BACKGROUND:Titanium mesh has good clinical effect in repairing skul defects, but due to the lack of bone induction ability, the titanium mesh has a poor integration with the bone tissue. OBJECTIVE:To observe the biological properties of the gradient bioactive coating materials on the titanium surface in the skul repair. METHODS: Osteoblasts were co-cultured with the titanium mesh with or without gradient bioactive coatings for 14 days, and then cel proliferation was detected using MTT method. Seventy-one patients with skul defects were enroled, including 43 males and 28 females, aged 15-60 years, and were subjected to skul repair using the titanium mesh with (observation group, n=3) or without (control group, n=38) gradient bioactive coatings. During the postoperative folow-up of 12 months, the repairing effects and adverse reactions were observed in the two groups. RESULTS AND CONCLUSION:(1)In vitrocel culture: the cel proliferative ability was increased significantly in the observation group as compared with the control group at 8, 10, 12 and 14 days after cel culture. (2)In vivo repair: the hospital stay and wound healing time in the observation group were significantly lower than those in the control group (P< 0.05), and at the final folow-up, the postoperative recovery effect was significantly higher in the observation group than the control group (P < 0.05). The titanium meshes were fixed firmly in the two groups, with no floating, infection and exposure. These results show that the titanium mesh with gradient bioactive coating has good biocompatibility and osteoinduction capacity.

BACKGROUND:Col agen/bioactive glass composite materials possess excellent osteogenic potential and biocompatibility, but its application in bone tissue engineering is limited by mechanical property and degradation. OBJECTIVE:To construct col agen/bioactive glass/chitosan composite scaffolds with good mechanical property, anti-degradation ability and bone repair property.
METHODS:Bioactive glass/col agen composite scaffolds with chitosan as dispersant were prepared by lyophylization. Fourier transform infrared spectroscopy, scanning electron microscope, X-ray diffraction, and dynamic biomechanical testing were used to characterize the structure and properties of the composite scaffolds. RESULTS AND CONCLUSION:Results show that charge-attractions in pre-prepared bioactive glass/chitosan solution increased the homogeneity of bioactive glass dispersed in col agen gel and the compressive modulus and strength increased significantly due to the homogeneity and intermolecular interactions between chitosan and col agen. The enzymatic degradation rate and mineralization activity in the simulated body fluid were also lower because of a high degree of embedment of bioactive glass in col agen/chitosan matrix, and entanglement of col agen in chitosan at molecular level, which decreased the exposure of bioactive glass to the simulated body fluid, and col agen to enzyme solution.

Objective To study the protective effects of taurine on liver and kidney injury induced by intestinal ischemia-reperfusion(I/R) in rats.Methods Male Wistar rats were randomly assigned into Sham,I/R,and taurine groups.Thirty min before operation,2% taurine(200 mg/kg) was injected via dorsal vein of the rat′s penis.Intestinal ischemia-reperfusion was produced by occlusion of superior mesenteric artery for one hour later,then the blood flow was restored by removing the clamps.Blood samples were taken from rats in I/R and taurine groups at 1.5,3,6 and 12h after reperfusion,and the serum levels of ALT,AST,BUN and Cr were measured to evaluate the functions of liver and kidney.Tissues from livers and kidneys were cryostated and stained with hematoxylin and eosin to observe changes in histological pathology.TUNEL was also performed to examine apoptotic cells and the average light density levels were measured.Results The serum levels of ALT,AST,BUN and Cr in I/R group were significantly higher than those in Sham group(P

Objective To investigate the mechanical prosperity and degradation rate of the scaffolds with compounding collagen and the nano sol-gel derived bioactive glass were studied,and provide the theoretical basis for the further application of collagen based scaffolds.Method The scaffold with compounding collagen and the nano sol-gel derived bioactive glass(58S)were prepared using the freeze-drying techniques with the bioactive glass as phase addition.By affecting the aggregation state of the collagen fibers with adjusting the supplementation of bioactive glass to change the microstructures of the compound scaffolds and finatly the compound scaffolds with different mechanical properties were prepared.Results (1)As the aggregation state of the collagen fibers changes,the scaffolds with the coarser collagen fibers is prepared with the diameters 400-600 nm approximately.The coarser collagen fibers will play an important role in improving the mechanical property and slowing down the degradation rate of the collagen based scaffolds.(2)The interactions between bioactive glass and collagen are studied by FTIR and Raman technologies.When the quality of content of collagen in the compound scaffolds is lower than 20%,the secondary structure of collagen is damaged severely.Conclusion The composite scaffolds with the mass ratio of collagen to bioactive glass 40:60 has the best performance in mechanical property and degradation,which will be helpful for further applications.

Objective This study was to explore deaf people's needs for a smooth communication with doctors and/or nurses during health consultation in the outpatient department or when being hospitalized and supply reference for compilation of sign language textbooks.Methods Purposive sampling was used and semi-structured interviews were conducted.Six deaf participants who met the inclusion and exclusion criteria were interviewed.It lased for 20 to 40 minutes for each interview.Interviews were recorded digitally and then transcribed and validated.Transcripts were analyzed using a method of thematic analysis.Results Three themes were identified,i.e.needs for sign language interpreters,needs for information and knowledge.and needs for psychosocial and emotional support.Needs for sign language interpreters meant that doctors and nurses were able to communicate with them using simple sign language instead of terminology.The required information and knowledge covered three aspects,i.e.health condition,pharmaceutical therapy,and self-care activity.Conclusions There may exist serious communicative barriers for deaf people during their health consultation in the outpatient department or when being hospitalized.There is a need for healthcare professionals who are competent in sign language to establish the health delivery environment with minimal barriers.

Objective This study aimed to explore issues about dysandia female during pregnancy,peripartum and contraception and to supply reference for their reproductive health improvement. Methods Purposive sampling strategy was used. With the aid of an interview guide, 12 dysaudia women who met inclu-sion and exclusion criteria were invited to be interviewed. Interviews were recorded, validated and then ana-lyzed. Results Four themes were generated, limited knowledge, passive information acquisition, total depen-dence on family and reluctant to talk about contraception. Total dependence on family was noticeable during pregnancy and peripartum. Though little was known about health protection related to pregnancy, peripartum and contraception, participants were passive at seeking for relevant information. Conclusions Deaf women may experience more threats to reproductive health in relation to pregnancy, peripartum and contraception that they require more guidance and assistance.

Objective:To evaluate the efficacy and safety of drug-coated balloon (DCB) with paclitaxel in the treatment of femoropopliteal artery in-stent restenosis.Methods:From Dec 2016 to Jul 2020, clinical and follow-up data of femoropopliteal artery in-stent restenosis (ISR) treated with paclitaxel DCB were retrospectively analyzed.Results:Firty-two patients (56 lower limbs) with femoropopliteal artery ISR underwent DCB therapy. According to Rutherford classification, 1 case was R2 (1.7%), 9 cases were R3 (23.2%), 23 cases were R4 (41.1%), 15 cases were R5 (26.8%) and 4 cases were R6 (7.1%). According to Tosaka classification of ISR, 46 (81.2%)limbs were Tosaka Ⅱ, 10(17.9%)limbs were Tosaka Ⅲ Mean lesion length of ISR was (240±122)mm. Bail-out stent implantation was performed in 25% cases. The median follow-up time was 18 months. The all-cause mortality rate was 11.8%, the major amputation rate was 5.9%, the primary patency rate was 53.4%, the primary assisted patency rate was 67.1%, the secondary patency rate was 93.2%, and the F-TLR was 77.2%.Conclusion:DCB is a safe and effective endovascular therapy for femoropopliteal artery ISR.

Objective:To evaluate the efficacy and safety of drug-coated balloon (DCB) with paclitaxel in the treatment of femoropopliteal arteriosclerosis obliterans (ASO).Methods:From Dec 2016 to Dec 2018, clinical data of femoropopliteal artery disease patients treated with paclitaxel DCB in Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed.Results:A total of 83 patients (95 lower limbs) underwent DCB therapy. Including 50 chronic total occlusion (CTO) lesions (52.6%) with mean lesion length of (18.35±10.61) cm. Twenty-four lesions (25.3%) were moderately or severely calcified. Bail-out stent implantation was performed in 29.5% cases. The mean follow-up time was 17.5 months. Twelve months after intervention, the all-cause mortality rate was 6.0%, the major amputation rate was 4.3%, the primary patency rate was 60.6%, the primary assisted patency rate was 72.4%, the secondary patency rate was 83.4%, and the freedom rate from clinically-driven target lesion revascularization(F-TLR) was 77.0%. Moderate to severe calcification was an independent risk factor for the primary patency of DCB therapy.Conclusion:DCB is a safe and effective endovascular therapy for femoropopliteal artery disease.

Objective:To evaluate the long-term outcome of Viabahn stent graft in the treatment of complex femoropopliteal occlusive lesions.Methods:From Sep 2013 to Mar 2020, clinical data of TASC C and D femoropopliteal lesions treated with Viabahn were retrospectively analyzed. Patency rates, the freedom rate from clinically-driven target lesion revascularization (F-TLR), limb salvage and survival after five years were calculated.Results:A total of 65 patients (67 lower limbs) were included. 20 limbs were TASC C lesions, 47 limbs were TASC D lesions. The mean lesion length was (29.1±9.4) cm, including 48 chronic total occlusion (CTO) lesions (71.6%) with mean lesion length of (26.1±10.4) cm. Technique success rate was 98.6%. Mean length of stent graft was (31.3±10.1) cm.Major amputation was performed in 4.2% cases within 5 years. All-cause mortality in 5 years was 23.1%. Primary patency rates at 1,3,and 5 years were 76.8%,59.4%,50.9%, Assisted primary patency rates were 88.4%, 83.4%, 83.4% and secondary patency rates were 88.4%, 85.8%, and 85.8% . F-TLR at 1, 3 and 5 year was 88.2%,76.9%,73.1% .Conclusion:Viabahn for complex and long femoropopliteal artery occlusions is an acceptable treatment with fair long-term outcome.

Objective:To evaluate the mid-term outcome of drug coated balloon (DCB) in the treatment of femoropopliteal artery occlusive disease(FPOD). Methods Clinical date of FPOD patients receiving DCB treatment at Renji Hospital from Dec 2016 to Dec 2020 were retrospectively analyzed . The primary patency, primary assisted patency, secondary patency, free from clinically-driven target lesion revascularization (F-TLR) and the safety outcomes such as perioperative adverse events, major amputation rate and all-cause mortality were calculated. Results:One hurdred and seventy two patients (191 lower limbs) received DCB treatment. Among them, 13 lesions were TASC A (6.8%), 38 lesions were TASC B (19.9%), 98 lesions were TASC C (51.3%), and 42 lesions were TASC D (22.0%). One hundred and twenty six lesions were de novo lesions (66.0%), 33 lesions were in-stent restenosis (17.3%, ISR), and 32 lesions were both de novo lesions and ISR (16.8%). The average length of lesions was (27.8±10.4) mm. Fourty-eight lesions were mildly calcified (25.1%), 20 lesions were moderately calcified (10.5%), and 25 lesions were severely calcified (13.1%). Among de novo lesions, 97 lesions were chronic total occlusion (CTO) lesions (61.4%), and the average length of CTO lesions was (17.2±12.4) cm. The technical success rate was 97.4%.The provisonal stent rate was 22.0%. 12 month and 24 month after operation, the primary patency rate was 68.4% and 55.9%, the primary assisted patency rate was 78.8% and 69.8%, the secondary patency rate was 95.8% and 91.5%, and the F-TLR rate was 85.3% and 81.9%. The de novo lesion subgroup had a 24-month postoperative primary patency rate of 62.7%, while the in-stent restenosis subgroup had a rate of 44.9%.All cause mortality was 13.4% and major amputation rate was 4.7%. Chronic limb-threatening ischemia ( P=0.046) and CTO lesions length ≥15 cm ( P=0.006) were independent risk factors affecting the primary patency rate. Conclusion:DCB is a safe and effective endovascular intervention therapy for the treatment of femoropopliteal artery disease.