Angiogenesis and osteogenesis have been considered as inseparable and critical processes for bone formation and fracture healing. One promising strategy to improve the capability of angiogenesis and ...osteogenesis on a titanium (Ti) surface involves the fabrication of stable multifunctional release interfaces. This study developed a combined sequential bio-interfacial release system with basic fibroblast growth factor (bFGF) and bone morphogenetic protein 2 (BMP-2) using a polydopamine (PDA) coating on the Ti surface to enhance angiogenesis and osteogenesis. Their surfaces were characterized and their biological properties were evaluated to provide sufficient supporting evidence for successfully fabricating the combined release system. The novel bio-interface demonstrated a significant improvement in surface hydrophilicity; highly effective growth factor adsorption; and moderate, sustained release on the surface of modified Ti substrates. Furthermore, this system surpassingly promoted the initial proliferation, migration and late angiogenic and osteogenic differentiation of HUVECs and MC3T3-E1 in vitro while also augmenting the osseointegration between the implant surface and the surrounding host tissues in vivo. All these results suggest that the fabrication of this novel bio-interface is a practical modification strategy for Ti implants to stimulate angiogenesis and osteogenesis and further optimize its clinical performance.
In order to overcome the biological inertness and lack of bioinductivity, we fabricated a novel combined sequential bio-interfacial release system with bFGF and BMP-2 via polydopamine coating on the Ti surface. This biological surface modification exhibited excellent biochemical properties and dual functions on angiogenesis and osteogenesis, both in vitro and in vivo. Display omitted
•We proposed a novel functional bio-interface, which facilitates the biocompatibility of titanium substrates.•We immobilized bFGF and BMP-2 via PDA, as a sustained release system, which notably improved angiogenesis and osteogenesis.•This bio-interface exhibited excellent multi-functions on initial proliferation, migration and late differentiation in vitro.•The osseointegration between the implant surface and the surrounding host tissues in vivo was also significantly enhanced.
In recent years, owing to the ongoing advancements in polymer materials, hydrogels have found increasing applications in the biomedical domain, notably in the realm of stimuli-responsive "smart" ...hydrogels. Nonetheless, conventional single-network stimuli-responsive "smart" hydrogels frequently exhibit deficiencies, including low mechanical strength, limited biocompatibility, and extended response times. In response, researchers have addressed these challenges by introducing a second network to create stimuli-responsive "smart" Interpenetrating Polymer Network (IPN) hydrogels. The mechanical strength of the material can be significantly improved due to the topological entanglement and physical interactions within the interpenetrating structure. Simultaneously, combining different network structures enhances the biocompatibility and stimulus responsiveness of the gel, endowing it with unique properties such as cell adhesion, conductivity, hemostasis/antioxidation, and color-changing capabilities. This article primarily aims to elucidate the stimulus-inducing factors in stimuli-responsive "smart" IPN hydrogels, the impact of the gels on cell behaviors and their biomedical application range. Additionally, we also offer an in-depth exposition of their categorization, mechanisms, performance characteristics, and related aspects. This review furnishes a comprehensive assessment and outlook for the advancement of stimuli-responsive "smart" IPN hydrogels within the biomedical arena. We believe that, as the biomedical field increasingly demands novel materials featuring improved mechanical properties, robust biocompatibility, and heightened stimulus responsiveness, stimuli-responsive "smart" IPN hydrogels will hold substantial promise for wide-ranging applications in this domain.
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Objectives
To compare the effectiveness and safety between autologous platelet‐rich plasma (PRP) and Local Anesthetic (LA)/corticosteroid in intra‐articular injection for the treatment of lumbar ...facet joint syndrome.
Methods
Forty‐six eligible patients with lumbar facet joint syndrome were randomized into group A (intra‐articular injection with PRP) and group B (intra‐articular injection with LA/corticosteroid). The following contents were evaluated: pain visual analog scale (VAS) at rest and during flexion, and the Roland‐Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for pain relief and applications of post‐treatment drugs. All outcome assessments were performed immediately after and at 1 week, 1, 2, 3, and 6 months after treatment.
Results
No significant difference between groups was observed at baseline. Compared with pretreatment, both group A and group B demonstrated statistical improvements in the pain VAS score at rest or during flexion, the RMQ, and the ODI (P < 0.01). And there were significant differences between the 2 groups on the above‐mentioned items (P < 0.05). For group B, subjective satisfaction based on the modified MacNab criteria and objective success rate were highest (80% and 85%) after 1 month, but only 50% and 20% after 6 months. However, for group A, they increased over time. In addition, there were no treatment‐related complications in either group during follow‐up.
Conclusions
Both autologous PRP and LA/corticosteroid for intra‐articular injection are effective, easy, and safe enough in the treatment of lumbar facet joint syndrome. However, autologous PRP is a superior treatment option for longer duration efficacy.
Irreversible electroporation (IRE) is a method of targeted cell ablation which has been suggested as a potential cancer therapy as it leaves structures such as blood vessels and the extracellular ...matrix intact, thereby allowing the rapid recovery of healthy tissue. Here, we investigated the effects of IRE on the colon in vivo in a porcine model.
IRE ablation was performed on the colon walls of 12 female Tibet mini-pigs, creating a total of 24 lesions. Lesions were monitored periodically by endoscopy. The pigs were euthanized 7, 14, 21 or 28 days after IRE ablation and the colons harvested for gross and histological analysis. Sections were stained with hematoxylin and eosin (H&E), Masson's trichrome (MT) stain and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay.
All pigs tolerated the ablation procedure without serious clinical symptoms or complications. There was no evidence of perforation by endoscopy or gross postmortem examination. All lesions were characterized by necrotic cell death with mild inflammation and hyperemia, with a sharp demarcation between ablated and adjacent normal tissue. A fibrous scar was observed in the ablated colon tissue. Histological analysis revealed damage to each layer of the colon. Histopathology findings also showed the preservation of extracellular structures and the recovery of the ablated colon.
The complete ablation of the target area, its rapid recovery and the lack of posttreatment symptoms suggest that IRE ablation may be a promising therapy for tumors located adjacent to or violating the colon wall.
Introduction
This study aimed to demonstrate the safety and effectiveness of modified percutaneous endoscopic transforaminal discectomy (PETD) in the surgical management of single-segment lumbar disc ...herniation (LDH) gluteal pain and to determine whether it provides a better clinical outcome than open lumbar discectomy (OD).
Methods
A retrospective analysis of patients treated with modified PETD and OD for gluteal pain in LDH from January 2015 to December 2020 was conducted. Sample size was determined using a priori power analysis. Demographic information, surgical outcomes including procedure time (minutes), intraoperative blood loss (mL), hospital days, costs (RMB), fluoroscopy shots, recurrence and complications, etc., were recorded and analyzed. Prognostic outcomes were assessed using the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Japanese Orthopedic Association Score (JOA) and modified MacNab criteria. The preoperative and postoperative VAS, ODI and JOA scores were recorded by two assistants. When the results were inconsistent, the scores were recorded again by the lead professor until all scores were consistently recorded in the data. MRI was used to assess radiological improvement and all patients received follow-ups for at least one year.
Results
The sample size required for the study was calculated by a priori analysis, and a total of 72 participants were required for the study to achieve 95% statistical test power. A total of 93 patients were included, 47 of whom underwent modified PETD, and 46 of whom underwent OD. In the modified PETD intragroup comparison, VAS scores ranged from 7.14 ± 0.89 preoperatively to 2.00 ± 0.58, 2.68 ± 0.70, 2.55 ± 0.69, 2.23 ± 0.81, and 1.85 ± 0.72 at 7 days, 1 month, 3 months, 6 months, and 12 months postoperatively. Patients showed significant pain relief postoperatively (
P
< 0.01). According to the modified MacNab score, the excellent rate in the PETD group was 89.36%. There was no significant difference compared to the OD group (89.13%,
P
> 0.05). Complication rates were lower (
P
> 0.05) but recurrence rates were higher (
P
> 0.05) in the modified PETD group than in the OD group. The modified PETD group had a faster operative time (
P
< 0.01), shorter hospital stay (
P
< 0.01), less intraoperative bleeding (
P
< 0.01), and less financial burden to the patient (
P
< 0.01) than the OD group. At 7 days postoperatively, the VAS score for low back pain was higher in the OD group than in the modified PETD group (
P
< 0.01). The VAS and JOA scores at 1, 3, 6, and 12 months postoperatively were not significantly different between the modified PETD and OD groups (
P
> 0.05), and the ODI was significantly different at 3 months postoperatively (
P
< 0.05).
Conclusion
Modified PETD treatment is safe and effective for gluteal pain due to L4/5 disc herniation and has the advantages of a lower complication rate, faster postoperative recovery, shorter length of stay, fewer anesthesia risks and lower cost of the procedure compared with OD. However, modified PETD has a higher recurrence rate.
Minimally invasive surgeries, including posterior endoscopic cervical foraminotomy (PECF), microsurgical anterior cervical foraminotomy (MACF), anterior transdiscal approach of endoscopic cervical ...discectomy (ATd-ECD), and anterior transcorporeal approach of endoscopic cervical discectomy (ATc-ECD), have obtained positive results for cervical spondylotic radiculopathy. Nonetheless, there is a lack of comparison among them regarding their biomechanical performance. The purpose of this study is to investigate the biomechanical changes of operated and adjacent segments after minimally invasive surgeries compared to a normal cervical spine. A three-dimensional model of normal cervical vertebrae C3-C7 was established using finite element analysis. Afterwards, four surgical models (PECF, MACF, ATd-ECD, and ATc-ECD) were constructed on the basis of the normal model. Identical load conditions were applied to simulate flexion, extension, lateral bending, and axial rotation of the cervical spine. We calculated the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus pressure (AFP), uncovertebral joints contact pressure (CPRESS), and facet joints CPRESS under different motions. For all circumstances, ATc-ECD was close to the normal cervical spine model, whereas ATd-ECD significantly increased ROM and joints CPRESS and decreased IDP in the operated segment. PECF increased more the operated segment ROM than did the MACF, but the MACF obtained maximum IDP and AFP. Except for ATc-ECD, the other models increased joints CPRESS of the operated segment. For adjacent segments, ROM, IDP, and joints CPRESS showed a downward trend in all models. All models showed good biomechanical stability. With their combination biomechanics, safety, and conditions of application, PECF and ATc-ECD could be appropriate choices for cervical spondylotic radiculopathy.
Platelet‐rich plasma (PRP), due to its promising therapeutic properties, has been used in regenerative medicine for more than 30 years and numerous encouraging outcomes have been obtained. Currently, ...by benefiting from new insights into PRP mechanisms and the excellent performance of extracellular vesicles (EVs) in the field of tissue repair and regeneration, studies have found that a large number of EVs released from activated platelets also participate in the regulation of tissue repair. A growing number of preclinical studies are exploring the functions of PRP‐derived EVs (PRP‐EVs), especially in tissue regeneration. Here, we summarize the latest progress in PRP‐EVs as a superior alternative cell‐free therapeutic strategy in regenerative medicine, clarify their underlying molecular mechanisms, and discuss the advantages and limitations of the upcoming clinical applications. This review highlights the potential of PRP‐EVs to replace the application of PRP or even become a superior alternative in regenerative medicine.
Platelet‐rich plasma (PRP) has been used in regenerative medicine for more than 30 years and has obtained numerous encouraging outcomes. Previous views suggested that the powerful repair ability of PRP was derived mainly from the abundant secreted growth factors. However, over the past five years, scientists found that, in addition to growth factors, a large number of EVs were also released from activated PRP to participate in the regulation of tissue repair. This review summarizes the latest reported progress of PRP‐EVs as a superior alternative cell‐free therapeutic strategy in regenerative medicine, clarifies their underlying molecular mechanisms and discusses the advantages and limitations of the upcoming clinical applications. Compared to the well‐studied PRP, PRP‐EVs exhibit more significant advantages in regenerative medicine. With the continuous advances in the understanding of the molecular mechanisms of PRP‐EVs and with more convincing clinical evidence, we believe that PRP‐EVs may replace the application of PRP or even become a superior alternative for regenerative medicine in the near future.
Molecules secreted by cells into the internal environment during aging, including those secreted in exosomes, have long been a matter of concern. Those cells that absorb exosomes, also known as ...recipient cells, exhibit certain phenotypic changes because of the regulatory role of functional molecules (including proteins and nucleic acids) released in exosomes. Involvement of noncoding RNAs (ncRNAs) in the regulation of aging has received increasing attention, and long ncRNAs (lncRNAs) have become one of the research hotspots in recent years. LncRNAs carried by exosomes play a role in intercellular communication between adjacent and distant cells. Moreover, exosomal lncRNAs promote the decline of organ functions and the development of age‐related diseases, including atherosclerosis, Type 2 diabetes, osteoporosis, osteoarthritis, rheumatoid arthritis, Parkinson's disease, multiple sclerosis, and cancer. Here, we review the regulatory roles of exosomal lncRNAs in aging and age‐related diseases.
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•The P-Gel coating obviously enhanced cell adhesion, spreading and proliferation.•The immobilization of BMP-2 via P-Gel coating enhanced osteogenic differentiation.•The combination of ...P-Gel and BMP-2 might promote osseointegration for implants.
Polyetheretherketone (PEEK) is a high-performance semicrystalline thermoplastic polymer that is widely used in the orthopedics treatment. However, due to its biological inertness, the surface modification of PEEK using different methods to improve the biocompatibility remains a significant challenge. Herein, we attempted to use the covalently coating of phosphorylated gelatin loaded with bone morphogenetic protein 2 (BMP-2) on hydroxylated micro-porous PEEK films for enhancing the biological activity. Environmental scanning electron microscope (ESEM), fourier transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS) and water contact angle measurements were applied to characterize the surface of modified or untreated PEEK films. The influence on cell adhesion, proliferation and differentiation was evaluated by culturing of mouse pre-osteoblasts (MC3T3-E1) on different modified PEEK substrates in vitro. Surface characterization showed that the modification was successfully performed on PEEK films. The biological results indicated that surface modification of micro-porous PEEK using phosphorylated gelatin significantly promoted cell adhesion and proliferation. And the osteogenic differentiation was effectively improved while loading with different amounts of BMP-2. Findings from this study indicated that this novel biological modification on PEEK films might be helpful for altering its biological inertness and further expand its medical applications as a kind of orthopedic implants.
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