1.Physicochemical properties of chitosan microspheres/silk fibroin/calcium sulfate bone cement
Peng WANG ; Bin PI ; Jinning WANG ; Xuesong ZHU ; Huilin YANG
Chinese Journal of Tissue Engineering Research 2014;(12):1831-1838
BACKGROUND:Calcium sulfate used in kyphoplasty and vertebrolplasty has good physical and chemical properties, exerts no toxic effects on human body and has the degradation performance. But its main drawback is rapid degradation.
OBJECTIVE:To develop a chitosan microsphere with silk fibroin/calcium sulfate cement to prepare drug carrier system.
METHODS:Chitosan microspheres were prepared by the emulsion method. Scanning electron microscopy, particle size analysis and swel ing rate were used to study the properties of the microspheres. Different silk concentrations (3%, 6%and 9%) and weight rates (0.5%,1%and 5%) of chitosan microspheres were used to determine the best formula which has the strongest mechanical properties. The composition of this composite bone cement was detected by using X-ray diffraction and Fourier transform infrared spectroscopy.
RESULTS AND CONCLUSION:When the concentration of silk fibroin was 6%and weight rate of chitosan microspheres was 0.5%, we could obtain the maximum compressive strength, which was (39.17±1.96) MPa. With this composition, the initial setting time was (12.99±1.63) minutes and the final setting time was (21.55±0.54) minutes. The results from X-ray diffraction and Fourier transform infrared spectroscopy demonstrated that the main phase composition was calcium sulfate, and silk and chitosan were also included. The composite chitosan microspheres exhibited a slightly wrinkled surface, but were stil intact in spherical shape, indicating the preparation of chitosan microspheres/silk fibroin/calcium sulfate cement was reliable and the product had good structures and properties.
2.Cytocompatibility and cytotoxicity of a novel composite bone cement material composed of chitosan microsphere, alpha-tricalcium phosphate and silk fibroin
Jinning WANG ; Bin PI ; Peng WANG ; Xuesong ZHU ; Huilin YANG
Chinese Journal of Tissue Engineering Research 2014;(16):2519-2525
BACKGROUND:With excelent biocompatibility and osteoconduction, calcium phosphate bone cement has been used in clinic, but the poor mechanical properties and lack of osteoinduction restrict its further use. OBJECTIVE:To investigate the cytocompatibility and cytotoxicity of a novel drug-carrying composite of bone cement composed of chitosan microsphere, α-tricalcium phosphate and silk fibroin. METHODS:MC3T3-E1 cels were cultured in vitroin minimum essential medium alpha medium (α-MEM), which was supplemented with 10% fetal bovine serum, and 1% streptomycin sulfate, extract of the cement material at concentrations of 100% and 50%, and 6.4 mL/L phenol. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to measure cellproliferation and the cytotoxicity was assessed by the activity of lactate dehydrogenase. The MC3T3-E1 cels culturedin vitro were colected and seeded on the composite cement material, and cellmorphology was observed by scanning electron microscope. RESULTS AND CONCLUSION:The extract of composite cement material had no influences on the MC3T3-E1 cellproliferation, showing no obvious cytotoxicity. The scanning electron microscope image showed MC3T3-E1 cels adhered and proliferated wel on the composite cement material composed of chitosan microsphere, α-tricalcium phosphate and silk fibroin, and pseudopodia out of the cels were closely attached to the material surface. In conclusion, the cement composite was proved to have satisfactory cytocompatibility and no obvious cytotoxicity.
3.Establishment of an in vitro model of brain blood barrier
Yunan YANG ; Yunhua GAO ; Jinning LOU ; Ping LIU ; Chixue FU
Journal of Third Military Medical University 2003;0(22):-
Objective To study the dynamic changes of transendothelial electrical resistance (TEER) on our in vitro model of brain blood barrier (BBB) made from primary culture of BALB/c mouse brain microvascular endothelial cells (BMVEC), and to explore the relation between TEER and BBB permeability, and search for the best culture condition. Methods BMVEC were isolated from BALB/c mouse and cultured on a transwell insert with special micro-pore. The cells were identified with immunohistochemical methods and electron microscope. TEER over BMVEC was measured after BBB model establishment for determining the 3H-Glucose permeability of BBB in vitro. Results BMVEC cultured in the transwell insert exhibited typical "flagstone" appearance and in a tight monolayer structure under electron microscope. Immunohistochemical detection of ZO-1 protein, a marker antigen of tight junction, showed smooth, continuous and tight junctions between confluent BMVEC. TEER over BMVEC monolayer increased to (346?10) ?/cm2 when the permeability for 3H-Glucose was decreased to the minimum. Conclusion BBB model in vitro made from primary culture of BMVEC in transwell has the basic characteristics of BBB in morphology, electrical resistance and permeability.
4.MR influence of different magnetic field and different scanner with same magnetic field on apparent diffusion coefficient of abdominal organs in healthy volunteers
Jiayin GAO ; Jiacheng ZHANG ; Zhenghan YANG ; Jinning LI ; Min CHEN ; Cheng ZHOU
Chinese Journal of Radiology 2013;(2):142-146
Objective To evaluate the reproducibility of ADC measurements at 1.5 vs 3.0 T and at 1.5 T of different scanners in liver,spleen and pancreas of healthy volunteers.Methods Abdominal DWI were performed on 33 healthy volunteers by using GE 1.5 T,Siemens 1.5 T and Philips 3.0 T MR scanners.The mean ADC values of liver,spleen,pancreatic head,body,and tail were calculated.The ADC data were analyzed by using paired-sample t tests.Results The mean ADC of liver at GE 1.5 T,Siemens 1.5T and Philips 3.0 T were (1.56 ±0.10) ×10-3,(1.67 ±0.15) ×10-3 and(1.35 ±0.12) ×10-3 mm2/s,spleen were (0.96±0.10) × 10 3,(0.98 ±0.11) ×10-3and(0.81 ±0.14) × 10-3 mm2/s,pancreatic head were (2.09 ± 0.27) × 10-3,(2.20 ± 0.21) × 10-3 and (2.05 ± 0.27) × 10-3 mm2/s,pancreatic body were (2.03 ± 0.27) × 10-3,(2.09 ± 0.30) × 10-3 and (1.76 ± 0.25) × 10-3 mm2/s,pancreatic tail were (1.88 ± 0.28) × 10-3,(1.88 ± 0.27) × 10-3 and (1.56 ± 0.27) × 10-3 mm2/s,respectively.From the aspect of different field strength MR scanners,there were significant differences in mean ADC of liver (t =11.073,P <0.01 in GE 1.5 T vs Philips 3.0 T; t =12.795,P <0.01 in Siemens 1.5 T vs Philips 3.0 T),spleen (t =4.143,P < 0.01 in GE 1.5 T vs Philips 3.0 T; t =5.376,P < 0.01 in Siemens 1.5 T vs Philips 3.0 T),pancreatic body (t =4.677,P < 0.01 in GE 1.5 T vs Philips 3.0 T; t =5.174,P <0.01 in Siemens 1.5 T vs Philips 3.0 T) and tail (t =5.356,P <0.01 in GE 1.5 T vs Philips 3.0 T; t =4.648,P <0.01 in Siemens 1.5 T vs Philips 3.0 T),but there were no significant differences in mean ADC of pancreatic head (t =0.340,P > 0.05 in GE 1.5 T vs Philips 3.0 T; t =1.349,P > 0.05 in Siemens 1.5 T vs Philips3.0 T).From the aspect of different 1.5 T MR scanners,there were significant differences in mean ADC of liver (t =-4.563,P < 0.01),but there were no significant differences in mean ADC of spleen (t =-0.732,P > 0.05),pancreatic head (t =-0.879,P > 0.05),body (t =-1.020,P >0.05) and tail (t =0.054,P > 0.05).Conclusion Between 1.5 T and 3.0 T MR scanners,there were significant differences in mean ADC of liver,spleen,pancreatic body and tail,but there were no significant differences in mean ADC of pancreatic head.At different 1.5 T MR scanners,there were significant differences in mean ADC of liver,but there were no significant differences in mean ADC of spleen,pancreatic head,body and tail.
5.Evaluation on the intervention of Nitroglycerin on ~(99m)TC-MIBI myocardial tomography imaging for myocardial viability
Yumei XIAO ; Jinning YANG ; Fan LI ; Mingjian XIAN ; Xuejing JIN ; Rongguang GUAN ; Jinchao CHEN ; Wei HUANG ; Yu KE
Journal of Chinese Physician 2001;0(05):-
Objective To study the value of the intervention of Nitroglycerin(NTG) on ~(99m)Tc-MIBI myocardial tomography imaging in the estimation of myocardial viability.Method According to the analysis of autologous electrocardiogram(ECG),a total of 66 patients with unstable angina(UA) was divided into group A and group B.The patients in group A were without old myocardial infarction and those of group B were with old myocardial infarction.The patients in the two groups were respectively underwent the resting ~(99m)Tc-MIBI myocardial tomography imaging and the NTG administration intervened the next day.The imaging was collected and tested by the computer.Results Of 594 myocardial segments in the 66 cases,242 segments(40.7%) in testing myocardial imaging were proved to be perfusion abnormal,while after the intervention of NTG administration,the perfusion of 114 segments(47.1%) had been improved according to the imaging.Conclusion The intervention of NTG administration on ~(99m)Tc-MIBI myocardial tomography imaging for myocardial viability is simple,safe,objective and accurate,which provides a forceful means for the post-operative evaluation and the selection of indication before the rebuilding of coronary artery of the UA patients.
6. Clinical application of computed tomography angiography and three-dimensional reconstruction in repairing high-voltage electrical burn wounds in necks, shoulders, axillas, and upper arms with tissue flaps
Zhibin YANG ; Jiandong NIU ; Yong MA ; Jinning LI ; Jiangyong SHEN ; Ming YAO
Chinese Journal of Burns 2018;34(12):874-880
Objective:
To explore the application value of computed tomography angiography (CTA) and three-dimensional reconstruction in repairing high-voltage electrical burn wounds in necks, shoulders, axillas, and upper arms with tissue flaps.
Methods:
From December 2014 to December 2018, 12 patients with high-voltage electrical burns in necks, shoulders, axillas, and upper arms were hospitalized. The size of wounds ranged from 13 cm×10 cm to 32 cm×15 cm after complete debridement. Before tissue flap repair, the subclavian artery-axillary artery-brachial artery and their branches were examined by CTA. The main target vessels and their branches were conducted by three-dimensional reconstruction, and the development of the axis vessels for the tissue flaps planning to dissect and their branches were observed. For wounds in upper arms, amputation stump bone exposed wounds, and wounds in axillas and the anterior, the latissimus dorsi myocutaneous flap is the first choice for repair, if the thoracodorsal artery and internal and external branches are well developed according to CTA examination. Latissimus dorsi myocutaneous flaps were used in 6 patients with the area of myocutaneous flap ranging from 16 cm×12 cm to 32 cm×17 cm. All the donor sites were covered by split-thickness skin graft of thighs. For large wounds in occiputs, necks, and scapulas, the contralateral lower trapezius myocutaneous flap is the first choice for repair, if the superficial descending branch and deep branch of the contralateral transverse cervical artery are well developed according to CTA examination. For small wounds in necks and scapulas, the ipsilateral lower trapezius myocutaneous flap can be used for repair, if the superficial descending branch of the ipsilateral transverse cervical artery is well developed according to CTA examination. Lower trapezius myocutaneous flaps were used in 4 patients with the area of myocutaneous flap ranging from 18 cm×12 cm to 25 cm×17 cm. The donor site of one patient was sutured directly and the donor site of the other 3 patients was covered by split-thickness skin graft of thighs. For wounds in the posteromedial side of upper arms and the anterior side of axillas, the lateral thoracic skin flaps can be used for repair, if the latissimus dorsi myocutaneous flap can not be utilized for reasons of back burn or no muscle is needed for dead space, when the blood supply of side chest skin is reliable according to CTA examination. Lateral thoracic skin flaps were used in 2 patients with the area of skin flap ranging from 16 cm×12 cm to 17 cm×14 cm. The donor site of one patient was sutured directly and the donor site of the other one patient was covered by split-thickness skin graft of thigh.
Results:
During the operation of tissue flap repair in 12 patients, the orientation and starting position of the axis vessels were consistent with those observed by CTA examination before operation. All the tissue flaps survived after operation. During follow-up of 1 to 24 months, the patients were satisfied with no serious scar contracture affecting the function nor secondary infection or chronic ulcer.
Conclusions
CTA and its three-dimensional reconstruction technique can clearly reconstruct the subclavian artery-axillary artery-brachial artery and their branches before repair of high-voltage burn wounds in necks, shoulders, axillas, and upper arms. It can be used to observe whether the vessels are embolized or not and the starting position and orientation of blood vessels, which can provide an important reference for the selection of tissue flap transplantion.
7.A cross-sectional survey on rehabilitation therapists in Grade Ⅲ public psychiatric hospitals
Yiqun KANG ; Jinning LIU ; Yunlong YANG ; Lili ZHANG ; Yunshu ZHANG ; Keqing LI
Chinese Mental Health Journal 2024;38(1):63-67
Objective:To understand the basic information such as age,job title,and education of rehabilita-tion therapists in the Grade Ⅲ public psychiatric hospitals in China,and provide fundamental data for the construc-tion of the mental health rehabilitation talent team.Methods:The staffing of rehabilitation therapists in 43 Grade Ⅲpublic psychiatric hospitals in eastern,central,and western regions of China were investigated.The age,education,job title,professional relevance and inter-regional differences of the rehabilitation therapists were statistically ana-lyzed.Results:There were 197 rehabilitation therapists in 43 hospitals surveyed.The age distribution was mainly in 20-30 and 30-40 years old with a bachelor's degree and junior,and more than half of the personnel had their first academy degree related to the rehabilitation profession.The differences in age,education,job title were statistically significant in the eastern,central and western regions.Conclusion:The overall quality of the rehabilitation therapists in China's Grade Ⅲ public psychiatric hospitals is relatively high,and the age structure is reasonable.However,the proportion of senior professional titles is relatively low.Therefore,it is necessary to focus on talent training and the establishment of promotion systems in the future,in order to improve the professional development space and level of the entire industry.
8.Dose-effect relationship of alfentanil inhibiting cardiovascular responses to endotracheal intubation when combined with midazolam and etomidate
Fengdan MA ; Mingyu YANG ; Bowei JIANG ; Yang YANG ; Rui LIU ; Jinning LIU ; Weiming LIU ; Chunguang WANG
Chinese Journal of Anesthesiology 2022;42(12):1473-1476
Objective:To investigate the dose-effect relationship of alfentanil inhibiting cardiovascular responses to tracheal intubation when combined with midazolam and etomidate.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients of either sex, aged 18-64 yr, with body mass index<32 kg/m 2, undergoing elective operation under general anesthesia with endotracheal intubation, were enrolled in this study.Midazolam 0.025 mg/kg was intravenously injected for adequate sedation, and 5 min later mean arterial pressure and heart rate were recorded for 3 consecutive times at an interval of 3 min, and the mean value was calculated and served as the baseline value.Etomidate 0.3 mg/kg was intravenously injected, and alfentanil and rocuronium 0.6 mg/kg were intravenously injected when bispectral index value < 60, and then 1.4 min later tracheal intubation was performed.The dose of alfentanil was determined by the Dixon′s up-and-down method.The initial dose of alfentanil was set at 20 μg/kg.The dose of alfentanil in the next patient was determined according to the development of cardiovascular responses to tracheal intubation, and the ratio between the two successive doses was 1.0∶1.1.The cardiovascular response was defined as as positive when the maximum value of mean arterial pressure or heart rate increased by ≥20% of the baseline value within 2 min after endotracheal intubation.Probit method was used to determine the ED 50, ED 95 and 95% confidence interval of alfentanil inhibiting cardiovascular responses to tracheal intubation. Results:When combined with midazolam and etomidate, the ED 50 (95% confidence interval) of alfentanil inhibiting cardiovascular responses to tracheal intubation was 21.343 (19.105-24.516) μg/kg, and the ED 95 (95% confidence interval) was 25.043 (22.983-48.983) μg/kg. Conclusions:When combined with midazolam and etomidate, the ED 50 and ED 95 of alfentanil inhibiting cardiovascular responses to tracheal intubation are 21.343 and 25.043 μg/kg, respectively.
9.Risk factors for residual pain after percutaneous kyphoplasty for osteoporotic vertebral fractures
Junjie NIU ; Li NI ; Dawei SONG ; Jinning WANG ; Tao FENG ; Shengyang JIN ; Yan YANG ; Huilin YANG ; Jun ZOU
Chinese Journal of Orthopaedic Trauma 2023;25(1):31-36
Objective:To analyze the risk factors for residual pain after percutaneous kyphoplasty (PKP) for osteoporotic vertebral fractures (OVF).Methods:Retrospectively analyzed were the patients with OVC who had been treated at Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University by single level PKP from January 2020 to December 2021. They were 40 men and 181 women, with an age of (69.6±8.2) years. By the pain score of visual analogue scale (VAS) on the postoperative day 3, they were assigned into 2 groups: a residual pain group (VAS≥4) and a control group (VAS<4). The general demographics, radiographic and surgical related data of the 2 groups were analyzed by single factor analysis, including their gender, age, bone mineral density, body mass index, glucocorticoid usage, follow-up time, duration of symptoms, fracture location, severity of fracture compression, intravertebral cleft, middle column involvement, thoracolumbar fascia injury, anesthesia method, puncture method, volume of bone cement injected, cement-endplates contact, pattern of cement distribution, cement leakage, vertebral height restoration, preoperative cobb angle and correction of cobb angle. The P<0.1 factors screened were further analyzed by the multivariate logistic regression to determine the final variables. Results:In the present study, 19 patients were assigned into the residual pain group and 202 patients the control group. The univariate analysis showed that body mass index ( P=0.059), intravertebral cleft ( P=0.049) and thoracolumbar fascia injury ( P< 0.001) increased the risk for residual pain. The multivariate logistic regression analysis showed that thora-columbar fascia injury was an independent risk factor for residual pain ( OR=6.127, 95% CI: 2.240 to 16.755, P<0.001). Conclusion:Thoracolumbar fascia injury is an independent risk factor for residual pain after PKP for OVF.
10.Relationship between clinical features and peripheral blood test indicators and curative effect in patients with acquired hemophagocytic syndrome
Yang CHEN ; Wenjing ZHANG ; Xue YAN ; Yongchao MA ; Ting ZHANG ; Lin GUI ; Lili YANG ; Jinning SHI ; Guangsheng HE
Journal of Leukemia & Lymphoma 2018;27(11):670-674
Objective To explore relationship between clinical features and peripheral blood test indicators and curative effect in adult patients with acquired hemophagocytic syndrome (HPS). Methods A total of 61 adult patients with acquired HPS who were admitted to the First Affiliated Hospital with Nanjing Medical University and the Affiliated Jiangning Hospital of Nanjing Medical University from April 2014 to March 2017 were enrolled, including 38 males and 23 females, with a median age of 48 years (17-86 years). The retrospective analyses of their clinical data and laboratory examination results were made in this study. Results There was no significant difference in the therapeutic effective rate of 61 HPS patients caused by different inducements after treatment (P =0.184). The prothrombin time (PT) before treatment was higher than that after treatment [(12.90±1.97) s vs. (12.35±1.78) s, P= 0.046]; the level of lactate dehydrogenase (LDH) before treatment was higher than that after treatment (median: 476 U/L vs. 231 U/L, P = 0.000); the level of D-dimer (D-D) before treatment was higher than that after treatment (median: 1.46 mg/L vs. 0.51 mg/L, P = 0.007); the level of aspartate aminotransferase (AST) before treatment was higher than that after treatment (median: 54.9 U/L vs. 26.0 U/L, P= 0.000); the level of serum calcium before treatment was lower than that after treatment [(2.07±0.20) mmol/L vs. (2.18±0.23) mmol/L, P = 0.043]. The peripheral blood platelet counts (Plt) in the effective group (32 cases) before treatment was higher than that in the ineffective group (29 cases) (median: 104.0×109/L vs. 63.5×109/L, P =0.007), the level of albumin (ALB) in the effective group was higher than that in the ineffective group [(35.50 ±6.17) mmol/L vs. (31.93 ±6.54) mmol/L, P = 0.033], the level of serum calcium in the effective group was higher than those in the ineffective group [(2.18±0.18) mmol/L vs. (2.08±0.20) mmol/L, P = 0.047], the level of prothrombin time (PT) in the effective group was lower than that in the ineffective group [(12.40±1.76) s vs. (13.43±2.06) s, P = 0.041], and the level of LDH in the effective group was lower than that in the ineffective group (median: 415.0 U/L vs. 593.5 U/L, P= 0.032). Conclusion The lower expressions of Plt, ALB and serum calcium, and the higher expressions of PT and LDH may indicate the poor prognosis of adult acquired HPS, and there fore these patients need to be paid attention.