlupan-3beta-ol-20-one(5) , lup-20(29)-en-3beta,15alpha-diol(6) , acetylaleuritolic acid( 7), stigmast4-en-3-one(8) , stig-mast-4-en-6beta-ol-3-one(9) , and stigmast4-en-3,6-dione(10). Compounds 1-3 and 5-10 were obtained from this species for the first time and 5 and 6 showed significant inhibitive activity and good selectivity against 11beta-HSD of mouse and human in vitro. [Key words] Ricinus communis; terpenoids; sterols; 11beta-HSD

Phosphoric acid and sodium fluoride: a novel etching combination on titanium.

We investigate whether a novel and inexpensive etching method, H3PO4 + NaF, on titanium could obtain both a lower hydrogen content and superior calcium phosphate deposition performance, while achieving similar surface roughness in comparison with the traditional etching method. Pure titanium samples were treated with different concentrations of H3PO4 + NaF at ambient temperature without auxiliary implementations (groups A, B and C), and were treated using the traditional method (group T). The samples were then maintained in simulated body fluid for 10 and 20 days. The surface morphology and chemistry, as well as the hydrogen content and distribution, were studied. The hydrogen content of the new groups are in the range of 31 (3.6)-86.9 (7.2) ppm, and that of group T is 287 (13.5) ppm. The amount of deposited calcium phosphates increases as the hydrogen content approaches 90 ppm; however, this trend does not apply as the hydrogen content exceeds 90 ppm. The surface roughnesses of groups A, B and C are in the range of 0.47 (0.01)-0.92 (0.05) µm. The new surface topography regularly transforms, and the surfaces with round pits exert a better effect on the deposition of calcium phosphates than the surfaces with sharp cusps.

The effects of different wavelength UV photofunctionalization on micro-arc oxidized titanium.

Many challenges exist in improving early osseointegration, one of the most critical factors in the long-term clinical success of dental implants. Recently, ultraviolet (UV) light-mediated photofunctionalization of titanium as a new potential surface treatment has aroused great interest. This study examines the bioactivity of titanium surfaces treated with UV light of different wavelengths and the underlying associated mechanism. Micro-arc oxidation (MAO) titanium samples were pretreated with UVA light (peak wavelength of 360 nm) or UVC light (peak wavelength of 250 nm) for up to 24 h. UVC treatment promoted the attachment, spread, proliferation and differentiation of MG-63 osteoblast-like cells on the titanium surface, as well as the capacity for apatite formation in simulated body fluid (SBF). These biological influences were not observed after UVA treatment, apart from a weaker effect on apatite formation. The enhanced bioactivity was substantially correlated with the amount of Ti-OH groups, which play an important role in improving the hydrophilicity, along with the removal of hydrocarbons on the titanium surface. Our results showed that both UVA and UVC irradiation altered the chemical properties of the titanium surface without sacrificing its excellent physical characteristics, suggesting that this technology has extensive potential applications and merits further investigation.

Titanate nanowire scaffolds decorated with anatase nanocrystals show good protein adsorption and low cell adhesion capacity.

BACKGROUND AND METHODS: In this report, layered microporous titanate nanowire scaffolds (TiNWs) were constructed via a hydrothermal route and then decorated with anatase nanocrystals (ANs@TiNWs) by immersion in TiCl(4) solution. The diameter and specific surface area of the ANs@TiNWs was measured. The TiNWs and ANs@TiNWs were then compared for their ability to adsorb protein and adhere to MG63 cells. RESULTS: The diameter and specific surface area of the ANs@TiNWs were significantly larger than for TiNWs, and the ANs@TiNWs had an enhanced protein-adsorbing effect. It was found that the MG63 cells were less able to adhere to the flat titanium substrate than the TiNWs and ANs@TiNWs, and that this cell-repellant ability was greater with ANs@TiNWs. Other MG63 cell functions, proliferation in particular, were also inhibited by ANs@TiNWs. CONCLUSION: ANs@TiNWs show a high protein adsorption and cell-repellant capacity which would be useful in drug delivery.

Use of a collagen membrane loaded with recombinant human bone morphogenetic protein-2 with collagen-binding domain for vertical guided bone regeneration.

BACKGROUND: Vertical bone regeneration of severe atrophic alveolar ridges remains a challenging procedure in implant dentistry. METHODS: The aim of this study, accordingly, is to use a rabbit vertical guided bone regeneration model to evaluate whether using a collagen membrane (CM) loaded with small doses of recombinant human bone morphogenetic protein-2 with collagen-binding domain (rhBMP-2/CBD) would enhance two-way vertical bone regeneration. In each of eight rabbits, four titanium cylinders were screwed in perforated slits made into the external cortical bones of the calvaria. The following four treatment modalities were randomly allocated: 1) cylinders filled with mineralized bone matrix and covered with CM/rhBMP-2/CBD; 2) cylinders filled with mineralized bone matrix and covered with CM/rhBMP-2; 3) cylinders filled with mineralized bone matrix and covered with CM alone; or 4) cylinders filled with mineralized bone matrix without a membrane cover. RESULTS: After 6 weeks, the new bones were examined by histologic analysis. Slender new bone trabeculae were observed in the superficial layer of the titanium cylinders covered with CM/rhBMP-2/CBD, and higher degrees of bone were observed in this group compared with the other three groups. The average area fraction of newly formed bone was significantly more in the CM/rhBMP-2/CBD group compared with the CM/rhBMP-2, CM, or the no membrane control groups (all P <0.01). CONCLUSIONS: The present study demonstrates that CMs loaded with small doses of rhBMP-2/CBD induce new bone formation not only from the surface of the native bone, but also from the superficial structures. The augmented new bone, therefore, is improved in both quantity and quality.

[Preparation and prescription of enteric coated pellets of Panax notoginseng saponins pellets].

OBJECTIVE: To prepare enteric coated pellets containing panax notoginseng saponins. METHOD: Panax notoginseng saponins loaded pellets were prepared by Extrusion-Spheronization method, and coated by Eudragit L30D-55 using Glatt fluid bed with the bottom spray process, central composite design was used to optimize the coating prescription. RESULT: The drug release of enteric coated pellets of panax notoginseng saponins pellets would be lower than 5% in 2 h in simulated gastric fluid, but reach above 85% in 3 h in simulated human gastroenteric environment. CONCLUSION: The enteric coated pellets of panax notoginseng saponins have good acid residence to avoid panax notoginseng saponins from degrading in gastric acid.