3D printing technology has great advantages in small batch and personalized customization, so it has attracted much attention in the biomedical field. The consumables available for 3D printing include polymer, metal, ceramic and derived materials. Biomedical ceramics, with high melting point and poor toughness, are the most difficult materials to be used in 3D printing. The progress of 3D printing ceramic preparation process using ceramic powder, ceramic slurry, ceramic wire, ceramic film and other different raw materials as consumables are reviewed, and the surface roughness, size, density and other parameters of ceramics prepared by SLS, 3DP, DIW, IJP, SL, DLP, FDM, LOM and other different processes are compared. The study also summarizes the clinical application status of 3D printed bioceramics in the field of hard tissue repair such as bone tissue engineering scaffolds and dental prostheses. The SL ceramic additive manufacturing technology based on the principle of UV polymerization has better manufacturing precision, forming quality and the ability to prepare large-size parts, and can also endow bioceramics with better biological properties, mechanical properties, antibacterial, tumor treatment and other functions by doping trace nutrients and surface functional modification. Compared with the traditional subtractive manufacturing process, the bioceramics prepared by 3D printing not only have good mechanical properties, but also often have better biocompatibility and osteoconductivity.
Bone and Bones ; Ceramics ; Printing, Three-Dimensional ; Tissue Engineering ; Tissue Scaffolds

Objective:To analyze the pathogen of 3 pediatric cases of scrub typhus without the eschar using metagenomics next-generation sequencing (mNGS), and the clinical application value of mNGS.Methods:Clinical data of 3 pediatric cases of severe scrub typhus without the eschar in the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from June 2018 to October 2019 were analyzed retrospectively.Among them, 2 cases were 5-year-old males and 1 case was 6-year-old female.Peripheral blood samples of 3 children were detected via mNGS technology.Results:Through mNGS detection, all 3 children were diagnosed with Orientia tsutsugamushi infection and were not complicated with other pathogenic infections.Case 1 died, and case 2 and case 3 were cured.Conclusions:Early diagnosis of scrub typhus without the eschar is difficult.Clinical infectious diseases, especially complicated and critical infectious diseases are difficult to be diagnosed at an early stage, mNGS can provide fast and accurate pathogenic diagnosis support for precise treatment.

Objective:To explore the application value of bacterial culture and antibody detection of pertussis in children.Methods:A total of 262 children diagnosed with pertussis at the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from January 2018 to January 2020 were collected as the research objects.Bacterial culture and serum antibody test for pertussis were performed in all cases.According to the gender, age, course of the disease, and whether the children were vaccinated with pertussis vaccine, the patients were divided into different groups and we compared the detection results of different groups.Results:The high incidence age of pertussis was less than 1 year old, mainly less than 6 months old(62.2%). The positive rate of bacterial culture was 82.4%, and the highest positive rate was found in the group of ≤6 months old (94.5%). The positive rate of bacterial culture decreased with the increase of age and course of disease, and the positive rate of children without pertussis vaccination was higher than children with pertussis vaccination( P<0.001). The positive rate of pertussis antibody test was 23.3%.The positive rate of antibody test increased with the increase of age and course of disease and the positive rate of children without pertussis vaccination was lower than children with pertussis vaccination( P<0.001). Conclusion:The high incidence age of pertussis is mainly less than 6 months old.Bacterial culture of pertussis has a good diagnostic value in the early stage of the course, and enzyme linked immunosorbent assay is more helpful in the late stage of the disease.

Objective To explore the value of controlled decompression under intracranial pressure monitoring in craniotomy of patients with severe cerebral hemorrhage.Methods One hundred and six patients with severe cerebral hemorrhage,admitted to our hospital from January 2015 to July 2018,were prospectively enrolled.These patients were divided into control group (n=5 l) and treatment group (n=55) according to their families' wishes.The patients in the control group were treated with traditional craniotomy and hematoma removal;the patients in the treatment group were treated with controlled decompression combined with craniotomy and hematoma clearance under intracranial pressure monitoring,and intracranial pressure monitoring and management were carried out after operation.The rate of bone flap acceptance during operation,incidences of complications such as re-bleeding,scalp exudation,intracranial infection and cerebral infarction after operation,rate of re-operation and Glasgow outcome scale scores 6 months after injury were compared and analyzed between the two groups.Results Five patients had midway withdrawal (2 from the control group and 3 from the treatment group),and 101 patients (49 from the control group and 52 from the treatment group) were included in the statistical analysis.The rate of bone flap acceptance in the treatment group (69.2％) was significantly higher than that in the control group (24.5％,P＜0.05).The incidences of complications such as bleeding,scalp exudation,intracranial infection and cerebral infarction (11.5％,7.7％,3.8％,and 13.5％) were significantly lower than those in the control group (30.6％,22.4％,16.3％,and 34.7％,P＜0.05).The re-operation rate (3.8％) was significantly lower than that in the control group (16.3％,P＜0.05).Good recovery rate in the treatment group (76.9％) was significantly higher than that in the control group (55.1％,P＜0.05).The mortality rate (7.7％) was significantly lower than that of the control group (22.4％,P＜0.05).Conclusion For patients with severe cerebral hemorrhage,controlled decompression under intracranial pressure monitoring combined with craniotomy and hematoma removal can significantly improve the rate of bone flap acceptance,reduce the rate of second-stage cranioplasty,reduce the incidence of complications and re-operation rate,and more effectively improve the quality of life and prognosis of patients.

Objective To explore the value of pulse index continuous cardiac output (PICCO) combined with intracranial pressure monitoring in patients with severe craniocerebral injury.Methods One hundred and thirty-eight patients with severe craniocerebral injury accepted controlling decompression surgical treatment in our hospital from February 2015 to February 2019 were prospectively chosen.According to patients' families will,postoperative application of PICCO combined with intracranial pressure monitoring for fluid management was performed in 72 patients (treatment group) and application of central venous pressure combined with intracranial pressure monitoring for fluid management was performed in 66 patients (control group).All patients were adjusted according to the monitoring results.The intracranial pressure and cerebral perfusion pressure one week after surgery,incidences of new traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection,scalp exudation,and intracranial infection,average hospitalization days,total hospitalization costs,intensity of antimicrobial use,and Glasgow coma scale scores two weeks after operation were compared and analyzed between the two groups.Glasgow outcome scale was used to evaluate the prognoses of the patients 6 months after injury.Results There were 7 patients (3 from the control group and 4 from the treatment group) dropped out of the study due to various reasons and 131 patients (63 from the control group and 68 from the treatment group) included in the final statistical analysis;there was no significant difference in drop-out rate of the two groups (P＞0.05).The intracranial pressure in the treatment group ([14.28±2.98] mmHg) was significantly lower than that in the control group ([18.99±2.78] mmHg) and cerebral perfision pressure ([66.72±2.25] mmHg) was significantly higher than that in the control group ([52.96±3.12] mmHg) one week after operation (P＜0.05).During hospitalization,the incidences of new traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection,scalp exudation and intracranial infection in the treatment group (8.8％,13.2％,11.8％,7.4％,and 2.9％) were significantly lower than those in the control group (22.2％,27.0％,25.4％,19.0％,and 12.7％,P＜0.05).The average hospitalization days,total hospitalization expenses and intensity of antimicrobial use in the treatment group were significantly shorter/lower than those in the control group (P＜0.05).Glasgow coma scale scores (11.88±1.78) and good recovery rate (76.5％) in the treatment group were significantly higher than those in the control group (8.06±1.12,54.0％) two weeks after operation (P＜0.05).Good recovery rate (76.5％) in the treatment group was significantly higher than that in the control group (54.0％,P＜0.05).The mortality rate (5.9％) was significantly lower than that in the control group (17.5％,P＜0.05).Conclusion PICCO combined with intracranial pressure monitoring can effectively improve intracranial pressure,optimize cerebral perfusion,reduce complications such as traumatic cerebral infarction,neurogenic pulmonary edema,pulmonary infection and intracranial infection in patients with severe craniocerebral injury,thereby improving prognosis and reducing mortality;besides that,it can reduce patients' exposure to anti-brain infection,and the breadth and intensity of bacterial drugs can reduce the length of hospitalization and total cost of hospitalization,thereby reducing the burden of family and society.

[ ABSTRACT] AIM: To study the effect of adenosine A 2A receptor antagonist SCH58261 on hypoxic-ischemic brain damage ( HIBD) in a mature fetal rabbit model .METHODS:Pregnant New Zealand white rabbits at gestational day 29 were selected and were randomly divided into sham-operated group, hypoxic-ischemic group, SCH58261 0.04 mg/kg group, SCH58261 0.12 mg/kg group and DMSO group.The intrauterine rabbit HIBD model was established .All pregnant rabbits were subjected to cesarean section 24 h after the sham operation or experimental procedure to induce hypoxic-ische-mic injury in the fetus .The survival neonatal rabbits were kept in a neonatal incubator at 35℃.The general conditions of the newborn rabbits were recorded .The degree of neurobehavioral damage in the newborn rabbits was estimated by a neu -robehavioral scoring protocol .The concentration of SCH 58261 in the serum of pregnant rabbits , the serum of neonatal rab-bits and the brain tissues of neonatal rabbits was measured by mass spectrometry .The mRNA expression of Bcl-2/Bax and protein levels of p-P38 mitogen-activated protein kinase (MAPK) in the cortex, hippocampus and striatum area in the brain of the neonatal rabbits were determined by real-time PCR and Western blot .RESULTS:SCH58261 was detected in the se-rum and brain tissues of the newborn rabbits .The SCH58261 concentration was approximately 40 μg/L in the brain tissue of the newborn rabbits .The mRNA expression of Bcl-2 in the cortex , hippocampus and striatum of brain tissues in SCH58261 0.04 mg/kg group and SCH58261 0.12 mg/kg group was higher , and the mRNA expression of Bax was lower than those in HI group (P<0.05).The protein level of p-P38 MAPK in the cortex, hippocampus and striatum of brain tis-sues was reduced in SCH58261 0.04 mg/kg group and SCH58261 0.12 mg/kg group compared with HI group (P<0.05). The protein level of p-P38 MAPK in SCH58261 0.12 mg/kg group was a little lower than that in SCH 58261 0.04 mg/kg group (P<0.05).CONCLUSION: Adenosine A2A receptor antagonist SCH58261 attenuates hypoxia-ischemia induced neonatal brain injury by blocking adenosine A 2A receptor, subsequently inhibiting p-P38 MAPK phosphorylation to reduce neuronal apoptosis .

Lactoferrin (Lf) is one of the food protein belonged to the innate immune system. Apart from its main biological function of binding and transport of iron ions, lactoferrin also has many other functions and properties such as antibacterial, antiviral, antiparasitic, catalytic, anti-cancer, anti-allergic and radioprotecting. Lf is usually used as additives of food and cosmetics. The research of lactoferrin has been increasingly reported, and the application of lactoferrin as a drug carrier has drawn extensive attention over the recent year. In this paper, researches of lactoferrin as drug carriers are classified and summarized in brain targeting, liver tumor targeting, lung tumor targeting and oral delivery systems according to their different characteristics.

Objective To evaluate the effectiveness of occlusive wrapping with plastic film in the delivery room to prevent heat loss and reduce the occurrence of hypothermia on admission to the Neonatal Intensive Care Unit (NICU) in very low birth weight infants.Methods A total of 209 very low birth weight infants (birth weight＜1 500 g and gestational age＜33 weeks),born in the Second Hospital of Wenzhou Medical University (Yuying Children's Hospital) and admitted to the NICU immediately after birth from June 1,2009 to December 1,2010,were randomized to the wrap group or non-wrap group.Infants randomized to the wrap group were dried and then wrapped with polyethylene film up to their necks immediately after delivery.They were then covered with warmed blankets and transported to the NICU by the neonatal team.The non-wrap group received routine care in the delivery room following the guidelines of the Neonatal Resuscitation Program.The t test and Chi-square test were used for statistical analysis.Results The mean rectal temperature on admission to the NICU was significantly higher in infants of wrap group compared with those of non-wrap group [(36.1 ± 0.8) ℃ vs (35.5 ± 1.0) ℃,t=4.707,P＜0.01],and the incidence of hypothermia was 41.0％ (43/105) in the wrap group which was lower than that in the non-wrap group (66.3％,69/104) (x2=13.547,P＜0.01).In infants ＜29 weeks of gestation,the mean rectal temperature on admission to the NICU was higher in the wrap group than in the non-wrap group [(36.1 ± 0.8) ℃ vs (35.4 ± 1.1) ℃,t=3.051,P＜0.01].In infants ≥ 29 weeks of gestation,the mean rectal temperature on admission to the NICU was higher in the wrap group than in the non wrap group [(36.0±0.9) ℃ vs (35.5±0.9) ℃,t=3.698,P＜0.01].The arterial blood gas base excess in the wrap group and non-wrap group was-(2.9±2.7) mmol/L and-(5.0±4.2) mmol/L,respectively (t=4.473,P＜0.01).The rate of endotracheal intubation was 20.0％ (21/105) in the wrap group and 27.9％ (29/104) in the non-wrap group,(x2=1.785,P=0.182).The duration of hospitalization was (49.2± 10.7) d in the wrap group and (45.8±9.1) d in the non-wrap group,and the difference was not statistically significant (t=1.152,P=0.251).Conclusions Wrapping very low birth weight infants with plastic film in the delivery room can reduce the occurrence of hypothermia.

Objective To establish an appropriate preterm hypoxic-ischemic brain injury animal model. Methods A total of 32 pregnant New Zealand white rabbits at gestational day 25 were selected. The uterine blood supply in pregnant rabbits was blocked for 30, 35, 37, 40 minutes respectively, while in the control group it was not blocked. Then the pregnant rabbits were subjected to cesarean section 24 hours (at embryonic day 26, A group) or 5 days (at embryonic day 30, B group) after the experimental procedure. The general conditions of the newborn rabbits were recorded. The degree of neurobehavioral impairment in newborn rabbits was evaluated. The histological changes of brain tissue were observed. Results In A group, all newborn rabbits survived with ischemia for 30 minutes, while the stillbirth rates increased from 31.0% to 100% with ischemia from 35 to 40 minutes. In survived nowborn rabbits, the brain water content and the number of apoptotic brain cells were increased with prolonged ischemia. All these differences were statistically significant (all P<0.05). In B group, the stillbirth rates increased to 50.0% and 65.7% respectively with ischemia for 35 or 37 minutes. The birth weight of survived newborn rabbits were significantly lower than that in the control group. The neurobehavioral test scores were significantly lower in ischemic groups than that in the control group. All these differences were statistically significant (all P<0.05). The pathological examination of brain tissue found that the white matter damage in B group was more obvious than that in A group. Conclusions Continuous blockage of uterine blood supply in pregnant rabbits at gestational day 25 causes stillbirth, neurobehavioral damages and white matter injury as well as fetal rabbit intrauterine growth restriction, which can be used for the preparation of preterm hypoxic-ischemic brain injury animal model.

OBJECTIVETo prepare the solid dispersion of tanshinone II A (TS II A) by the combined application of nano-silica and poloxamer 188 (F68), in order to observe its dissolution and stability.

METHODTanshinone II A solid dispersion was prepared by the solvent method with nano-silica and poloxamer 188 as binary vectors. Its physical characteristics, in vitro dissolution and stability were further assessed.

RESULTThe tanshinone II solid dispersion was prepared with the weight ratio of nano-silica and poloxamer 188 of 1: 3. The differential scanning calorimetry (DSC) demonstrated that Tanshinone II A existed in vectors as amorphous state. The in vitro dissolution of tanshinone II A solid dispersion is up to 90% at 60 min. Accelerating experiment showed that content and in vitro dissolution of tanshinone II A solid dispersion did not change after storage over 3 months.

CONCLUSIONSolid dispersion of binary vector of tanshinone II A can obviously improve the dissolution and stability of tanshinone II in practice.