Impacts of residual 3D printing metal powders on immunological response and bone regeneration: an in vivo study.

Residual powder is a defect in powder bed fusion-based additive manufacturing (3D printing), and it is difficult to completely remove it from as-printed materials. In addition, it is not necessary to apply 3D printed implants with residual powder in the clinic. The immunological response triggered by the residual powder is an important area of study in medical research. To further understand the possible immunological reactions and hidden dangers caused by residual powders in vivo, this study compared the immunological reactions and osteolysis caused by typical powders for four implant materials: 316 L stainless steel, CoCrMo, CP-Ti, and Ti-6Al-4V (particle size range of 15-45 µm), in a mouse skull model. Furthermore, the possible immunological responses and bone regeneration induced by the four 3D printed implants with residual powder in a rat femur model were compared. In the mouse skull model, it was found that the 316L-S, CoCrMo-S, and especially the 316L-M powders, upregulated the expression of pro-inflammatory factors, increased the ratio of RANKL/OPG, and activated more functional osteoclasts, resulting in more severe bone resorption compared with those in other groups. In the rat femur model, which is more suitable for clinical practice, there is no bone resorption in implants with residual powders, but they show good bone regeneration and integration ability because of their original roughness. The results indicate that the expressions of inflammatory cytokines in all experimental groups were the same as those in the control group, showing good biological safety. The results answered some critical questions related to additively manufactured medical materials in vivo and indicated that as-printed implants may have great potential in future clinical applications.

Process Optimization and Tailored Mechanical Properties of a Nuclear Zr-4 Alloy Fabricated via Laser Powder Bed Fusion.

A nuclear Zr-4 alloy with a near full density was fabricated via laser powder bed fusion (LPBF). The influences of process parameters on the printability, surface roughness, and mechanical properties of the LPBF-printed Zr-4 alloy were investigated. The results showed that the relative density of the Zr-4 alloy samples was greater than 99.3% with the laser power range of 120-160 W and the scanning speed range of 600-1000 mm/s. Under a moderate laser power in the range of 120-140 W, the printed Zr-4 alloy possessed excellent surface molding quality with a surface roughness less than 10 µm. The microstructure of the printed Zr-4 alloy was an acicular α phase with an average grain size of about 1 µm. The Zr-4 alloy printed with a laser power of 130 W and a scanning speed of 400 mm/s exhibited the highest compression strength of 1980 MPa and the highest compression strain of 28%. The findings demonstrate the potential in the fabrication of complex Zr-4 alloy parts by LPBF for industrial applications.

Sex life and sexuality among tongqi: doing gender and heterosexuality.

The term tongqi refers to cisgender, heterosexual women who unwittingly marry non-straight men. In mainland China, their adverse social position and health have been the subject of concern. This study aims to broaden and diversify perceptions of the lived experiences of tongqi by focusing on sex and sexualities in mixed-orientation marriages. Four themes (lack of sexuality-related exploration before marriage, the unsatisfactory nature of marital sex life, the exercise of sexual agency, and increased self-awakening) were developed from observations of a tongqi online support group and 12 semi-structured interviews with members. Using inductive thematic analysis, findings reveal how heteronormativity oppresses and punishes both tongqi and their non-straight husbands. In most cases, husbands not 'doing heterosexuality' as expected were still found to be 'doing gender' in patriarchal ways, with wives' subordinate status thereby being reinforced, making them more vulnerable. However, despite women's sexual autonomy and agency being constrained by normative forces, some were able to navigate their conjugal relationships by practising sexual autonomy and agency within and outside their marriage.

First-principle calculations of sulfur dioxide adsorption on the Ca-montmorillonite.

According to the serious problem of sulfur dioxide pollution, montmorillonite is one of the effective ways in gas pollution control because of its excellent absorption properties. One of the fundamental questions is to fully understand sulfur dioxide absorption mechanism of montmorillonite. In this study, using the first-principle methods, we studied the adsorption characteristics of Ca-montmorillonite in the presence of [Formula: see text]. The adsorption energy and elasticity constants as a function of the adsorption capacity were also studied. The calculated results show that bridge site is the most stable adsorption site for [Formula: see text] with the adsorption energy of - 140 meV. As adsorbent, Ca-montmorillonite is a clay with layer-structure, most of bond lengths(such as Al-O, Mg-O, Si-O, and H-O) does not obviously change. As adsorbed gas, the O-S-O bond angle of adsorbed [Formula: see text] change from [Formula: see text] to [Formula: see text]. The volume and adsorption energies of Ca-montmorillonite almost increase linearly with increasing [Formula: see text] adsorption. By calculating the montmorillonite elasticity constants under different adsorption capacity, we found that the elasticity constant C33 which perpendicular to the crystal face, with the maximum changes from 450 to 326 GPa. In addition, Young's modulus,bulk modulus and shear modulus significantly decrease with the increasing adsorption. The calculated results will not only help to understand the physical and chemical of montmorillonite but may also provide theoretical guidance for dealing with the problem of gas pollution.

Study on Interfacial Bonding Properties of NiTi/CuSn10 Dissimilar Materials by Selective Laser Melting.

The dissimilar materials bonding of NiTi alloy with shape memory effect (SME) and CuSn10 alloy with good ductility, electrical conductivity, and thermal conductivity can be used in aerospace, circuits, etc. In order to integrate NiTi and CuSn10 with greatly different physical and chemical properties by selective laser melting (SLM), the effects of forming interlayers with different SLM process parameters were explored in this study. The defects, microstructure, and component diffusion at the interface were also analyzed. Columnar grain was found along the molten pool boundary of the interfacial region, and grains in the interfacial region were refined. Elements in the interfacial region had a good diffusion. Phase identifying of the interface showed that Ni4Ti3 was generated. The analysis showed that the columnar grain, refined grains in the interfacial region, and a certain amount of Ni4Ti3 could strengthen the interfacial bonding. This study provides a theoretical basis for forming NiTi/CuSn10 dissimilar materials structural members.

"I did not know I was gay": sexual identity development and fluidity among married tongzhi in China.

This study aimed to analyse the life experiences of married tongzhi (defined here as men who are sexually attracted to men) in mixed-orientation marriages in mainland China. The study used a life course perspective to understand sexual identity development among tongzhi, born in the 1970s or thereabouts, in heterosexual marriage and rural China. The study focused on identifying the experiences of the 13 tongzhi participants. Using thematic analysis, we found sexual identity development was influenced by China's historical and social context and, in particular, internal (e.g. internalised heteronormativity), informational (e.g. Internet), and cultural (e.g. family-oriented) factors. Some tongzhi did not follow an identity development trajectory as "out and proud" since their identities were embedded in the complexity of family life and social pressure, the invisibility of "gay circles", and normative social roles. They chose instead to maintain their heteronormative marriages, while seeking to explore and fulfil their homoerotic desires. Implications are discussed for epistemology, methodology and advocacy.

Tribo-Induced Near-Infrared Light Emission between Metal and Quartz.

Triboluminescence (TL) refers to the luminescence phenomenon at the material surface under the action of pressure or shear. This fascinating phenomenon can directly convert mechanical energy into light emission without the need for other auxiliary components; therefore, it attracts more and more researchers to conduct research in different wavelength ranges, such as X-ray, ultraviolet, visible light, and terahertz. However, there have been few reports on the study of the near-infrared (NIR) range, which is very important in the integrity of the triboluminescence research. In this research, we found that NIR light with a wavelength ranging from 800 to 1000 nm was generated by friction between solid metals and a quartz crystal. Analysis of the cross section of the quartz disk after friction revealed that the TL phenomenon had a strong relationship with the doping of metal grains into the silica. Density functional theory (DFT) and X-ray photoelectron spectroscopy were also conducted to further identify the results. We infer that such light emission arises from the implantation of metal grains into the surface of the quartz, which forms a metal-insulator junction with amorphous silica. Moreover, electron transition between the metal and the insulator, followed by a transition at the center of the defects, causes near-infrared light emission. Our research reveals the infrared luminescence behavior from a different perspective, the transfer of materials, and perhaps deepens the understanding of the near-infrared emission mechanism.

Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting.

In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM) technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360-HV1 390, an ultimate tensile strength of 1000-1100 MPa, yield strength of 900-950 MPa, and an elongation of 8%-10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time.

Novel customized template designing for patellar resurfacing in total knee arthroplasty.

Due to the irregular shape of patella and difficulty in identifying its bony landmarks, it can be a challenge for surgeons to accurately and symmetrically perform patellar resurfacing. Three-dimensional (3D) models of 20 patellae were generated from computed tomographic images. Using a computer-assisted preoperative planning technique, customized template designs were developed to guide patellar resurfacing. The patellar models and corresponding templates were produced through rapid prototyping. The accuracy of this technique was assessed after applying the templates on patellar models and cadaver specimens, respectively. Using preoperative planning and predesigned templates, a significant improvement in symmetric patellar resurfacing, with a mean angle of 1.21° mediolateral (ML) obliquity and 1.95° superoinferior (SI) obliquity, was observed compared with the conventional sawguide technique (mean angle of ML and SI was 4.13°, 4.95°, respectively). Additionally, the use of customized templates reproduced the desired preplanned patellar resection. Preoperative planning with 3D imaging and customized templates improved the accuracy of patellar resurfacing in terms of the obliquity and thickness. CLINICAL RELEVANCE: A novel customized template designed for patellar resectioning will benefit surgeons in performing patellar resurfacing. This technique will provide accurate patellar resurfacing in clinical practice. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1798-1803, 2016.

Intraoperative anthropomorphic study of anterior femoral condyles compared with sizing of femoral arthroplasty.

PURPOSE: The present study was designed to compare the dimensions of the anterior femoral condyle with those of the anterior component flange using intraoperative morphological data. METHODS: Overall, 1227 knees in 962 patients were included in this study. The height of the anterior lateral/medial condylar height (ALCH/AMCH) was measured and compared between men and women. These morphological data were compared with the dimensions of the chosen component for each patient. The lateral/medial anterior femoral offset was calculated, and the over-/understuffing rates were compared between men and women. RESULTS: The median ALCH in men was 8.5 mm (6.5, 10.0 mm) versus 7.0 mm (6.0, 9.0 mm) in women. The median AMCH in men was 4.0 mm (2.5, 6.0 mm) versus 3.5 mm (2.5, 6.0 mm) in women. There was a significant difference between the genders with respect to ALCH (p < 0.05). When the dimensions of the component were compared with those of the native knee, the anterior lateral flange height was smaller than the native knees (1.3 mm in male, 0.7 mm in female), but the anterior medial flange height was larger than the corresponding condyle (1.8 mm in male, 1.8 mm in female). A significant difference was observed between the genders with respect to the ideal fit rate of ALCH (p < 0.01). CONCLUSION: The results demonstrate that gender differences exist in the anterior lateral condyles of knees. The anterior flange of component is not designed to precisely reproduce normal trochlear anatomy. LEVEL OF EVIDENCE: II.

Design and Fabrication of a Precision Template for Spine Surgery Using Selective Laser Melting (SLM).

In order to meet the clinical requirements of spine surgery, this paper proposes the fabrication of the customized template for spine surgery through computer-aided design. A 3D metal printing-selective laser melting (SLM) technique was employed to directly fabricate the 316L stainless steel template, and the metal template with tiny locating holes was used as an auxiliary tool to insert spinal screws inside the patient's body. To guarantee accurate fabrication of the template for cervical vertebra operation, the contact face was placed upwards to improve the joint quality between the template and the cervical vertebra. The joint surface of the printed template had a roughness of Ra = 13 ± 2 µm. After abrasive blasting, the surface roughness was Ra = 7 ± 0.5 µm. The surgical metal template was bound with the 3D-printed Acrylonitrile Butadiene Styrene (ABS) plastic model. The micro-hardness values determined at the cross-sections of SLM-processed samples varied from HV0.3 250 to HV0.3 280, and the measured tensile strength was in the range of 450 MPa to 560 MPa, which showed that the template had requisite strength. Finally, the metal template was clinically used in the patient's surgical operation, and the screws were inserted precisely as the result of using the auxiliary template. The geometrical parameters of the template hole (e.g., diameter and wall thickness) were optimized, and measures were taken to optimize the key geometrical units (e.g., hole units) in metal 3D printing. Compared to the traditional technology of screw insertion, the use of the surgical metal template enabled the screws to be inserted more easily and accurately during spinal surgery. However, the design of the high-quality template should fully take into account the clinical demands of surgeons, as well as the advice of the designing engineers and operating technicians.

Comprehensive assessment of patellar morphology using computed tomography-based three-dimensional computer models.

BACKGROUND: The objectives of this study were to assess patellar morphology using computed tomography-based three-dimensional computer models and to determine the utility of the subchondral method for patellar resection in total knee arthroplasty (TKA). METHODS: Overall, 120 subjects (60 males, 60 females) from 20 to 50 years old were included. Computer tomography images were used to construct 3D computer models of 240 knees. An anthropometric analysis of variance was used with the models to detect differences between the sides, age groups, and genders. RESULTS: Based on the available numbers, there were significant gender differences in the patellar length, width, and thickness even with strict control for the height and weight of the patients. The average patellar width/thickness ratio was 1.95, regardless of gender, and there was a good correlation between the patellar width and thickness (male: r=0.68, p<0.01; female: r=0.75, p<0.01). After using the subchondral method to virtually resect the patellae, the mean thickness for males and female was 14.0mm and 12.3mm, respectively. The proportion of the residual bony thickness that was less than 12 mm was 5.83% (seven cases) in the male group and up to 42.5% (51 cases) in the female group. There was excellent intra-observer reliability and inter-observer reliability regarding the dimensional measurements in this study. CONCLUSIONS: A robust method of measuring and virtually resecting the patella was established. The anthropometric dimensions of this study could provide basic data for guiding surgical management of the patella in TKA and are useful in designing patellar implants. CLINICAL RELEVANCE: The anthropometric patellar information is essential for surgeons to perform patellar resurfacing in TKA.

Intraoperative anthropometric measurements of tibial morphology: comparisons with the dimensions of current tibial implants.

PURPOSES: This study analyzed morphological differences in the resected proximal tibial surfaces of Chinese males and females undergoing total knee arthroplasty (TKA) and compared the measurements with the dimensions of five currently used tibial implants. METHODS: The mediolateral (ML), middle anteroposterior (AP), medial anteroposterior (MAP), and lateral anteroposterior (LAP) dimensions of the resected tibial surfaces of 976 Chinese TKA knees (177 male, 799 female) were measured. The ML/AP ratio of every knee was calculated. These morphological data were compared with the dimensions of five currently used tibial implants. RESULTS: The ML, AP, MAP, and LAP dimensions of the resected proximal tibias showed significant differences according to gender. Compared with currently used tibial implants, the smaller implants showed tibial ML undersizing and the larger implants showed tibial ML overhang. The ML/AP aspect ratio progressively decreased with increasing AP dimension in the resected proximal tibias, which contrasts with the relatively constant or increased (NexGen) aspect ratio in currently used tibial implants. Males showed a higher ML/AP aspect ratio than females for a given AP dimension. This indicates that for an implant with a given AP dimension, the tibial ML dimension tends to be undersized in males and to overhang in females. CONCLUSION: The results of this study may provide fundamental data for designing suitable tibial implants for use in the Chinese population, especially for design of gender-specific prostheses. LEVEL OF EVIDENCE: II.

[Simultaneous determination of five nucleotides in Bulbus Fritillariae by RP-HPLC].

A high-performance liquid chromatography method was developed for determination of five nucleotides in Bulbus Fritillariae. The five nucleotides were uridine, adenine, guanosine, thymidine, adenosine, respectively. A Welch materials XB-C18 column (4.6 mm x 250 mm, 5 microm) was used and the chromatographic separation was achieved using 5 mmoL x L(-1) ammonium acetate-acetic acid buffer solution (pH 4.30, B) and methanol (A) as mobile phases, the gradient elution program: 0-10 min, 0%-1% A, 10-20 min, 1%-5% A, 20-25 min, 5% A, 25-35 min, 5%-30% A, 35-37 min, 30%-0% A, 37-40 min, 0% A with a flow rate of 1 mL x min(-1) and monitored at 260 nm, the injection volume was 20 microL. The peak areas of nucleotides and the concentrations showed a good linear relation ranged from 0.24 to 13.60 mg x L(-1), r > 0.9983. The intra- and inter-day pecision results were adequate with the RSDs of 2.1% or below. The repeatability was good and the RSD were smaller than 5.5%. The recoveries of nucleosides were in the range of 93.55% and 101.9%, RSD < 3.0%; The order of nucleotides contents in different Bulbus Fritillariae was F. hupehensis > F. thunberqii > F. cirrhosa approximately F. ussuriensis. The method is simple, convenient and accurate. It can be used for the determination of nucleosides and supplying evidence for exploiting and applying of Bulbus Fritillariae.