减少手术创伤始终是妇科肿瘤手术快速康复的决定性因素

减少手术创伤始终是快速康复的决定性因素,这一点在目前的加速康复外科研究尤其是复杂手术,如妇科肿瘤手术中尚未得到充分重视。尊重学习曲线、全面规划手术方案、总结失利经验、开展前瞻性研究是解决此问题的主要方案。本文着重讨论妇科肿瘤手术创伤对术后加速康复的影响及可能的改进措施。     

Size controlled synthesis of well-distributed nano-silver on hydroxyapatite using alkanolamine compounds

A well-distributed nano-silver hydroxyapatite composite has been successfully prepared by a one-pot synthesis method. Hydroxyapatite was separately synthesized by a sol-gel method, then impregnated with silver nanoparticles with the mediation of Uncaria gambir Roxb. leaf extract in the presence of three kinds of alkanolamine compound; monoethanolamine (MEA), diethanolamine (DEA), and triethanolamine (TEA) as capping agents. The effect of different capping agents on the properties of the silver nanoparticles and the nano-silver hydroxyapatite composite were studied. UV–visible spectrophotometer analysis exhibited absorbance peaks at 402–439 nm which specifically corresponds to spherical silver nanoparticles. Higher optical absorbance was observed in TEA-capped silver nanoparticles, than in DEA and MEA-capped ones. X-ray diffraction (XRD) analysis showed a highly crystalline hexagonal structure for hydroxyapatite and no detected metallic silver. However, the presence of 1.65% silver was confirmed by energy dispersive x-ray (EDX) spectroscopy analysis. Transmission electron microscopy (TEM) analysis revealed spherical silver nanoparticles with a size range of 2–62 nm (smallest mean diameter of 2 nm) adhered to the hydroxyapatite surface. The TEA capped impregnated silver nanoparticles were the smallest, corresponding to the best capping performance, followed by those capped by DEA and MEA. Small-sized nanoparticles on hydroxyapatite are beneficial for highly antibacterial bone implants.     

Chromophore-Free Sealing and Repair of Soft Tissues Using Mid-Infrared Light-Activated Biosealants

Poor strength, infection, leakage, long procedure times, and inflammation limit the efficacy of common tissue sealing devices in surgeries and trauma. Light-activated sealing is attractive for tissue sealing and repair, and can be facilitated by the generation of local heat following absorption of nonionizing laser energy by chromophores. Here, the inherent ability of biomaterials is exploited to absorb nonionizing, mid-infrared (midIR) light in order to engender rapid photothermal sealing and repair of soft tissue wounds. In this approach, the biomaterial simultaneously acts as a photothermal convertor as well as a biosealant, which dispenses the need for exogeneous light-absorbing nanoparticles or dyes. Biomechanical recovery, mathematical modeling, histopathology analyses, tissue strain mapping using digital imaging correlation, and visualization of the biosealant-tissue interface using hyperspectral imaging indicate superior performance of midIR sealing in live mice compared to conventional sutures and glue. The midIR-biosealant approach demonstrates rapid sealing of soft tissues, improves cosmesis, lowers potential for scarring, obviates safety concerns because of the nonionizing light used, and allows adoption of a wide diversity of biomaterials. Taken together, the studies demonstrate a novel advance both in biomaterials for surgical sealing along with the use of nonionizing midIR light, with high potential for clinical translation.     

Finite element analysis of femoral components paper III – hip joints

Finite element analysis of the hip implant is conducted in this paper for representative femoral cross-section geometries and development of stress in the presence of bone cement is elucidated. Differences in cement stresses generated by varying implant cross-sections were compared with conventional features derived from representative implants. The analysis was performed under idealized implant assemblies by constraining the implant movement in the assembly. The cross-sections and implant geometries used are generic and intended to be representative of available geometries. This paper is a part of student research projects, prepared from a series of activities in biomedical implant research currently underway at Ohio Northern and Arkansas Tech Universities.     

钛合金植入物材料的表面改性研究进展

简介了钛合金植入物材料的开发及表面改性技术。     

A study on microstructure and properties of calcium phosphate coatings processed using ion beam assisted deposition on heated substrates

In this study a set of thin Hydroxyapatite (HA) [Ca₁₀(PO₄)₆(OH)₂] coatings was deposited on heated silicon and titanium substrates using Ion Beam Assisted Deposition (IBAD). The effects of substrate temperature and processing parameters on the microstructural properties and composition of the coatings are being studied. Analytical techniques include transmission electron microscopy (TEM), scanning transmission electron microscopy (STEM) with an energy dispersive X-ray spectroscopy (EDS), as well as scanning electron microscopy (SEM) with EDX, X-ray diffraction (XRD), and Fourier Transform Infrared Spectroscopy (FTIR). The current results indicate that as substrate temperature increases the Ca/P ratio of the coatings both on titanium and silicon substrates increases. The crystallinity of the coatings and the number of calcium phosphate compounds within the coating including HA also increases. STEM-EDS revealed an atomically diffused intermediate layer at the interface between the coating and substrate. XRD results along with TEM selected area diffraction (SAD) revealed that the coatings are composed of HA, other calcium phosphate, and calcium oxide compounds.     

Thick bone section preparation using a silicon-rubber-based sealant

A method has been developed, using a silicon-rubber-based sealant, which allows 2–3-mm-thick specimens to be maintained in a protected fluid environment for a number of months, without risk of dehydration. Following this, the specimen can be retrieved, stained, embedded and sectioned further. For example, 2-mm-thick sections of fixed unstained bone are easily examined by means of epi-illuminated polarized light and fluorescence microscopies using either conventional or confocal optics. The method could easily be extended to other tissues, for example brain tissue.     

The T Cell Repertoires from Nickel Sensitized Joint Implant Failure Patients

Nickel (Ni²⁺) is one of the most common allergens, affecting around 10–15% of the general population. As the demand for orthopedic implant surgery rises, the number of surgical revisions due to joint implant failure also increases. There is evidence that some patients develop joint failure due to an immune response to a component of the implant, and we have found that Ni²⁺ is an especially important cause. Hence, understanding the mechanisms by which Ni²⁺ allergy induces joint implant failure becomes a critical research question. The structural basis of Ni²⁺ activation of pathogenic T cells is still not clear. The purpose of this study was to characterize Ni²⁺-reactive T cell repertoires derived from the peripheral blood of joint failure patients due to Ni²⁺ sensitization using single-cell sequencing techniques. We stimulated the proliferation of Ni²⁺ -reactive T cells from two implant failure patients in vitro, and sorted them for single-cell VDJ sequencing (10× genomics). We identified 2650 productive V-J spanning pairs. Both TCR α chains and β chains were enriched. TRBV18 usage is the highest in the P7 CD4+ population (18.1%), and TRBV5-1 usage is the highest in the P7 CD8+ population (12.1%). TRBV19 and TRBV20-1 segments are present in a high percentage of both P7 and P9 sequenced T cells. Remarkably, the alpha and beta chain combination of TRAV41-TRBV18 accounts for 13.5% of the CD4+ population of P7 patient. Compared to current Ni specific T cell repertoire studies of contact dermatitis, the Vα and Vβ usages of these joint implant failure patients were different. This could be due to the different availability of self-peptides in these two different tissues. However, TRBV19 (Vβ17) was among frequently used TCR β chains, which are common in previous reports. This implies that some pathogenic T cells could be similar in Ni²⁺ hypersensitivities in skin and joints. The alignment of the TCR CDR3β sequences showed a conserved glutamic acid (Glu) that could potentially interact with Ni²⁺. The study of these Ni²⁺ specific TCRs may shed light on the molecular mechanism of T cell activation by low molecular weight chemical haptens.